Abstract
Background
Mental health disorders among children are highly prevalent worldwide. In most countries, the primary care physician is point of first contact with the medical system for children with these problems. There are few data from developing countries about the ways in which these children present barriers that may hinder appropriate recognition, treatment, or referral. This study sought to explore the range and expression of childhood behavioral disorders encountered by primary care pediatricians in Jordan, as well as barriers to the identification and management of these conditions.
Results
We used qualitative methodology to conduct 8 focus-group interviews with physicians in Jordan. A total of 36 physicians participated. Themes that emerged from the interviews were organized into four categories. The first category described specific behavioral disorders encountered by physicians, autism being the most common and problematic. Second were themes related to system issues impacting the approach to behavioral problems. These included deficiencies in physician training and a lack of mental health services. Third were family-related issues such as parenting practices and family structure that were perceived to contribute to behavioral morbidity. Finally, sociocultural attitudes that included resistance to medicalization, reluctance to discuss behavioral issues, and interpretation of certain childhood behaviors affected help-seeking behavior and acceptance of diagnosis and treatment.
Conclusions
Sociocultural and structural issues strongly influence the presentation and management of behavioral and mental health conditions among pediatric patients in Jordan. These findings have significant implications for the development of approaches to the detection and management of these problems in developing countries. The creation of robust pathways for early detection and intervention among children at risk for mental health can help reduce the burden of mental health morbidity in the region.