Gateway Behavioral Health Services , Brunswick , GA , USA.
Department of Nursing, College of Health and Human Sciences, Georgia Southern University , Statesboro , GA , USA.
Issues Ment Health Nurs. 2019 Nov;40(11):951-956. doi: 10.1080/01612840.2019.1630532. Epub 2019 Aug 5.
Mental health-care delivery to young people with first-episode schizophrenia presents significant challenges especially in underserved areas. This chart review reveals the importance of family support as a predictor for medication and treatment adherence with this vulnerable group. An unexpected disengagement rate of 47% was discovered. It was further discovered that receiving care with telehealth delivery was a significant predictor of lost to follow-up or treatment nonadherence. Recommendations include psychoeducation for families during the initial crisis, initiation of long-acting injectable antipsychotics early in care, a hybrid telehealth intervention with in-home medication delivery, and collaboration with educational, vocational county agencies for employment support. A system of care must be developed to support young people with this severe illness for optimum outcome and protection of long-term cognitive functioning.
精神卫生保健服务提供给首发精神分裂症的年轻人带来了重大挑战,尤其是在服务不足的地区。本病历回顾揭示了家庭支持作为预测药物治疗和治疗依从性的重要性,对于这群弱势群体来说。研究发现,有 47%的患者出现了意外脱失。进一步发现,通过远程医疗进行治疗是导致失访或治疗不依从的一个重要预测因素。建议包括在初始危机期间对家庭进行心理教育,在治疗早期开始使用长效注射抗精神病药物,采用家庭送药的远程医疗混合干预措施,并与教育、职业县机构合作提供就业支持。必须建立一个医疗保健系统,以支持患有这种严重疾病的年轻人,以获得最佳结果并保护长期认知功能。