Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC).
Psychol Serv. 2022 Aug;19(3):488-493. doi: 10.1037/ser0000534. Epub 2021 Jun 3.
Timely care initiation is a priority within the Veterans Health Administration (VHA). Patients with serious mental illnesses (SMI) are a group that benefits from timely care initiation due to elevated risks of negative outcomes with delayed care. However, no evaluation has assessed whether VHA SMI patients disproportionately experience delays in mental health care initiation. VHA administrative care data were used to compare delays in mental health care initiation for VHA patients with and without SMI who had newly identified mental health needs. Analyses assessed rates of delayed initial mental health appointments within five settings (General Mental Health [GMH], Primary Care Mental Health Integration [PC-MHI], Post-Traumatic Stress Disorder [PTSD], Substance Use Disorder [SUD], and Psychosocial Rehabilitation clinics [PSR]). SMI patients were more likely to receive delayed initial appointments in three of five clinical settings (PTSD, SUD, PSR) and had significantly longer average wait times for an initial appointment when referred to the PTSD clinic for an initial appointment. Overall, SMI patients were equally as likely to receive delayed initial appointments. While VHA SMI patients were not more likely to experience delayed mental health care initiation overall, they were more likely to experience delays within three of the five treatment settings. Findings suggest that the majority of VHA SMI patients experience equivalent timeliness, though those with more complex needs, and particularly those with trauma-related care needs, may be more likely to experience treatment initiation delays. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
及时启动护理是退伍军人健康管理局(VHA)的首要任务。患有严重精神疾病(SMI)的患者由于延迟护理会增加负面结果的风险,因此从及时护理启动中受益。然而,尚无评估表明 VHA SMI 患者是否不成比例地延迟了心理健康护理的启动。使用 VHA 管理护理数据比较了有和没有新发现的心理健康需求的 SMI 患者在五个环境中(一般心理健康[GMH]、初级保健心理健康整合[PC-MHI]、创伤后应激障碍[PTSD]、物质使用障碍[SUD]和心理社会康复诊所[PSR])延迟启动心理健康护理的情况。在五个临床环境中的三个环境中(PTSD、SUD、PSR),SMI 患者更有可能接受延迟的初始预约,并且在 PTSD 诊所预约初始预约时,他们的平均等待时间明显更长。总体而言,SMI 患者同样有可能接受延迟的初始预约。虽然 VHA SMI 患者总体上不太可能延迟接受心理健康护理,但他们更有可能在五个治疗环境中的三个环境中出现延迟。研究结果表明,大多数 VHA SMI 患者的及时性相当,但那些有更复杂需求的患者,特别是那些有与创伤相关的护理需求的患者,可能更有可能出现治疗启动延迟。(PsycInfo 数据库记录(c)2022 APA,保留所有权利)。