Staudt Marlys, Cherry Donna
College of Social Work, University of Tennessee, 202 Henson Hall, Knoxville, TN 37996, USA.
Psychiatr Serv. 2009 Jan;60(1):56-60. doi: 10.1176/ps.2009.60.1.156.
This study examined service delivery to parental caregivers with mental health problems, substance use problems, or both. The study sought to determine whether, once need is identified, suitable services are offered and then provided.
The study was a secondary analysis of the 1994 National Study of Protective, Preventive, and Reunification Services Delivered to Children and Their Families. The national study interviewed child welfare caseworkers about the problems of and services provided to 2,109 families.
Of parents with mental problems, 77.9% were offered services and 84.0% of those were provided services. Of parents with substance use problems, 65.7% were offered treatment and 67.5% of those were provided it. Other problems included lack of parenting skills, lack of education and job skills, parent-child conflict, and lack of income. Significant associations were found between caseworkers' identifying problems and offering relevant services. Caregivers with substance use problems were less likely to be offered substance treatment services than caregivers with both mental health and substance use problems.
The child welfare system may facilitate service use for caregivers. More research is needed to understand the process of service delivery to caregivers, including why services are not offered to some caregivers and why some services are not provided after being offered. Future research should examine why caregivers with substance use problems are vulnerable to not receiving treatment and whether and how service use varies for other problems not examined in this study.
本研究调查了为有心理健康问题、物质使用问题或两者皆有的父母照顾者提供服务的情况。该研究旨在确定一旦确定需求后,是否会提供并进而提供合适的服务。
本研究是对1994年全国儿童及其家庭保护性、预防性和团聚服务研究的二次分析。该全国性研究就2109个家庭的问题及所提供的服务对儿童福利个案工作者进行了访谈。
有心理问题的父母中,77.9%获得了服务,其中84.0%得到了服务提供。有物质使用问题的父母中,65.7%获得了治疗,其中67.5%得到了治疗。其他问题包括缺乏育儿技能、缺乏教育和工作技能、亲子冲突以及缺乏收入。在个案工作者识别问题与提供相关服务之间发现了显著关联。与既有心理健康问题又有物质使用问题的照顾者相比,有物质使用问题的照顾者获得物质治疗服务的可能性较小。
儿童福利系统可能会促进照顾者使用服务。需要更多研究来了解向照顾者提供服务的过程,包括为何有些照顾者未获得服务,以及为何有些服务在提供后未得到落实。未来的研究应探讨为何有物质使用问题的照顾者容易得不到治疗,以及对于本研究未考察的其他问题,服务使用情况是否以及如何有所不同。