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移民青年、家长和临床医生对社区心理健康服务的看法:探寻安全路径

Perspectives of Migrant Youth, Parents and Clinicians on Community-Based Mental Health Services: Negotiating Safe Pathways.

作者信息

Nadeau Lucie, Jaimes Annie, Johnson-Lafleur Janique, Rousseau Cécile

机构信息

Divisions of Social and Cultural Psychiatry and of Child Psychiatry, Department of Psychiatry, McGill University, Montreal, QC Canada.

Transcultural Research and Intervention Team (TRIT), CIUSSS du Centre-Ouest-de-l'île-de-Montréal, Montreal, QC Canada.

出版信息

J Child Fam Stud. 2017;26(7):1936-1948. doi: 10.1007/s10826-017-0700-1. Epub 2017 Mar 27.

Abstract

Youth mental health (YMH) services are greatly underutilized, particularly for migrant youth. Collaborative models of care offer promising avenues, but research on these treatment modalities is still scarce, particularly for migrants. The goal of this exploratory study is to better understand quality of care including factors improving access to care and collaborative YMH services use, efficacy and satisfaction, for this vulnerable population. This qualitative study relies on a multi-informants (youth, parents, clinicians) and multiple case study design to explore YMH collaborative services for migrant youth living in an urban setting (Montreal, Canada). Participants are five young patients (12-15 years old), one of their parents and their primary care therapist ( = 15). They come from migrant families, have a psychiatric diagnosis and have been receiving mental health services in a collaborative care setting for at least 6 months. Transcripts of semi-structured interviews for the five triads were thematically analyzed to draw similarities and contrasts between actors, across and within case-studies. Based on these findings, four themes emerged concerning the optimal care setting for collaborative YMH services for migrant families: (1) providing an equilibrium between communication, collaboration and privacy/confidentiality, (2) special attention to ensuring the continuity of care and the creation of a welcoming environment where trusting relationships can develop, (3) the inclusion of family intervention, and (4) the provision of collaborative decision-making pathways to care, addressing interprofessional and interinstitutional collaboration as well as cultural differences in explanatory models and values.

摘要

青少年心理健康(YMH)服务的利用率极低,尤其是对移民青少年而言。合作式护理模式提供了有前景的途径,但对这些治疗方式的研究仍然匮乏,特别是针对移民群体。这项探索性研究的目的是更好地了解针对这一弱势群体的护理质量,包括改善获得护理的机会和使用合作式青少年心理健康服务的因素、疗效和满意度。这项定性研究采用多 informant(青少年、家长、临床医生)和多案例研究设计,以探索为居住在城市环境(加拿大蒙特利尔)的移民青少年提供的青少年心理健康合作服务。参与者包括五名年轻患者(12 - 15岁)、他们的一名家长以及他们的初级护理治疗师(共15人)。他们来自移民家庭,患有精神疾病诊断,并且在合作式护理环境中接受心理健康服务至少6个月。对五个三人小组的半结构化访谈记录进行了主题分析,以找出案例研究之间和内部各行为者之间的异同。基于这些发现,出现了四个关于为移民家庭提供合作式青少年心理健康服务的最佳护理环境的主题:(1)在沟通、合作与隐私/保密之间取得平衡;(2)特别注意确保护理的连续性,并营造一个能发展信任关系的友好环境;(3)纳入家庭干预;(4)提供合作式护理决策途径,解决跨专业和跨机构合作以及解释模式和价值观方面的文化差异。

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