Harpaz-Rotem Ilan, Leslie Douglas, Rosenheck Robert A
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06519, USA.
Psychiatr Serv. 2004 Sep;55(9):1022-8. doi: 10.1176/appi.ps.55.9.1022.
This study examined use of mental health services among children and adolescents with private insurance who were entering treatment. Variations in service use were examined by age, gender, diagnosis, recent psychiatric hospitalization, and type of insurance. Differences between children who received treatment from mental health professionals and those who were treated by primary care physicians were also examined.
Drawn from a large database, the sample comprised 11,659 new users of mental health services. Service use was defined as the total number of days children were retained in treatment and the total number of mental health contacts recorded.
The overall mean number of visits within a six-month period was 3.9. The average duration of treatment was 75.36 days. Children who were treated by a mental health specialist were less likely to drop out of treatment and had a larger number of visits. Severity of illness, psychiatric hospitalization, and managed care insurance coverage were also associated with lower risk of dropout and greater intensity of care.
Children's access to services does not guarantee sustained involvement in treatment. To more fully address the nature of service use among children, a closer look at specific barriers to continued involvement in services is needed.
本研究调查了参加治疗的有私人保险的儿童和青少年使用心理健康服务的情况。按年龄、性别、诊断、近期精神科住院情况和保险类型对服务使用的差异进行了研究。还对接受心理健康专业人员治疗的儿童与接受初级保健医生治疗的儿童之间的差异进行了研究。
样本取自一个大型数据库，包括11659名心理健康服务的新用户。服务使用定义为儿童接受治疗的总天数以及记录的心理健康接触的总数。
六个月内的总体平均就诊次数为3.9次。平均治疗时长为75.36天。接受心理健康专家治疗的儿童退出治疗的可能性较小，就诊次数较多。疾病严重程度、精神科住院情况和管理式医疗保险覆盖范围也与较低的退出风险和更高的护理强度相关。
儿童获得服务并不保证其持续参与治疗。为了更全面地了解儿童服务使用的本质，需要更深入地研究持续参与服务的具体障碍。
