Disparities in Psychiatric Background and Service Utilization: A Comparative Study of Rural and Urban Health Board Applicants in Child and Adolescent Psychiatry
Öz
Background: Regional disparities between rural and urban environments significantly impact access to pediatric mental health services. While environmental factors influence childhood psychological well-being, the gap in service utilization and clinical characteristics between these two settings remains under-researched.
Methods: This study compared clinical and demographic profiles of pediatric patients across rural and urban sites (n = 203). Statistical analyses, including Chi-square and t-tests, were utilized to identify significant differences in psychiatric history, medication use, and diagnostic distributions.
Results: Analysis revealed no significant differences in sex distribution (p=.218) or mean age between rural (M=106.40 months) and urban (M=113.98 months) groups (p =.292). However, profound disparities were observed in healthcare utilization: urban patients were significantly more likely to have had prior psychiatric consultations (87.5% vs. 16.8%, p<.001) and were prescribed psychiatric medications at a substantially higher rate (50.0% vs. 12.1%, p<.001). Furthermore, significant differences emerged in presenting complaints (p<.001), clinical diagnoses (p<.001), and special needs (p<.001).
Conclusion: The findings underscore a critical gap in psychiatric care accessibility, with rural populations showing markedly lower rates of prior consultation and pharmacological intervention. These results suggest that rural patients may only access specialized care at later or more acute stages of illness. To achieve health equity, it is essential to incentivize rural medical assignments, modernize infrastructure, and integrate mental health literacy into school curricula and primary care training.
Anahtar Kelimeler
Child psychiatry, rural-urban disparity, healthcare access, clinical demographics, mental health equity.
Destekleyen Kurum
This research did not receive any specific grant from funding agencies.
Etik Beyan
This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Gazi University. (23.10.2025,E-77082166-604.01-1365903)
Teşekkür
None
Kaynakça
- Biscontini T. Psychological development. Salem Press Encyclopedia: Salem Press; 2024.
- Erikson EH. Childhood and society: Norton New York; 1963.
- Ghandour RM, Sherman LJ, Vladutiu CJ, Ali MM, Lynch SE, Bitsko RH, et al. Prevalence and treatment of depression, anxiety, and conduct problems in US children. J Pediatr. 2019;206:256-67. e3.
- Yıldız D, Tarakçıoğlu MC. Çocuklar için özel gereksinim raporu (ÇÖZGER) almak için başvuran hastaların klinik özellikleri, eş tanılarının incelenmesi, yeni değişen ÇÖZGER yönetmeliğine göre aldıkları tanı ve özür oranlarının eski tanı ve özür oranları ile karşılaştırılması. İstanbul Kanuni Sultan Süleyman Tıp Dergisi 12.2 (2020): 144-150.
- Demirci K, Akpinar A, Unal GO, Yaman AR, Demirdas A, Atay IM, et al. Investigation of psychiatric pathologies in subjects who apply to the health board. Psychiat Clin Psych, 2015, 25, S137.
- Achenbach TM, Ivanova MY, Rescorla LA, Turner LV, Althoff RR. Internalizing/externalizing problems: Review and recommendations for clinical and research applications. J Am Acad Child Psy. 2016;55(8):647-56.
- Schlack R, Peerenboom N, Neuperdt L, Junker S, Beyer AK. The effects of mental health problems in childhood and adolescence in young adults: Results of the KiGGS cohort. J Health Monit. 2021;6(4):3-19. Epub 20211208. doi: 10.25646/8863. PubMed PMID: 35146318;
- Gamm L, Stone S, Pittman S. Mental health and mental disorders—A rural challenge: A literature review. Rural healthy people. 2010;2(1):97-114.
- Merikangas KR, He JP, Brody D, Fisher PW, Bourdon K, Koretz DS. (2010). Prevalence and treatment of mental disorders among US children. Pediatrics, 125(1), 75–81.
- Holzer CE, Goldsmith HF, Ciarlo JA. Effects of rural-urban county type on the availability of health and mental health care providers. Mental Health, United States,1998. Washington, DC: U.S. Department of Health and Human Services; 1998. p. 204-13.