College of Nursing, University of Central Florida, Orlando, Florida, USA.
Issues Ment Health Nurs. 2020 Feb;41(2):113-121. doi: 10.1080/01612840.2019.1646363. Epub 2019 Oct 29.
A decade after the Mental Health Parity and Addiction Equity Act was implemented to ensure access to mental health and substance abuse services for U.S. citizens, accessing mental health care still is problematic for many needing services. More than 123 million Americans reside in federally-designated Mental Health Professional Shortage Areas (MHPSA) compared to 84 million living in similarly-designated primary care shortage areas and 62 million in dental health shortage areas. Health professional shortage areas are geographic areas that have a shortage of primary medical, dental, or mental health providers. Geographic Information Systems (GIS) with spatial analysis approaches provide tools to understand the ever-changing distribution of health care, outcomes, and delivery to improve care. The aim of this integrative review is to describe and synthesize the literature on GIS approaches to improve access to mental health care services. GIS Bibliography, PubMed, CINAHL, PsycINFO, Academic Search Premier, Social Sciences Citation Index, and Oalster were searched for articles between January 1, 1998 and January 1, 2018 that met established inclusion/exclusion criteria. Among the 138 articles reviewed, 18 met criteria and were included in the review. GIS approaches to improve access to mental health care can be categorized as (1) type of care (integrated, community), (2) contributions to access (distance, time, cost, perception of traveling, inequalities), and (3) the utilization of services. Results from the literature suggest closer examination of measures used to assess geographic variations in accessibility is needed for ultimately improving quality of care for people in MHPSA.
《精神健康和平等法案》实施十年来，旨在确保美国公民获得精神健康和药物滥用服务，然而，许多需要服务的人仍然难以获得精神保健。与居住在类似指定的初级保健短缺地区的 8400 万人和居住在牙科保健短缺地区的 6200 万人相比，超过 1.23 亿美国人居住在联邦指定的精神健康专业人员短缺地区（MHPSA）。卫生专业人员短缺地区是指初级医疗、牙科或精神健康提供者短缺的地理区域。地理信息系统（GIS）和空间分析方法提供了了解医疗保健、结果和提供方式不断变化的分布的工具，以改善医疗服务。本综合评价的目的是描述和综合 GIS 方法改善精神保健服务获取途径的文献。GIS 文献、PubMed、CINAHL、PsycINFO、学术搜索高级版、社会科学引文索引和 Oalster 被搜索了 1998 年 1 月 1 日至 2018 年 1 月 1 日之间符合既定纳入/排除标准的文章。在审查的 138 篇文章中，有 18 篇符合标准并被纳入审查。改善精神保健服务获取途径的 GIS 方法可以分为（1）护理类型（综合、社区），（2）对获取途径的贡献（距离、时间、成本、旅行感知、不平等），和（3）服务的利用。文献结果表明，需要更仔细地检查用于评估可及性地理差异的措施，以最终改善 MHPSA 地区人们的护理质量。
