University of California, Irvine, 653 E. Peltason Drive, Irvine, CA, 92617, USA.
Community Ment Health J. 2021 Aug;57(6):1142-1150. doi: 10.1007/s10597-020-00745-x. Epub 2020 Nov 9.
We examined whether county-level increases in continuity of mental health care (i.e., mental health visits per mental health patient) at Community Health Centers (CHCs) correspond with a decline in Emergency Department (ED) visits for suicidal ideation and self-harm (1) overall, and (2) among specific race/ethnicities across 211 counties from 10 US states, from 2006 to 2015 (sample size = 1412 county-years). We used fixed effects linear regression analyses with county-level socioeconomic covariates and year indicators. In the full sample, continuity of mental health care at CHCs varies inversely with ED visits for suicidal ideation/self-harm (coefficient: -0.04, p < 0.1). Race-specific analyses show that a one unit increase in continuity of mental health care at CHCs corresponds with a 5% decline in ED visits for suicidal ideation/self-harm among whites (p < 0.05). Expansion of mental health care services at CHCs may serve as a key point of prevention for suicidal behavior.
我们考察了社区卫生中心(CHCs)的精神卫生保健连续性(即每位精神卫生患者的就诊次数)的县级别增长是否与自杀意念和自伤的急诊就诊次数(1)整体下降,以及(2)在美国 10 个州的 211 个县中特定种族/族裔群体的下降有关,时间跨度为 2006 年至 2015 年(样本量=1412 个县年)。我们使用了带有县级别社会经济协变量和年份指标的固定效应线性回归分析。在全样本中,CHCs 的精神卫生保健连续性与自杀意念/自伤的急诊就诊次数呈反比变化(系数:-0.04,p<0.1)。种族特异性分析表明,CHCs 的精神卫生保健连续性增加一个单位,与白人自杀意念/自伤的急诊就诊次数下降 5%(p<0.05)相对应。CHCs 精神卫生保健服务的扩大可能是预防自杀行为的一个关键点。