被拘留青少年重返社区后与精神卫生保健的联系：一项定性研究
Connection to mental health care upon community reentry for detained youth: a qualitative study.
作者信息
Aalsma Matthew C, Brown James R, Holloway Evan D, Ott Mary A
机构信息
Department of Pediatrics, Section of Adolescent Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
出版信息
BMC Public Health. 2014 Feb 5;14:117. doi: 10.1186/1471-2458-14-117.
BACKGROUND
Although detained youth evidence increased rates of mental illness, relatively few adolescents utilize mental health care upon release from detention. Thus, the goal of this study is to understand the process of mental health care engagement upon community reentry for mentally-ill detained youth.
METHODS
Qualitative interviews were conducted with 19 youth and caregiver dyads (39 participants) recruited from four Midwest counties affiliated with a state-wide mental health screening project. Previously detained youth (ages 11-17), who had elevated scores on a validated mental health screening measure, and a caregiver were interviewed 30 days post release. A critical realist perspective was used to identify themes on the detention and reentry experiences that impacted youth mental health care acquisition.
RESULTS
Youth perceived detention as a crisis event and having detention-based mental health care increased their motivation to seek mental health care at reentry. Caregivers described receiving very little information regarding their child during detention and felt "out of the loop," which resulted in mental health care utilization difficulty. Upon community reentry, long wait periods between detention release and initial contact with court or probation officers were associated with decreased motivation for youth to seek care. However, systemic coordination between the family, court and mental health system facilitated mental health care connection.
CONCLUSIONS
Utilizing mental health care services can be a daunting process, particularly for youth upon community reentry from detention. The current study illustrates that individual, family-specific and systemic issues interact to facilitate or impair mental health care utilization. As such, in order to aid youth in accessing mental health care at detention release, systemic coordination efforts are necessary. The systematic coordination among caregivers, youth, and individuals within the justice system are needed to reduce barriers given that utilization of mental health care is a complex process.
背景
尽管被拘留青少年的精神疾病发病率有所上升，但相对较少的青少年在从拘留所获释后会寻求心理健康护理。因此，本研究的目的是了解患有精神疾病的被拘留青少年在社区重新融入时参与心理健康护理的过程。
方法
对从与全州心理健康筛查项目相关的四个中西部县招募的19对青少年和照顾者二元组（39名参与者）进行了定性访谈。之前被拘留的青少年（11 - 17岁）在经过验证的心理健康筛查量表上得分较高，以及一名照顾者在获释后30天接受了访谈。采用批判实在论的视角来确定影响青少年获得心理健康护理的拘留和重新融入经历的主题。
结果
青少年将拘留视为危机事件，在拘留期间接受心理健康护理增加了他们在重新融入时寻求心理健康护理的动力。照顾者表示在拘留期间收到的关于其孩子的信息非常少，感觉“被排除在外”，这导致了心理健康护理利用困难。在社区重新融入时，拘留释放与首次接触法院或缓刑监督官之间的长时间等待与青少年寻求护理的动力下降有关。然而，家庭、法院和心理健康系统之间的系统协调促进了心理健康护理的联系。
结论
利用心理健康护理服务可能是一个艰巨的过程，特别是对于从拘留所重新融入社区的青少年来说。当前的研究表明，个人、家庭特定和系统问题相互作用，促进或损害心理健康护理的利用。因此，为了帮助青少年在拘留释放时获得心理健康护理，系统协调努力是必要的。鉴于心理健康护理的利用是一个复杂的过程，需要照顾者、青少年和司法系统内的个人之间进行系统协调，以减少障碍。
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