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面向有情绪和焦虑问题的青少年的医疗服务提供的参与和获取模型。

An engagement and access model for healthcare delivery to adolescents with mood and anxiety concerns.

机构信息

FEMAP, London, Canada.

出版信息

Early Interv Psychiatry. 2012 Feb;6(1):97-105. doi: 10.1111/j.1751-7893.2011.00312.x. Epub 2011 Dec 16.

Abstract

AIM

Mood and anxiety disorders typically begin during adolescence or early adulthood. Yet services targeting this population are frequently lacking. This study implemented an outreach, access and assessment programme for youth with these concerns. The data reported constitute an evaluation of this mental healthcare delivery approach.

METHODS

This evaluation included specification of both programme and implementation theories through causal and programme logic models and formative (process) evaluation. Outreach focused on access points for youth such as schools and family physicians' offices. Concerned youth were encouraged to self-refer. Participants completed a semi-structured clinical interview and symptom and function questionnaire package.

RESULTS

Engagement sessions were conducted and results involved 93 youth. The majority of youth self-referred, a process not possible in traditional physician-referral healthcare systems. Interestingly, almost half had received prior treatment and over half had tried a psychiatric medication. Yet participants had significant symptomatology: 81% reported moderate to severe depressive symptoms; 95% reported high levels of trait-anxiety. Functional impairment was substantial: on average, participants missed 2.6 days of school/work and functioned at reduced levels on 4.2 days in the week prior to assessment. Demographic details are presented.

CONCLUSION

This study evaluated a mental healthcare delivery system that identified individuals with significant distress and functional impairment from mood/anxiety concerns and previous unsuccessful treatment attempts, verifying that they were in need of mental health services. This approach provides a model for outreach and assessment in this population, where earlier intervention has the potential to prevent chronic mental illness and disability.

摘要

目的

情绪和焦虑障碍通常在青少年或成年早期开始。然而,针对这一人群的服务常常缺乏。本研究实施了一项针对有这些问题的青年的外展、获得和评估计划。报告的数据构成了对这种心理健康保健提供方法的评估。

方法

这项评估通过因果和计划逻辑模型以及形成性(过程)评估来明确计划和实施理论。外展工作侧重于学校和家庭医生办公室等青年的切入点。鼓励有问题的青年自我推荐。参与者完成了一项半结构化的临床访谈和症状及功能问卷包。

结果

进行了参与会议,结果涉及 93 名青年。大多数青年是自我推荐的,这在传统的医生推荐医疗保健系统中是不可能的。有趣的是,近一半的人以前接受过治疗,超过一半的人尝试过精神药物。然而,参与者有明显的症状:81%的人报告有中度至重度抑郁症状;95%的人报告有高度的特质焦虑。功能障碍相当严重:平均而言,参与者缺课/旷工 2.6 天,在评估前一周的 4.2 天里,功能水平降低。介绍了人口统计细节。

结论

本研究评估了一种心理健康保健提供系统,该系统从情绪/焦虑问题和以前不成功的治疗尝试中识别出有明显痛苦和功能障碍的个体,并证实他们需要心理健康服务。这种方法为该人群的外展和评估提供了一个模型,早期干预有可能预防慢性精神疾病和残疾。

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