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美国有心理健康和/或药物使用障碍的孕妇全国样本中,心理健康治疗的种族/民族差异。

Racial/ethnic differences in mental health treatment among a national sample of pregnant women with mental health and/or substance use disorders in the United States.

机构信息

School of Nursing, University of Louisville, Louisville, KY, USA.

School of Nursing, University of Louisville, Louisville, KY, USA.

出版信息

J Psychosom Res. 2019 Jun;121:74-80. doi: 10.1016/j.jpsychores.2019.03.015. Epub 2019 Mar 16.

Abstract

OBJECTIVE

To examine racial/ethnic differences in the receipt of mental health treatment among pregnant women with mental health (i.e., depression and serious psychological distress) and/or substance use disorders.

METHOD

Secondary analysis of data from the National Survey on Drug Use and Health was conducted. The sample consisted of 1232 pregnant women with mental health/substance use disorders.

RESULTS

Black/African American (Adjusted Odds Ratio [AOR]: 0.36, 95% Confidence Interval [CI]: 0.17-0.75), other non-Hispanic (AOR: 0.24, 95% CI: 0.11-0.52), and Hispanic (AOR: 0.42, 95% CI: 0.22-0.81) pregnant women had significantly lower odds of mental health treatment receipt compared to Whites, even when controlling for age, education, marital status, number of children, employment status, income, health insurance, county urbanicity, self-rated health status, type of mental health condition, and time. There were no racial/ethnic differences by mental health and/or substance use disorders. Among pregnant women who perceived unmet mental health treatment need (N = 299), a greater proportion of White compared to Non-White pregnant women perceived cost as an obstacle to access treatment (62.1% vs. 35.6%, p = .001); however, the two groups did not differ in other perceived barriers to mental health treatment (i.e., opposition to treatment, stigma, time/transportation limitation, and not knowing where to go).

CONCLUSIONS

Strategies are needed to increase access to mental health treatment among racial/ethnic minority women who are pregnant and have mental health/substance use disorders. Further studies are required to understand racial/ethnic differences in the perceived barriers to mental health treatment.

摘要

目的

探讨有心理健康(即抑郁和严重心理困扰)和/或物质使用障碍的孕妇接受心理健康治疗方面的种族/民族差异。

方法

对全国药物使用与健康调查的数据进行了二次分析。样本包括 1232 名有心理健康/物质使用障碍的孕妇。

结果

与白人相比,黑人和非裔美国人(调整后的优势比 [AOR]:0.36,95%置信区间 [CI]:0.17-0.75)、其他非西班牙裔(AOR:0.24,95% CI:0.11-0.52)和西班牙裔(AOR:0.42,95% CI:0.22-0.81)孕妇接受心理健康治疗的可能性显著较低,即使在控制了年龄、教育程度、婚姻状况、子女数量、就业状况、收入、医疗保险、县城乡结构、自我评估的健康状况、心理健康状况的类型和时间等因素后也是如此。在心理健康和/或物质使用障碍方面,没有种族/民族差异。在认为未满足心理健康治疗需求的孕妇中(N=299),与非白人孕妇相比,更多白人孕妇认为费用是获得治疗的障碍(62.1%比 35.6%,p=0.001);然而,这两组在其他心理健康治疗的感知障碍方面没有差异(即,反对治疗、污名化、时间/交通限制以及不知道去哪里)。

结论

需要制定策略,增加有心理健康/物质使用障碍的少数族裔孕妇获得心理健康治疗的机会。需要进一步研究以了解种族/民族差异在心理健康治疗感知障碍方面的原因。

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