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为有心理健康需求的离开照料者提供过渡性护理:“他们让你注定失败!”

Transitioning care-leavers with mental health needs: 'they set you up to fail!'.

作者信息

Butterworth Sarah, Singh Swaran P, Birchwood Max, Islam Zoebia, Munro Emily R, Vostanis Panos, Paul Moli, Khan Alia, Simkiss Douglas

机构信息

Research and Innovation, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK.

Department of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.

出版信息

Child Adolesc Ment Health. 2017 Sep;22(3):138-147. doi: 10.1111/camh.12171. Epub 2016 Jun 29.

Abstract

BACKGROUND

Children in the UK care system often face multiple disadvantages in terms of health, education and future employment. This is especially true of mental health where they present with greater mental health needs than other children. Although transition from care - the process of leaving the local authority as a child-in-care to independence - is a key juncture for young people, it is often experienced negatively with inconsistency in care and exacerbation of existing mental illness. Those receiving support from child and adolescent mental health services (CAMHS), often experience an additional, concurrent transfer to adult services (AMHS), which are guided by different service models which can create a care gap between services.

METHOD

This qualitative study explored care-leavers' experiences of mental illness, and transition in social care and mental health services. Twelve care-leavers with mental health needs were interviewed and data analysed using framework analysis.

RESULTS

Sixteen individual themes were grouped into four superordinate themes: overarching attitudes towards the care journey, experience of social care, experience of mental health services and recommendations.

CONCLUSIONS

Existing social care and mental health teams can improve the care of care-leavers navigating multiple personal, practical and service transitions. Recommendations include effective Pathway Planning, multiagency coordination, and stating who is responsible for mental health care and its coordination. Participants asked that youth mental health services span the social care transition; and provide continuity of mental health provision when care-leavers are at risk of feeling abandoned and isolated, suffering deteriorating mental health and struggling to establish new relationships with professionals. Young people say that the key to successful transition and achieving independence is maintaining trust and support from services.

摘要

背景

英国照料系统中的儿童在健康、教育和未来就业方面往往面临多重不利因素。在心理健康方面尤其如此,他们比其他儿童有更大的心理健康需求。尽管从照料中过渡——即从作为受照料儿童离开地方当局到独立的过程——对年轻人来说是一个关键节点,但这一过程往往体验不佳,存在照料不一致以及现有精神疾病恶化的情况。那些接受儿童及青少年心理健康服务(CAMHS)支持的人,通常还会同时转至成人服务(AMHS),而这两种服务遵循不同的服务模式,可能会在服务之间造成照料缺口。

方法

这项定性研究探讨了离开照料系统者在精神疾病以及社会照料和心理健康服务过渡方面的经历。对12名有心理健康需求的离开照料系统者进行了访谈,并使用框架分析法对数据进行了分析。

结果

16个个体主题被归纳为四个上位主题:对照料历程的总体态度、社会照料经历、心理健康服务经历和建议。

结论

现有的社会照料和心理健康团队可以改善对经历多重个人、实际和服务过渡的离开照料系统者的照料。建议包括有效的路径规划、多机构协调,以及明确谁负责精神卫生保健及其协调工作。参与者要求青少年心理健康服务贯穿社会照料过渡过程;并在离开照料系统者有被遗弃和孤立感、心理健康状况恶化以及难以与专业人员建立新关系的风险时,提供持续的心理健康服务。年轻人表示,成功过渡并实现独立的关键是维持来自服务机构的信任和支持。

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