Lawrence S. Bloomberg Faculty of Nursing, 7938University of Toronto, Toronto, ON, Canada.
7978Centre for Addiction and Mental Health, Toronto, ON, Canada.
Can J Psychiatry. 2022 Dec;67(12):928-938. doi: 10.1177/07067437221115947. Epub 2022 Aug 4.
Youth face numerous challenges in receiving coordinated and continuous mental health services, particularly as they reach the age of transition from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS). The Longitudinal Youth in Transition Study (LYiTS) follows youth prospectively as they cross this transition boundary to better understand their transition pathways and resulting symptoms and health service use outcomes. The current paper presents the baseline profile description for the LYiTS cohort and additionally examines differences in symptoms and functioning and health service utilization between youth receiving services at hospital- versus community-based CAMHS.
A cross-sectional design was used. A sample of 237 16-18-year-old youth recruited from outpatient CAMHS at two hospitals and two community sites completed self-report measures at their first of four annual assessments. A latent profile analysis was conducted to identify symptomology profiles, and youth were compared on symptoms and health service use between hospital- and community-based sites.
Four distinct symptomology profiles were identified (subclinical, moderate internalizing, moderate externalizing, and high symptomology). Symptom profiles and functioning levels reported by youth were no different across both types of organization, although there were differences detected in health service utilization, such as type of provider seen and use of medications.
These findings suggest that there is little difference in symptomology between youth accessing hospital versus community-based CAMHS. With growing interest in understanding the effectiveness and cost-effectiveness of different models of mental health care, these findings provide a new understanding of the clinical and service use profiles of transition-aged youth that will be explored further as this cohort is followed across the CAMHS to AMHS transition boundary.
年轻人在接受协调和连续的心理健康服务方面面临诸多挑战,尤其是在他们达到从儿童和青少年心理健康服务(CAMHS)过渡到成人心理健康服务(AMHS)的年龄时。纵向青年过渡研究(LYiTS)前瞻性地跟踪年轻人跨越这一过渡边界,以更好地了解他们的过渡途径以及由此产生的症状和健康服务使用结果。本文介绍了 LYiTS 队列的基线概况描述,并进一步研究了在医院和社区 CAMHS 接受服务的年轻人之间症状和功能以及卫生服务利用方面的差异。
采用横断面设计。从两家医院和两家社区的门诊 CAMHS 招募了 237 名 16-18 岁的年轻人,他们在四次年度评估中的第一次完成了自我报告测量。进行了潜在剖面分析以确定症状学特征,并比较了医院和社区CAMHS 之间的症状和健康服务利用情况。
确定了四个不同的症状学特征(亚临床、中度内在化、中度外在化和高症状学)。两种类型的组织之间,年轻人报告的症状特征和功能水平没有差异,但在卫生服务利用方面存在差异,例如所就诊的提供者类型和药物的使用。
这些发现表明,在接受医院与社区 CAMHS 服务的年轻人之间,症状学没有差异。随着人们越来越关注理解不同心理健康护理模式的有效性和成本效益,这些发现为理解过渡年龄段年轻人的临床和服务使用特征提供了新的认识,随着这一队列在跨越 CAMHS 到 AMHS 过渡边界的过程中被进一步跟踪,这些发现将得到进一步探讨。