Mental Health care for children -Geographical Disparities in Treatment in Norway

Regional disparities in mental health care highlight the need for better coordination between primary and specialized services to ensure equitable access and improve early intervention for children.

Introduction: Mental health disorders among children and adolescents constitute an escalating public health concern. The mental health care atlas for children and adolescents examines specialized and primary mental health services across Norway, analyzing geographical disparities, treatment intensity, and the impact of the COVID-19 pandemic on service provision. Methods: This study utilizes data from the Norwegian Patient Register (NPR), the Municipal Patient and User Register (KPR), and demographic statistics from Statistics Norway (SSB). Patient rates and health care service activities were analyzed across hospital referral areas from 2019-2023. Measures of variation, including the coefficient of variation (CV) and the systematic component of variation (SCV), were employed to assess differences in treatment practices. Patient rates per 1000 population were calculated for each referral area and adjusted for sex and age distribution to ensure comparability. Results: Annually, approximately 68,000 children and adolescents receive outpatient mental health treatment, accounting for a total of 792,000 consultation days. There are significant regional differences in consultation days per patient, with Oslo University Hospital (OUS) reporting a higher number per patient compared to Førde referral area. Over the past five years, the most significant increases in treatment have been observed for attention-deficit/hyperactivity disorder (ADHD) and autism. Sex differences are significant, with boys predominantly diagnosed with ADHD and autism in the 6–12 age group, while girls represent the majority of cases for anxiety and depression in the 13–17 age group. Although the total number of treated children shows minor geographical variation, substantial disparities exist in the treatment of specific conditions, particularly depression. Comorbidity is prevalent, particularly between ADHD and specific developmental disorders, potentially contributing to differences in treatment needs and clinical practices. Conclusion: The findings of this study highlight significant regional disparities in treatment intensity and access to mental health services, emphasizing the necessity for enhanced coordination between primary and specialized healthcare services. These insights can inform healthcare policy and planning to ensure more equitable access to mental health services, irrespective of place of living.