Kaiser Permanente Medical Center, Oakland, California, and Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco (Hirschtritt); Mental Health America, Alexandria, Virginia (Howard); Kaiser Permanente Washington Health Research Institute, Seattle (Simon).
Psychiatr Serv. 2023 Aug 1;74(8):889-891. doi: 10.1176/appi.ps.20220503. Epub 2023 Jan 31.
Recent implementation of the nationwide 988 Suicide and Crisis Lifeline has expanded telephone-based mental health crisis services and created a unified framework for crisis care in the United States. However, the infrastructure for the final step of the crisis continuum-an appropriate mental health service for persons in crisis to receive the care they need-is fragmented, unevenly distributed, underfunded, and understudied. Given the few options for individuals in crisis, most often inpatient psychiatric hospitals are the default option. In this Open Forum, the authors describe the scope of the problem and propose how clinicians, policy makers, and researchers can improve the availability of evidence-based disposition options for individuals in crisis.
最近,全国范围内的 988 自杀和危机生命线的实施扩大了基于电话的心理健康危机服务,并为美国的危机护理建立了一个统一的框架。然而,危机连续体的最后一步的基础设施——为处于危机中的人提供他们所需的护理的适当心理健康服务——是分散的、不平衡的、资金不足的,并且研究不足。鉴于危机中的个人选择有限,大多数情况下,住院精神病院是默认选择。在这个论坛中,作者描述了问题的范围,并提出了临床医生、政策制定者和研究人员如何能够改善为处于危机中的个人提供基于证据的处置选择的可及性。