South Western Sydney Local Health District (SWSLHD) NSW Health, Australia.
University of Canterbury, New Zealand.
J Am Acad Child Adolesc Psychiatry. 2023 Jan;62(1):8-11. doi: 10.1016/j.jaac.2022.06.016. Epub 2022 Aug 6.
Children and adolescents (young people) who experience maltreatment early in life and are subsequently placed in out-of-home care (OOHC) are specifically at risk for poor mental health outcomes. Although rates vary by survey and location, up to half of these young people have clinical-level mental health difficulties, and another 20% to 25% have difficulties approaching clinical significance. These difficulties are characterized by high symptom complexity and severity, and include maltreatment-related mental health symptoms. Many young people in OOHC are difficult to engage with and retain in treatment, compounded by a lack of specialized mental health services and a history of problematic social interactions with supports. They are often reluctant to seek help because of stigmatization and confidentiality concerns, limited opportunities for decision making, service inaccessibility, distrust of mental health services, and their perception that professionals do not understand their circumstances. We propose 6 clinical practice modifications for mental health services working with young people in OOHC to enhance therapeutic engagement and to maximize their therapeutic outcomes.
儿童和青少年（年轻人）在生命早期经历虐待，随后被安置在家庭外照料（OOHC）中，特别容易出现心理健康不良的后果。尽管调查和地点不同，高达一半的这些年轻人有临床水平的心理健康困难，另外 20%到 25%的人有接近临床意义的困难。这些困难的特点是症状复杂和严重程度高，包括与虐待有关的心理健康症状。许多 OOHC 中的年轻人难以参与和保留在治疗中，再加上缺乏专门的心理健康服务和与支持人员之间存在问题的社会互动历史。他们往往不愿意寻求帮助，因为担心污名化和保密性问题、决策机会有限、服务难以获得、对心理健康服务的不信任，以及他们认为专业人员不了解他们的情况。我们提出了 6 种针对 OOHC 中的年轻人的心理健康服务的临床实践修改，以增强治疗性接触并最大限度地提高他们的治疗效果。
