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社会结构因素在精神健康障碍治疗中的作用。

The role of social structural factors in treatment of mental health disorder.

机构信息

School of Social Work, University of Alabama, Tuscaloosa, AL 35487-0314, USA.

出版信息

J Ment Health. 2012 Oct;21(5):430-8. doi: 10.3109/09638237.2012.664303. Epub 2012 May 1.

Abstract

BACKGROUND

Mental disorder implies a biopsychosocial condition, so adequate mental health treatment involves not just medical and pharmacological care but also psychotherapy or counseling.

AIMS

The present study determined how social structural factors might explain accessing of primary care providers and specialty care providers in response to mental disorder, hypothesizing that the two broad types of care differ as to the likelihood of offering minimally adequate treatment.

METHOD

We analyzed data from the cross-sectional study called "2000-2001 Healthcare for Communities", employing five imputed data sets to handle missing data and defining minimally adequate treatment of mental disorder as "at least four counseling sessions at any provider and prescribed medication". Results While mental disorder can be treated in primary care or specialty facilities, our results show that minimally adequate treatment (as defined) is most likely to be obtained via specialty care.

CONCLUSION

For individuals with mental disorder, accessing only primary care creates social inequity, because care from specialty facilities is comparatively more adequate.

摘要

背景

精神障碍暗示了一种生物心理社会状况,因此,充分的心理健康治疗不仅需要医疗和药物护理,还需要心理治疗或咨询。

目的

本研究旨在确定社会结构因素如何解释人们在精神障碍方面寻求初级保健提供者和专科保健提供者的情况,假设这两种广泛的护理方式在提供基本充分治疗的可能性方面存在差异。

方法

我们分析了名为“2000-2001 年社区医疗保健”的横断面研究的数据,采用了五个插补数据集来处理缺失数据,并将精神障碍的基本充分治疗定义为“在任何提供者处至少进行四次咨询和规定的药物治疗”。结果表明,精神障碍可以在初级保健或专科机构中得到治疗,但我们的研究结果表明,通过专科机构获得基本充分治疗(如定义)的可能性最大。

结论

对于患有精神障碍的个人来说,仅获得初级保健会造成社会不平等,因为来自专科机构的护理相对更充分。

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