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有严重自杀念头的成年人未接受心理健康治疗的自我报告原因。

Self-Reported Reasons for Not Receiving Mental Health Treatment in Adults With Serious Suicidal Thoughts.

作者信息

Kuramoto-Crawford S Janet, Han Beth, McKeon Richard T

机构信息

Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, US Department of Health and Human Services, Rockville, Maryland, USA.

Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Room 15E85C, Rockville, MD 20857.

出版信息

J Clin Psychiatry. 2017 Jun;78(6):e631-e637. doi: 10.4088/JCP.16m10989.

Abstract

OBJECTIVE

This study examined self-reported reasons for not receiving mental health treatment among adults with past-year serious suicidal thoughts and their sociodemographic characteristics associated with these reasons.

METHODS

Using the 2008-2013 National Surveys on Drug Use and Health, we examined 8,400 respondents aged 18 years or older who had past-year serious thoughts of suicide and did not receive mental health treatment that year. Logistic regression analyses were conducted to estimate the associations between sociodemographic characteristics and self-reported reasons for not receiving mental health treatment among these suicidal adults.

RESULTS

Among adults with serious suicidal thoughts who did not receive mental health treatment in the past year, three-fourths did not feel the need for treatment. Of the one-fourth of those who felt the need for treatment, the main reason for not receiving treatment was financial (58.4%), followed by logistical reasons such as not knowing where to go (36.1%). A greater proportion of suicidal adults than nonsuicidal adults perceived more than 1 barrier to treatment (43.8% vs 34.3%). Among suicidal adults who did not receive mental health treatment that year, the odds of not feeling the need for mental health treatment were higher in men (adjusted odds ratio [AOR] = 1.68; 95% CI, 1.42-1.99), adults aged 50 years or older (AOR = 3.02; 95% CI, 2.02-4.51), racial and ethnic minorities (AORs = 1.59-2.13), publicly insured (AOR = 1.54; 95% CI, 1.14-2.07), and nonmetropolitan residents (AOR = 1.50; 95% CI, 1.20-1.88).

CONCLUSIONS

Most suicidal adults did not feel the need for mental health treatment. Of those who felt the need, multiple barriers were identified. A multifaceted approach to address these barriers is needed to promote receipt of mental health treatment among this vulnerable population.

摘要

目的

本研究调查了过去一年有严重自杀念头的成年人未接受心理健康治疗的自我报告原因,以及与这些原因相关的社会人口学特征。

方法

利用2008 - 2013年全国药物使用和健康调查,我们研究了8400名年龄在18岁及以上、过去一年有严重自杀念头且当年未接受心理健康治疗的受访者。进行逻辑回归分析,以估计这些有自杀倾向的成年人的社会人口学特征与未接受心理健康治疗的自我报告原因之间的关联。

结果

在过去一年有严重自杀念头但未接受心理健康治疗的成年人中,四分之三的人认为不需要治疗。在认为需要治疗的四分之一人群中,未接受治疗的主要原因是经济问题(58.4%),其次是后勤问题,如不知道去哪里(36.1%)。有自杀倾向的成年人比无自杀倾向的成年人中,认为治疗存在多个障碍的比例更高(43.8%对34.3%)。在当年未接受心理健康治疗的有自杀倾向的成年人中,男性(调整后的优势比[AOR]=1.68;95%置信区间,1.42 - 1.99)、50岁及以上成年人(AOR = 3.02;95%置信区间,2.02 - 4.51)、少数种族和族裔(AOR = 1.59 - 2.13)、参加公共保险者(AOR = 1.54;95%置信区间,1.14 - 2.07)以及非大城市居民(AOR = 1.50;95%置信区间,1.20 - 1.88)认为不需要心理健康治疗的几率更高。

结论

大多数有自杀倾向的成年人认为不需要心理健康治疗。在那些认为需要治疗的人中,发现了多种障碍。需要采取多方面的方法来解决这些障碍,以促进这一弱势群体接受心理健康治疗。

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