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青少年心理健康护理:使用的预测因素并不总是与使用量的预测因素相同。

Mental Health Care for Youth: Predictors of Use are not always the same as Predictors of Volume.

作者信息

Alexandre Pierre K

机构信息

Department on Mental Health, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD 21205, USA.

出版信息

Soc Sci J. 2008 Dec;45(4):619-632. doi: 10.1016/j.soscij.2008.09.004.

Abstract

This study identifies determinants of adolescents' propensity to use outpatient mental care as well as factors predicting number of visits after contact with a provider was made. We examined three types of treatment outlets: day treatment program (DTP); mental health clinic (MHC); and private specialty services (PSS). Among youth, 1.6% visited DTP; 2.3% visited MHC; and 11.1% had PSS; with overlaps in services utilization. Results from multivariable logistic regressions indicate that most of the individual characteristics differentiated youth on odds of using MHC and PSS, but not DTP. Health status, alcohol dependence, drug dependence, and problematic conduct behaviors and having Medicaid increased the odds of using all three services. Censored regressions used to model number of visits among service users found that girls consistently used more visits than boys. The results suggest that policies that encourage seeking help to a mental care provider may be in instances different from those aimed at motivating retention in treatment.

摘要

本研究确定了青少年使用门诊心理护理倾向的决定因素,以及在与提供者接触后预测就诊次数的因素。我们考察了三种类型的治疗机构:日间治疗项目(DTP);心理健康诊所(MHC);以及私人专科服务(PSS)。在青少年中,1.6%的人去过DTP;2.3%的人去过MHC;11.1%的人接受过PSS;服务利用存在重叠情况。多变量逻辑回归结果表明,大多数个体特征在使用MHC和PSS的几率上区分了青少年,但在DTP方面并非如此。健康状况、酒精依赖、药物依赖、问题行为以及拥有医疗补助增加了使用所有三种服务的几率。用于对服务使用者的就诊次数进行建模的删失回归发现,女孩的就诊次数始终多于男孩。结果表明,鼓励向心理护理提供者寻求帮助的政策可能与旨在促使坚持治疗的政策情况不同。

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