He Amy S, Traube Dorian E, Brimhall Kim C, Lim Caroline, Lecklitner Greg, Olson Adrienne
Dr. He is with the Graduate School of Social Work, University of Denver, Denver. Dr. Traube, Dr. Brimhall, and Ms. Lim are with the School of Social Work, University of Southern California, Los Angeles. Dr. Lecklitner is with the Child Welfare Division, Los Angeles County Department of Mental Health, Los Angeles. Ms. Olson is with the Los Angeles County Department of Children and Family Services, Los Angeles.
Psychiatr Serv. 2017 Aug 1;68(8):776-782. doi: 10.1176/appi.ps.201600266. Epub 2017 Apr 17.
Use of administrative data from child welfare (CW) and mental health systems in Los Angeles County provided a unique opportunity to more closely examine mental health needs of children dually served by these systems. This study examined the presence of mental disorders and correlates of receipt of mental health services by diagnostic classification in this population.
Data were obtained for 3,191 children receiving services from Los Angeles County's Department of Children and Family Services and Department of Mental Health (DMH) between July 2011 and July 2012. Multivariate linear and logistic regression models examined the relationship between sociodemographic and CW-related characteristics and receipt of outpatient services by clinician-diagnosed mental disorder.
Of the 3,191 referred children, 68% met criteria for one of the four diagnostic classifications. Mood disorders were the most common diagnosis (30%), followed by anxiety disorders (20%), behavior disorders (9%), and attention-deficit hyperactivity disorder (9%). Children with prior DMH involvement received more services regardless of diagnosis. Older children (ages ≥15) received more services than younger children, whereas younger children were more likely to receive family therapy. Race-ethnicity did not play a significant role in predicting service receipt.
The unique mental health needs of CW-involved children were exemplified by the differences found in the percentages of children with diagnoses of mental disorders between this sample and children in the general population. Because of family and placement disruptions among CW-involved children, it is important that the provision of individual therapy is not overlooked in favor of family therapy.
利用洛杉矶县儿童福利(CW)和心理健康系统的行政数据,提供了一个独特的机会来更密切地检查由这些系统双重服务的儿童的心理健康需求。本研究调查了该人群中精神障碍的存在情况以及按诊断分类接受心理健康服务的相关因素。
获取了2011年7月至2012年7月期间从洛杉矶县儿童和家庭服务部及心理健康部(DMH)接受服务的3191名儿童的数据。多变量线性和逻辑回归模型研究了社会人口学和与儿童福利相关的特征与临床诊断的精神障碍患者接受门诊服务之间的关系。
在3191名被转诊的儿童中,68%符合四种诊断分类之一的标准。情绪障碍是最常见的诊断(30%),其次是焦虑障碍(20%)、行为障碍(9%)和注意力缺陷多动障碍(9%)。无论诊断如何,之前参与过心理健康部服务的儿童接受的服务更多。年龄较大的儿童(≥15岁)比年龄较小的儿童接受的服务更多,而年龄较小的儿童更有可能接受家庭治疗。种族在预测服务接受情况方面没有发挥重要作用。
本样本中患有精神障碍的儿童百分比与普通人群中的儿童存在差异,这体现了涉及儿童福利的儿童独特的心理健康需求。由于涉及儿童福利的儿童存在家庭和安置方面的干扰,因此提供个体治疗不应被忽视而偏向家庭治疗,这一点很重要。