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初级综合医疗与专科心理健康服务的障碍:拉丁裔和非拉丁裔白人初级医疗患者的观点

Barriers to integrated primary care and specialty mental health services: Perspectives from Latinx and non-Latinx White primary care patients.

作者信息

Anastasia Elizabeth A, Guzman Linda E, Bridges Ana J

机构信息

Department of Psychological Science, University of Arkansas.

出版信息

Psychol Serv. 2023;20(Suppl 1):48-63. doi: 10.1037/ser0000639. Epub 2022 Mar 24.

DOI:10.1037/ser0000639
PMID:35324233
Abstract

Significant disparities in access to mental health care exist in the current mental health system; integrated primary care (IPC) offers an alternative model of service delivery with initial evidence for reducing disparities. Little is known about whether, and how, IPC reduces barriers to mental health services. Here we report on a set of three studies using mixed methodology to explore the perceptions of potential recipients of care regarding barriers to accessing mental health treatment by setting (IPC or specialty mental health [SMH]) and ethnicity (Latinx or non-Latinx White). In Study 1, a main effect of setting indicated IPC patients perceived fewer barriers to accessing IPC than SMH. A setting by ethnicity interaction revealed Latinx patients perceived greater barriers to SMH than non-Latinx White patients. In Study 2, data from qualitative interviews suggested IPC patients found behavioral health treatment in IPC to be accessible and satisfactory. In Study 3, a non-treatment-seeking sample did not endorse a difference in barriers by setting or ethnicity. Overall, it appears IPC patients perceive behavioral health treatment delivered in primary care to be satisfactory, beneficial, and successful in reaching individuals with mental health need who otherwise may not receive care. Non-treatment-seeking individuals with lower psychiatric distress did not identify a difference in barriers between IPC and SMH settings. Findings are consistent with the potential of the IPC setting for reducing barriers to care, although key elements of IPC may need to be addressed to increase acceptability across all population subgroups. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

摘要

当前的心理健康系统在获得心理健康护理方面存在显著差异;综合初级保健(IPC)提供了一种替代的服务提供模式,初步证据表明其可减少差异。关于IPC是否以及如何减少心理健康服务障碍,人们知之甚少。在此,我们报告三项研究,采用混合方法,以探讨潜在护理接受者对通过机构类型(IPC或专科心理健康[SMH])和种族(拉丁裔或非拉丁裔白人)获得心理健康治疗的障碍的看法。在研究1中,机构类型的主效应表明,IPC患者认为获得IPC服务的障碍比SMH患者少。机构类型与种族的交互作用显示,拉丁裔患者认为获得SMH服务的障碍比非拉丁裔白人患者更大。在研究2中,定性访谈的数据表明,IPC患者认为在IPC中接受行为健康治疗是可及且令人满意的。在研究3中,一个非寻求治疗的样本并未认可机构类型或种族在障碍方面存在差异。总体而言,IPC患者似乎认为在初级保健中提供的行为健康治疗是令人满意、有益的,并且成功地惠及了有心理健康需求但可能无法获得护理的个体。精神痛苦较低的非寻求治疗个体并未发现IPC和SMH机构在障碍方面存在差异。研究结果与IPC机构在减少护理障碍方面的潜力一致,尽管可能需要解决IPC的关键要素,以提高在所有人群亚组中的可接受性。(PsycInfo数据库记录(c)2024美国心理学会,保留所有权利)

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BMC Public Health. 2024 Nov 8;24(1):3091. doi: 10.1186/s12889-024-20533-6.