RAND Health Care, RAND Corporation, Boston (McBain); Santa Monica, California (Collins, Wong, Cefalu, Roth, Burnam); and Pittsburgh (Breslau).
Psychiatr Serv. 2020 Jun 1;71(6):580-587. doi: 10.1176/appi.ps.201900204. Epub 2020 Mar 2.
Personal recovery measures have been examined among treatment-seeking individuals enrolled in high-quality care. The authors examined whether utilization of mental health services as typically delivered is associated with personal recovery among adults with clinically significant psychological distress.
The Kessler Psychological Distress Scale (K-6) measured respondents' (N=1,954) psychological distress level. The authors also assessed five dimensions of personal recovery-hope, life satisfaction, empowerment, connectedness, and internalized stigma. Multivariable linear regression analyses were used to examine relationships between personal recovery and treatment, self-reported treatment completion, provider type, and adequacy of care, adjusting for covariates including K-6 score.
Participants who received care >12 months prior to the survey reported lower levels of hope (95% confidence interval [CI]=-0.36, -0.06, p<0.01), empowerment (95% CI=-0.26, -0.02, p<0.05), and connectedness (95% CI=-0.37, -0.06, p<0.01) than those who had not received treatment. Those who received care in the past 12 months reported lower levels of hope (95% CI=-0.47, -0.14, p<0.001) and life satisfaction (95% CI=-0.42, -0.05, p<0.01). However, treatment completion was associated with higher levels of empowerment (95% CI=0.02, 0.56, p<0.05) and hope (95% CI=0.04, 0.62, p<0.05) and lower levels of stigma (95% CI=-1.21, -0.21, p<0.01) compared with noncompletion. Differences according to provider type and adequacy of care were nonsignificant.
Utilization of mental health services was associated with lower levels of personal recovery, which may indicate that care-as typically utilized and received-does not promote personal recovery. Longitudinal research is needed to determine causal relationships underlying these associations.
个人康复措施已在接受高质量治疗的寻求治疗的个体中进行了研究。作者研究了通常提供的心理健康服务的利用情况是否与患有临床显著心理困扰的成年人的个人康复相关。
Kessler 心理困扰量表(K-6)衡量了受访者(N=1954)的心理困扰程度。作者还评估了个人康复的五个维度,包括希望、生活满意度、赋权、联系和内化污名。使用多变量线性回归分析来检查个人康复与治疗、自我报告的治疗完成情况、提供者类型和护理充足性之间的关系,调整了包括 K-6 评分在内的协变量。
在调查前 12 个月接受治疗的参与者报告的希望(95%置信区间 [CI]=-0.36,-0.06,p<0.01)、赋权(95% CI=-0.26,-0.02,p<0.05)和联系(95% CI=-0.37,-0.06,p<0.01)水平低于未接受治疗的参与者。在过去 12 个月内接受过治疗的参与者报告的希望(95% CI=-0.47,-0.14,p<0.001)和生活满意度(95% CI=-0.42,-0.05,p<0.01)水平较低。然而,与未完成治疗相比,完成治疗与更高的赋权水平(95% CI=0.02,0.56,p<0.05)和希望水平(95% CI=0.04,0.62,p<0.05)以及更低的污名水平(95% CI=-1.21,-0.21,p<0.01)相关。根据提供者类型和护理充足性的差异无统计学意义。
心理健康服务的利用与个人康复水平较低相关,这可能表明通常利用和接受的护理并不促进个人康复。需要进行纵向研究来确定这些关联背后的因果关系。