贫困家庭在利用服务和儿童心理健康治疗方面的障碍。
Barriers to Service Utilization and Child Mental Health Treatment Attendance Among Poverty-Affected Families.
机构信息
Dr. Bornheimer is with the School of Social Work, University of Michigan, Ann Arbor. Dr. Acri is with the McSilver Institute for Poverty Policy and Research, New York University Medical Center, New York University, New York. Dr. Gopalan is with the School of Social Work, University of Maryland, Baltimore. Dr. McKay is with the Brown School of Social Work, Washington University in St. Louis.
出版信息
Psychiatr Serv. 2018 Oct 1;69(10):1101-1104. doi: 10.1176/appi.ps.201700317. Epub 2018 Jul 9.
OBJECTIVE
The majority of children who initially engage in mental health treatment in the United States drop out prematurely, a problem further exacerbated among children living in poverty. This study examined the relationships between sociodemographic characteristics, barriers to treatment use, and session attendance.
METHODS
Data were obtained from participants (N=225) in the 4R2S field trial. Barriers were measured using the Kazdin Barriers to Treatment Participation Scale.
RESULTS
Barriers endorsed by families attending less treatment primarily aligned with practical rather than perceptual obstacles. Critical events linked to lower attendance included moving too far away from the clinic, a job change, and a child's moving out of the home.
CONCLUSIONS
Child mental health programs serving low-income families may consider structural modifications to allow for greater family support as well as flexibility in treatment delivery by leveraging technology. Future research is needed to evaluate barriers to treatment and alternate modalities in relation to service utilization.
目的
大多数最初在美国接受心理健康治疗的儿童会过早地退出治疗，而生活在贫困中的儿童这一问题更加严重。本研究探讨了社会人口统计学特征、治疗使用障碍与治疗出席之间的关系。
方法
数据来自 4R2S 现场试验的参与者（N=225）。使用 Kazdin 治疗参与障碍量表来测量障碍。
结果
参加治疗较少的家庭所认同的障碍主要与实际障碍而非感知障碍有关。与较低的出席率相关的关键事件包括离诊所太远、工作变动以及孩子搬出家。
结论
为低收入家庭服务的儿童心理健康项目可能会考虑进行结构调整，以便通过利用技术为家庭提供更多支持，并在治疗提供方面具有更大的灵活性。未来的研究需要评估与服务利用相关的治疗障碍和替代模式。
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