Geller Jeffrey L, Biebel Kathleen
Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
Psychiatr Q. 2006 Winter;77(4):273-91. doi: 10.1007/s11126-006-9013-z.
Psychiatric disorders are the leading reason for hospitalization among 5-19 year olds. Current data, however, suggest there are fewer than necessary available services for children and adolescents requiring intensive, inpatient psychiatric care. Children and adolescents with behavioral health problems, the majority of whom do not receive appropriate treatment, have increased risk of school failure, family disruption, out-of-home placements, poor employment opportunities, and poverty in adulthood. This paper will examine the challenges inherent in serving children and adolescents with serious emotional disturbances, avenues of financing for treatment and services, and various loci of intervention for high-risk children, including inpatient settings and systems of care. The goals of this paper are to illustrate the complexities of working with children and adolescents most in need of intensive psychiatric services, to explore how inpatient services "fit" into existing treatment approaches, and to discuss the efficacy of downsizing or closing inpatient psychiatric units for this population.
精神疾病是5至19岁青少年住院治疗的主要原因。然而，目前的数据表明，对于需要强化住院精神科护理的儿童和青少年而言，可用服务的数量少于所需数量。有行为健康问题的儿童和青少年，其中大多数未得到适当治疗，在学业失败、家庭破裂、离开家庭安置、就业机会不佳以及成年后贫困方面的风险增加。本文将探讨为患有严重情绪障碍的儿童和青少年提供服务所固有的挑战、治疗和服务的融资途径，以及针对高危儿童的各种干预场所，包括住院环境和护理系统。本文的目标是说明与最需要强化精神科服务的儿童和青少年打交道的复杂性；探讨住院服务如何“融入”现有的治疗方法；并讨论缩减或关闭针对该人群的住院精神科病房的效果。
