Stiffman Arlene Rubin, Freedenthal Stacey, Dore Peter, Ostmann Emily, Osborne Victoria, Silmere Hiie
George Warren Brown School of Social Work, Washington University, St. Louis, MO 63130, USA.
Psychiatr Serv. 2006 Aug;57(8):1185-91. doi: 10.1176/ps.2006.57.8.1185.
American-Indian adolescents have high rates of addiction and mental health problems but low rates of service use. The gap between service need and use appears to be even larger than the known gap for the general population, and few of the services are provided by specialists. This study examined receipt of treatment by American-Indian youths for addictions or mental health problems, the service provider who first identified a problem and sent a youth to treatment, and the extent to which the provider's knowledge and assessment predicted variance in service actions.
A sample of 401 American-Indian youths (196 from an urban area and 205 from a reservation) aged 12 to 19 years was first interviewed in person in 2001. A total of 188 of the youths' treatment providers were then interviewed.
Structural equation modeling showed that 30 percent of the variance in addictions or mental health services provided to youths was predicted by the provider's assessment of the youth's mental health, the provider's resource knowledge, and provider type.
The results demonstrate that professional, informal, and traditional providers play a pivotal role in providing treatment services offered to American-Indian youths and that these providers were more likely to identify a youth's problems and to offer and refer services when the provider knew more about community resources for the youth and about the youth's personal and environmental problems.
美国印第安青少年成瘾和心理健康问题的发生率较高，但接受服务的比例较低。服务需求与使用之间的差距似乎比一般人群中已知的差距更大，而且很少有服务由专科医生提供。本研究调查了美国印第安青少年接受成瘾或心理健康问题治疗的情况、首先识别问题并将青少年送去治疗的服务提供者，以及提供者的知识和评估在多大程度上预测了服务行为的差异。
2001年，对401名年龄在12至19岁之间的美国印第安青少年（196名来自城市地区，205名来自保留地）进行了首次面对面访谈。随后，对其中188名青少年的治疗提供者进行了访谈。
结构方程模型显示，提供者对青少年心理健康的评估、提供者的资源知识和提供者类型可预测向青少年提供的成瘾或心理健康服务中30%的差异。
结果表明，专业、非正式和传统提供者在为美国印第安青少年提供治疗服务方面发挥着关键作用，而且当提供者更了解青少年的社区资源以及青少年的个人和环境问题时，这些提供者更有可能识别青少年的问题并提供和转介服务。
