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社区心理健康护理的变化格局:2010-2017 年国家数据中的治疗服务可及性。

The Changing Landscape of Community Mental Health Care: Availability of Treatment Services in National Data, 2010-2017.

机构信息

Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta (Cummings); Center for Mental Health, Department of Psychiatry, Perelman School of Medicine (Smith, Marcus), Leonard Davis Institute of Health Economics (Smith), and School of Social Policy and Practice (Cullen, Marcus), University of Pennsylvania, Philadelphia.

出版信息

Psychiatr Serv. 2021 Feb 1;72(2):204-208. doi: 10.1176/appi.ps.201900546. Epub 2020 Dec 18.

Abstract

OBJECTIVE

The authors sought to describe changes in availability of crisis and substance use treatment services in U.S. mental health facilities (including outpatient and inpatient facilities) from 2010 to 2017.

METHODS

Using National Mental Health Services Survey data, the authors of this descriptive study examined changes in the proportion of facilities providing crisis and substance use treatment services during the 2010-2017 period.

RESULTS

Although the proportion of outpatient facilities offering treatment for substance use increased significantly during the period studied (adjusted relative risk [ARR]=1.05, 95% confidence interval [CI]=1.01-1.10), the proportion of outpatient facilities offering crisis services significantly decreased, including emergency psychiatric walk-in services (ARR=0.81, 95% CI=0.75-0.88) and crisis intervention (ARR=0.88, 95% CI=0.83-0.93).

CONCLUSIONS

Mental health facilities are an integral piece of the behavioral health safety net and need to respond to changes in service needs. Findings suggest that mental health facilities have not shifted their services mix to address the ongoing suicide epidemic.

摘要

目的

作者试图描述 2010 年至 2017 年期间,美国精神卫生机构(包括门诊和住院机构)中危机和物质使用治疗服务的供应情况变化。

方法

本描述性研究的作者使用国家心理健康服务调查数据,研究了在 2010-2017 年期间,提供危机和物质使用治疗服务的设施比例的变化。

结果

尽管在研究期间,提供物质使用治疗的门诊设施比例显著增加(调整后相对风险 [ARR]=1.05,95%置信区间 [CI]=1.01-1.10),但提供危机服务的门诊设施比例显著下降,包括急诊精神科门诊服务(ARR=0.81,95%CI=0.75-0.88)和危机干预(ARR=0.88,95%CI=0.83-0.93)。

结论

精神卫生机构是行为健康安全网的一个组成部分,需要应对服务需求的变化。研究结果表明,精神卫生机构尚未调整其服务组合,以应对持续不断的自杀流行。

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