Department of Social Work & Sociology, North Carolina Agricultural & Technical State University, Greensboro, NC, USA.
School of Social Work, University of Central Florida, Orlando, FL, USA.
J Racial Ethn Health Disparities. 2023 Oct;10(5):2231-2243. doi: 10.1007/s40615-022-01402-7. Epub 2022 Sep 13.
The aim of this study is to examine service utilization disparities among Black youth participating in Linking Individuals Needing Care (LINC), a 90-day research-informed suicide care coordination intervention.
An open trial pilot was conducted to examine the effectiveness of LINC in increasing access to and engagement in mental health and non-mental health services among suicidal youth (N = 587). Other variables of interest included service use facilitators and service use barriers. Generalized linear mixed models with binomial distribution and logit link were performed to ascertain if service use facilitators and barriers were associated with service utilization and if disparities in service use and engagement existed between Black and White suicidal youth through a comparative analysis.
Service utilization differences were found between Black and White youth. While Black and White youth were both likely to engage in individual therapy (OR = 1.398, p < .001) and non-mental health services (OR = 1.289, p < .001), utilization rates for mental health and medication management services were lower for Black (55.1% to 60.6%) youth compared to White (66.0% to 71.0%) youth. Specifically, Black youth were significantly less likely than Whites to receive medication management (OR = .466, p = .002). Systemic barriers such long waitlists for care (OR = 1.860, p = .039) and poor relationship with providers (OR = 7.680, p = .028) increased odds of engagement in non-mental health services. Clinical disorders and engagement in suicide-related behaviors increased the likelihood of obtaining care from both medication management and non-mental health services.
Care coordination services for suicidal youth can increase access and engagement in mental health and non-mental health services. Culturally adapted models attending to cultural and social assets of Black families are needed to reduce disparities and suicide risk among Black youth.
本研究旨在考察参与 Linking Individuals Needing Care（LINC）的黑人群体中的青少年在服务利用方面的差异，LINC 是一项为期 90 天的以研究为基础的自杀护理协调干预措施。
开展了一项开放性试验性研究，以考察 LINC 在增加有自杀倾向的年轻人（N=587）获得和参与心理健康和非心理健康服务方面的有效性。其他感兴趣的变量包括服务利用的促进因素和障碍。采用二项分布和对数链接的广义线性混合模型，以确定服务利用促进因素和障碍是否与服务利用相关，以及通过比较分析，黑人和白人自杀青少年之间是否存在服务利用和参与的差异。
发现黑人和白人青少年之间存在服务利用差异。尽管黑人和白人青少年都更有可能接受个体治疗（OR=1.398，p<.001）和非心理健康服务（OR=1.289，p<.001），但接受心理健康和药物管理服务的黑人（55.1%至 60.6%）青少年的比例低于白人（66.0%至 71.0%）青少年。具体而言，黑人青少年接受药物管理的可能性明显低于白人（OR=0.466，p=0.002）。系统障碍，如护理等待时间长（OR=1.860，p=0.039）和与提供者的关系不佳（OR=7.680，p=0.028），增加了接受非心理健康服务的几率。临床障碍和参与自杀相关行为增加了获得药物管理和非心理健康服务的可能性。
为有自杀倾向的青少年提供护理协调服务可以增加获得和参与心理健康和非心理健康服务的机会。需要针对黑人家庭的文化和社会资产进行文化适应性模型，以减少黑人群体中的差异和自杀风险。
