School of Education, Boston University, Two Silber Way, Boston, MA 02215, USA.
J Am Acad Child Adolesc Psychiatry. 2013 May;52(5):501-10. doi: 10.1016/j.jaac.2013.03.002. Epub 2013 Apr 3.
Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources that they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to increase service use. This article examines associations of school resources with past-year mental health service use among students with 12-month DSM-IV mental disorders.
Data come from the U.S. National Comorbidity Survey Adolescent Supplement (NCS-A), a national survey of adolescent mental health that included 4,445 adolescent-parent pairs in 227 schools in which principals and mental health coordinators completed surveys about school resources and policies for addressing student emotional problems. Adolescents and parents completed the Composite International Diagnostic Interview and reported mental health service use across multiple sectors. Multilevel multivariate regression was used to examine associations of school mental health resources and individual-level service use.
Nearly half (45.3%) of adolescents with a 12-month DSM-IV disorder received past-year mental health services. Substantial variation existed in school resources. Increased school engagement in early identification was significantly associated with mental health service use for adolescents with mild/moderate mental and behavior disorders. The ratio of students to mental health providers was not associated with overall service use, but was associated with sector of service use.
School mental health resources, particularly those related to early identification, may facilitate mental health service use and may influence sector of service use for youths with DSM disorders.
尽管学校被认为是发现青少年精神障碍的关键场所,但对于学校提供的心理健康服务人员数量和类型是否会影响学生的心理健康服务使用情况,人们知之甚少。这些信息可以为开发和分配适当的基于学校的资源提供信息,以增加服务的使用。本文探讨了学校资源与具有 12 个月 DSM-IV 精神障碍的学生过去一年心理健康服务使用之间的关联。
数据来自美国国家共病调查青少年补充调查(NCS-A),这是一项针对青少年心理健康的全国性调查,包括 227 所学校的 4445 对青少年-家长对,其中校长和心理健康协调员完成了关于解决学生情绪问题的学校资源和政策的调查。青少年和家长完成了复合国际诊断访谈,并报告了多个部门的心理健康服务使用情况。使用多层次多元回归分析了学校心理健康资源与个体层面服务使用之间的关联。
近一半(45.3%)患有 12 个月 DSM-IV 障碍的青少年在过去一年中接受了心理健康服务。学校资源存在很大差异。学校对早期识别的参与度增加与轻度/中度精神和行为障碍青少年的心理健康服务使用显著相关。学生与心理健康服务提供者的比例与整体服务使用无关,但与服务使用部门有关。
学校心理健康资源,特别是与早期识别相关的资源,可能促进心理健康服务的使用,并可能影响患有 DSM 障碍的青少年的服务使用部门。