Child and adolescent mental health: analysis of therapeutic itineraries in an inner municipality without Child and Adolescent Psychosocial Care Centers

Research on therapeutic itineraries in child and adolescent mental health has been predominantly carried out in Child and Adolescent Psychosocial Care Centers or in regions that have these services. To expand the understanding of this field, this study analyzed the therapeutic itineraries of children and adolescents assisted by the Multiprofessional Mental Health Team service - locally known as "Mental Health" - in an inner municipality without Child and Adolescent Psychosocial Care Centers. Semi structured interviews were conducted with 12 mothers and two fathers to understand their motivations for seeking care, the places they visited, and the experiences they had in this process. The data were analyzed by descending hierarchical classification, made possible by IRaMuTeQ. In total, four categories were formed: (1) initial detection of needs, (2) motivations for seeking care, (3) service dynamics, and (4) factors that affect continuity of care. Schools prevailed as the drivers of the search for care, whereas basic health units acted more as referral points for specialists. Psychologists and psychiatrists from the Multiprofessional Mental Health Team, speech therapists from the Polyclinic, and neurologists from the private network and the Regional Center of Specialties were the specialties that received the most visits. Participants deemed the high turnover of professionals as the main barrier to access and continuity of care. Unlike other studies - which have been developed in contexts with more comprehensive service networks -, which often suggest strengthening the existing child and adolescent mental health networks, this study highlights the need to build such networks from the ground up.