Center for Health Research.
Department of Psychiatry, Columbia University.
Psychiatr Rehabil J. 2012 Sep;35(5):360-368. doi: 10.1037/h0094494.
The purpose of this study was to identify better methods of engaging youths in mental health services by asking experienced mental health consumers for suggestions for clinicians.
177 members of an integrated health plan, ranging in age from 16-84 years and diagnosed with schizophrenia, schizoaffective disorder, bipolar disorder, or affective psychosis, completed four in-depth semistructured interviews over 24 months as part of a study of recovery from serious mental illness. We transcribed and coded interviews, extracted a set of common themes addressing consumer recommendations to clinicians, and compared these themes across age groups.
Five primary themes emerged in participants' recommendations: (1) use an age-appropriate approach that reflects youth culture and lifestyles; (2) foster development of autonomy; (3) take a personal, rather than diagnostic, approach; (4) be empathetic and authentic; and (5) create a safe and supportive environment. Consumers age 30 and older described three additional areas in which clinicians could contribute to youths' well being: (1) help find the right diagnosis and the right medication, (2) counsel youths to avoid using alcohol and drugs, and (3) take steps to help prevent social isolation.
Study findings suggest that many strategies recommended for working with adults may benefit young people, but that developmentally appropriate modifications to these approaches are needed to foster treatment engagement among youths.
本研究旨在通过向经验丰富的心理健康消费者征求对临床医生的建议,找出让年轻人参与心理健康服务的更好方法。
作为严重精神疾病康复研究的一部分,177 名年龄在 16-84 岁之间、被诊断为精神分裂症、分裂情感障碍、双相情感障碍或情感性精神病的综合健康计划成员完成了四项深入的半结构化访谈,历时 24 个月。我们对访谈进行了转录和编码,提取了一套针对消费者向临床医生提出建议的常见主题,并比较了这些主题在不同年龄组之间的差异。
参与者的建议中出现了五个主要主题:(1)采用反映青年文化和生活方式的适龄方法;(2)培养自主性;(3)采取个人而非诊断的方法;(4)富有同理心和真实性;(5)营造安全和支持性的环境。30 岁及以上的消费者还描述了临床医生可以促进年轻人健康的另外三个方面:(1)帮助找到正确的诊断和正确的药物;(2)劝导年轻人避免使用酒精和毒品;(3)采取措施帮助预防社交孤立。
研究结果表明,许多与成年人合作的策略可能对年轻人有益,但需要对这些方法进行适合其发展阶段的修改,以促进年轻人的治疗参与。