College of Nursing, Washington State University, Spokane, Washington.
College of Nursing, University of South Carolina, Columbia, South Carolina.
Am J Prev Med. 2023 Jan;64(1):1-8. doi: 10.1016/j.amepre.2022.09.003. Epub 2022 Oct 22.
The purpose of this study was to examine geographic variation in the availability of and barriers to school-based mental health services.
A weighted, nationally representative sample of U.S. public schools from the 2017-2018 School Survey on Crime and Safety was used. Schools reported the provision of diagnostic mental health assessments and/or treatment as well as factors that limited the provision of mental health services. Availability of mental health services and factors limiting service provision were examined across rurality, adjusting for school enrollment and grade level. The analysis was conducted in December 2021.
Half (51.2%) of schools reported providing mental health assessments, and 38.3% reported providing treatment. After adjusting for enrollment and grade level, rural schools were 19% less likely, town schools were 21% less likely, and suburban schools were 11% less likely to report providing mental health assessments than city schools. Only suburban schools were less likely than city schools to provide mental health treatment (incidence rate ratio=0.85; 95% CI=0.72, 1.00). Factors limiting the provision of services included inadequate access to professionals (70.9%) and inadequate funding (77.0%), which were most common among rural schools.
Significant inequities in school-based mental health services exist outside of urban areas.
本研究旨在探讨学校心理健康服务的可及性和障碍的地域差异。
使用了来自 2017-2018 年学校犯罪和安全调查的美国公立学校加权全国代表性样本。学校报告了提供诊断性心理健康评估和/或治疗的情况，以及限制心理健康服务提供的因素。在调整了入学人数和年级水平后，研究了心理健康服务的可用性以及限制服务提供的因素在农村地区的情况。分析于 2021 年 12 月进行。
一半（51.2%）的学校报告提供心理健康评估，38.3%的学校报告提供治疗。在调整了入学人数和年级水平后，农村学校提供心理健康评估的可能性比城市学校低 19%，城镇学校低 21%，郊区学校低 11%。只有郊区学校比城市学校更不可能提供心理健康治疗（发病率比=0.85；95%置信区间=0.72,1.00）。限制服务提供的因素包括专业人员的服务不足（70.9%）和资金不足（77.0%），这在农村学校最为常见。
城市地区以外的学校心理健康服务存在显著的不平等。
