<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2504-3145</journal-id>
<journal-title><![CDATA[Portuguese Journal of Public Health]]></journal-title>
<abbrev-journal-title><![CDATA[Port J Public Health]]></abbrev-journal-title>
<issn>2504-3145</issn>
<publisher>
<publisher-name><![CDATA[Escola Nacional de Saúde Pública]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2504-31452024000300221</article-id>
<article-id pub-id-type="doi">10.1159/000540772</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Improving Access to Mental Health Care through a Stepped Care Approach: Preliminary Results from a University Students&#8217; Sample]]></article-title>
<article-title xml:lang="pt"><![CDATA[Melhorar o acesso aos cuidados de saúde mental através do modelo &#8216;Stepped care&#8217;: resultados preliminares de uma amostra de estudantes universitários]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Marques]]></surname>
<given-names><![CDATA[Marisa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Caetano]]></surname>
<given-names><![CDATA[Sofia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Xavier]]></surname>
<given-names><![CDATA[Sandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Melo]]></surname>
<given-names><![CDATA[Ana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[Andreia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martins]]></surname>
<given-names><![CDATA[Joana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lavaredas]]></surname>
<given-names><![CDATA[Célia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[Bruno]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Morais]]></surname>
<given-names><![CDATA[Sofia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Moura]]></surname>
<given-names><![CDATA[Diana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Madeira]]></surname>
<given-names><![CDATA[Nuno]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Queirós]]></surname>
<given-names><![CDATA[António]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martins]]></surname>
<given-names><![CDATA[Maria João]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,University of Coimbra  ]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Centro Clínico da Guarda Nacional Republicana  ]]></institution>
<addr-line><![CDATA[Lisbon ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Centro Hospitalar e Universitário de Coimbra  ]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2024</year>
</pub-date>
<volume>42</volume>
<numero>3</numero>
<fpage>221</fpage>
<lpage>230</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2504-31452024000300221&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2504-31452024000300221&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2504-31452024000300221&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Recently, university counseling services have been faced with an increasing number of students seeking psychological support. However, human resources and time constraints limit the services to respond adequately. Recently, national guidelines for Mental Health Services in Higher Education recommended the stepped care approach to increase efficiency. The present study aimed to explore the implementation of a stepped care model in a Portuguese public university, analyzing students&#8217; sociodemographic and clinical characteristics, and presenting the flow of the stepped care approach and the students&#8217; waiting periods in each step.  Methods:  An observational study was conducted in the University of Coimbra&#8217;s health services between May 2019 and June 2021. Descriptive statistics were performed to describe the sociodemographic and clinical characteristics of the sample, the flow of the stepped care approach, and students&#8217; waiting periods.  Results:  We enrolled 295 students in the present study. The findings of this study revealed that over 40% had a clinical diagnosis of anxiety or depressive disorders. In terms of students&#8217; flow within the stepped care model, 82% of students sought psychological help through self-referral. Concerning the implementation of the stepped care model, results have shown that most students wait less than a month to access each step.  Discussion/Conclusions:  Although preliminary, our results suggest that the stepped care model might be a useful service organization, mainly in a community in which accessibility to services and speed of response are particularly important. Most students being self-referred highlight the importance of direct contact between the university community and the health services. Additionally, anxiety and mood disorders were the most prevalent diagnoses in our sample, which also points to the relevance of a stepped care approach, since other studies have highlighted its advantages for this kind of clinical population.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  Os Serviços de Saúde no contexto do Ensino Superior têm-se deparado recentemente com um número crescente de estudantes que procuram apoio psicológico. Contudo, a insuficiência de recursos humanos e as limitações de tempo influenciam negativamente a resposta adequada dos serviços. Recentemente, as diretrizes nacionais para os serviços de saúde mental no ensino superior recomendaram a abordagem &#8220;Stepped care&#8221; para aumentar a eficiência das respostas. O presente estudo teve como objetivo explorar a implementação de um modelo &#8220;Stepped care&#8221; numa instituição do ensino superior pública portuguesa, analisando as características sociodemográficas e clínicas dos estudantes, o seu fluxo pelas várias respostas do &#8220;Stepped care&#8221; e os tempos de espera em cada patamar.  Métodos:  Foi realizado um estudo observacional nos serviços de saúde da Universidade de Coimbra entre maio de 2019 e junho de 2021. Foi utilizada estatística descritiva com o objetivo de descrever as características sociodemográficas e clínicas da amostra, o fluxo dos estudantes pelas várias respostas do &#8220;Stepped care&#8221; e os tempos de espera.  Resultados:  ados: Foram incluídos 295 estudantes neste estudo. Os resultados indicam que mais de 40% dos pacientes tinham diagnóstico clínico de ansiedade ou perturbações depressivas. Quanto ao fluxo dos estudantes pelas várias respostas do &#8220;Stepped care&#8221;, 82% procuraram ajuda psicológica por iniciativa própria. No que diz respeito à implementação do modelo &#8220;Stepped care&#8221;, os resultados mostraram que a maioria dos estudantes esperou menos de um mês para aceder a cada patamar.  Discussão/Conclusões:  Os nossos resultados, ainda que preliminares, sugerem que o modelo &#8220;Stepped care&#8221; pode ser uma abordagem útil na organização de serviços, principalmente numa comunidade em que a acessibilidade aos serviços e a brevidade de resposta são particularmente importantes. A maioria dos estudantes procurou ajuda psicológica por iniciativa própria, o que realça a importância do contato direto entre a comunidade e os serviços de saúde. A elevada prevalência de diagnósticos de perturbações de ansiedade e de humor na nossa amostra, é outro fator que reforça a relevância da abordagem &#8220;Stepped care&#8221; neste contexto, tendo em conta que estudos anteriores demonstraram as vantagens do modelo em populações clínicas com estes diagnósticos.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Accessibility]]></kwd>
<kwd lng="en"><![CDATA[Stepped care]]></kwd>
<kwd lng="en"><![CDATA[Mental health care]]></kwd>
<kwd lng="en"><![CDATA[University students]]></kwd>
<kwd lng="en"><![CDATA[Prevention]]></kwd>
<kwd lng="en"><![CDATA[Psychological therapies]]></kwd>
<kwd lng="pt"><![CDATA[Acessibilidade]]></kwd>
<kwd lng="pt"><![CDATA[Stepped care]]></kwd>
<kwd lng="pt"><![CDATA[Cuidados de saúde mental]]></kwd>
<kwd lng="pt"><![CDATA[Estudantes universitários]]></kwd>
<kwd lng="pt"><![CDATA[Prevenção]]></kwd>
<kwd lng="pt"><![CDATA[Terapias psicológicas]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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