Department of Psychology, University of California.
Department of Psychology, University of Maryland.
J Clin Child Adolesc Psychol. 2023 May-Jun;52(3):360-375. doi: 10.1080/15374416.2022.2127103. Epub 2022 Nov 30.
Youth psychiatric emergencies have increased at alarming rates, and disproportionately so for youth of color. Outpatient follow-up care is critical for positive youth outcomes, but rates of follow-up remain low, especially for racial/ethnic minoritized youth. Mobile crisis response can initiate care connection. The current study (1) describes the population who received mobile crisis response (MCR) within the nation's largest county public mental health system, (2) assesses rates of follow-up outpatient services after MCR, and (3) examines racial/ethnic disparities in outpatient services and correlates of receipt of therapy dose (≥8 sessions).
Administrative claims for MCR and outpatient services for youth ages 0 to 18 were abstracted from the Los Angeles County Department of Mental Health.
From October 2016-2019, 20,782 youth received a MCR, 52.5% of youth were female, and youth mean age was 13.41 years. The majority of youth (91.8%) received some outpatient services after their first MCR. However, only 56.7% of youth received ≥1 therapy session. In a logistic regression, youth age, gender, race/ethnicity, primary language, primary diagnosis, insurance status, MCR call location, and MCR disposition significantly predicted receipt of ≥8 therapy sessions.
Findings highlight disparities in therapy receipt for Asian American Pacific Islander, Black, and White youth (relative to Latinx youth), older youth, youth whose MCR was initiated from a police station call, and youth whose MCR did not result in hospitalization. We discuss priorities for quality improvement for MCR processes and strategies to promote linkage to care to achieve mental health equity.
青年精神科急诊数量以惊人的速度增长，尤其是少数族裔青年的比例更高。门诊后续护理对青年的积极结果至关重要，但后续护理的比例仍然很低，尤其是对少数族裔青年。移动危机干预可以启动护理联系。本研究（1）描述了在全国最大的县公共心理健康系统中接受移动危机干预（MCR）的人群，（2）评估了 MCR 后门诊服务的随访率，以及（3）考察了门诊服务中的种族/民族差异，以及接受治疗剂量（≥8 次）的相关性。
从洛杉矶县心理健康部提取了 0 至 18 岁青少年 MCR 和门诊服务的行政索赔数据。
从 2016 年 10 月至 2019 年，20782 名青少年接受了 MCR，其中 52.5%的青少年为女性，平均年龄为 13.41 岁。大多数青少年（91.8%）在首次 MCR 后接受了一些门诊服务。然而，只有 56.7%的青少年接受了≥1 次治疗。在逻辑回归中，青少年的年龄、性别、种族/民族、主要语言、主要诊断、保险状况、MCR 呼叫地点和 MCR 处置方式显著预测了接受≥8 次治疗的可能性。
研究结果突出了在接受治疗方面的差异，包括亚洲裔、非裔和白人（相对于拉丁裔）青少年、年龄较大的青少年、MCR 是从警察局呼叫开始的青少年、以及 MCR 没有导致住院的青少年。我们讨论了 MCR 流程质量改进的优先事项和促进护理联系的策略，以实现精神健康公平。
