Kessell Eric R, Catalano Ralph A, Christy Annette, Monahan John
School of Public Health, University of California, Berkeley, 22 Warren Hall, Berkeley, CA 94720, USA.
Psychiatr Serv. 2006 Oct;57(10):1435-9. doi: 10.1176/ps.2006.57.10.1435.
This study tested the hypothesis that contraction of regional economies affects the incidence of involuntary admissions to psychiatric emergency services by reducing community tolerance for persons perceived as threatening to others.
This hypothesis was tested with time-series analyses of the relationship between initial claims for unemployment in Florida between July 4, 1999, and June 28, 2003, and the weekly number of men and women presented by police to be examined for involuntary psychiatric hospitalization because of danger to others. The analyses controlled for admissions presented by mental health professionals because of danger to others and for admissions presented by police because of neglect or disability.
When the analyses controlled for autocorrelation and other covariates, claims for unemployment insurance were significantly associated with the number of men presented by police for danger to others. During the study period, police presented 5,897 men for examination because of danger to others. Increased unemployment claims were associated with approximately 309 more men being presented for examination than expected from prior presentation rates and from the number presented by mental health professionals for danger to others and by police for neglect or disability. No such association was found for women.
Consistent with theory, this study found that presentations for involuntary admission to psychiatric services increased after contractions in the labor market. Combining the methods of this study with econometric forecasting may allow providers to anticipate better the need for psychiatric services.
本研究检验了以下假设，即区域经济收缩会通过降低社区对被视为对他人构成威胁者的容忍度，从而影响精神科急诊服务非自愿入院的发生率。
通过对1999年7月4日至2003年6月28日佛罗里达州失业初始索赔与警方每周提交的因对他人构成危险而接受非自愿精神科住院检查的男性和女性人数之间的关系进行时间序列分析，来检验这一假设。分析控制了心理健康专业人员因对他人构成危险而提交的入院病例，以及警方因疏忽或残疾而提交的入院病例。
在分析控制了自相关和其他协变量后，失业保险索赔与警方提交的因对他人构成危险的男性人数显著相关。在研究期间，警方提交了5897名男性因对他人构成危险而接受检查。失业保险索赔增加与比根据先前提交率以及心理健康专业人员因对他人构成危险和警方因疏忽或残疾而提交的人数预期多出约309名男性接受检查有关。未发现女性存在此类关联。
与理论一致，本研究发现劳动力市场收缩后，精神科服务非自愿入院的情况有所增加。将本研究方法与计量经济学预测相结合，可能使服务提供者能够更好地预测精神科服务的需求。
