1 Mental Health Branch, Correctional Service of Canada.
2 School of Epidemiology and Public Health, University of Ottawa, Ontario.
Can J Psychiatry. 2018 Oct;63(10):692-700. doi: 10.1177/0706743718762099. Epub 2018 Feb 28.
Disparities in mental health care exist between regional and demographic groups. While screening is recommended as part of a correctional mental health strategy, little work has been done to explore whether it can narrow regional and demographic disparities in access to care. We compared treatment access rates by sex, race, age, and region in relation to screening results.
We conducted a retrospective cohort study using administrative data. All 7965 admissions to the prison system were followed for a median of 14 months.
Males and non-Indigenous minority racial groups had lower rates of treatment regardless of screening results; they were less likely both to self-report needs and to receive treatment if these needs were reported. Regional differences revealed higher treatment rates in Atlantic Canada and Ontario, as well as higher rates of inmates self-reporting needs on screening who did not receive treatment in the Atlantic, Québec, and Pacific regions. There were minimal differences between inmates of different age groups.
Findings suggest potential resource gaps and/or differences in the performance of screening to detect mental health needs across demographic and regional groups. Screening did not narrow, and may have widened, differences between groups.
心理健康护理在地区和人口群体之间存在差异。虽然筛查被建议作为矫正心理健康策略的一部分，但很少有工作致力于探索它是否可以缩小获得护理方面的地区和人口差异。我们比较了与筛查结果相关的按性别、种族、年龄和地区划分的治疗可及性率。
我们使用行政数据进行了回顾性队列研究。对监狱系统的所有 7965 名入院患者进行了中位数为 14 个月的随访。
无论筛查结果如何，男性和非原住民少数族裔群体的治疗率都较低；他们不仅更有可能自我报告需求，而且如果报告了这些需求，他们也更不可能得到治疗。地区差异显示，在大西洋省份和安大略省的治疗率较高，在大西洋、魁北克和太平洋地区，自我报告筛查需求的囚犯的治疗率较高，但他们没有得到治疗。不同年龄组的囚犯之间差异极小。
这些发现表明，在人口统计学和地区群体中，筛查检测心理健康需求的表现可能存在潜在的资源差距和/或差异。筛查并没有缩小，甚至可能扩大了群体之间的差异。
