Department of Health Policy and Management, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis (all authors); Center for Biomedical Informatics, Regenstrief Institute, Indianapolis (Vest).
Psychiatr Serv. 2023 Sep 1;74(9):929-935. doi: 10.1176/appi.ps.20220427. Epub 2023 Mar 6.
The authors aimed to examine adoption of behavioral health crisis care (BHCC) services included in the Substance Abuse and Mental Health Services Administration's (SAMHSA's) best practices guidelines.
Secondary data from SAMHSA's Behavioral Health Treatment Services Locator in 2022 were used. BHCC best practices were measured on a summated scale capturing whether a mental health treatment facility (N=9,385) adopted BHCC best practices, including provision of these services to all age groups: emergency psychiatric walk-in services, crisis intervention teams, onsite stabilization, mobile or offsite crisis responses, suicide prevention, and peer support. Descriptive statistics were used to examine organizational characteristics (such as facility operation, type, geographic area, license, and payment methods) of mental health treatment facilities nationwide, and a map was created to show locations of best practices BHCC facilities. Logistic regressions were performed to identify facilities' organizational characteristics associated with adopting BHCC best practices.
Only 6.0% (N=564) of mental health treatment facilities fully adopted BHCC best practices. Suicide prevention was the most common BHCC service, offered by 69.8% (N=6,554) of the facilities. A mobile or offsite crisis response service was the least common, adopted by 22.4% (N=2,101). Higher odds of adopting BHCC best practices were significantly associated with public ownership (adjusted OR [AOR]=1.95), accepting self-pay (AOR=3.18), accepting Medicare (AOR=2.68), and receiving any grant funding (AOR=2.45).
Despite SAMHSA guidelines recommending comprehensive BHCC services, a fraction of facilities have fully adopted BHCC best practices. Efforts are needed to facilitate widespread uptake of BHCC best practices nationwide.
作者旨在研究《物质滥用和心理健康服务管理局(SAMHSA)最佳实践指南》中包含的行为健康危机护理(BHCC)服务的采用情况。
使用了 2022 年 SAMHSA 的行为健康治疗服务定位器中的二次数据。BHCC 最佳实践是通过一个总和量表来衡量的,该量表捕捉了心理健康治疗机构(N=9385)是否采用了 BHCC 最佳实践,包括向所有年龄段提供这些服务:紧急精神病门诊服务、危机干预小组、现场稳定、移动或现场外危机应对、自杀预防和同伴支持。使用描述性统计数据来检查全国范围内心理健康治疗机构的组织特征(如机构运营、类型、地理区域、许可证和支付方式),并创建了一个地图来显示最佳实践 BHCC 设施的位置。进行逻辑回归以确定与采用 BHCC 最佳实践相关的设施组织特征。
只有 6.0%(N=564)的心理健康治疗机构完全采用了 BHCC 最佳实践。自杀预防是最常见的 BHCC 服务,69.8%(N=6554)的机构提供了这种服务。移动或现场外危机应对服务是最不常见的,只有 22.4%(N=2101)的机构采用了这种服务。采用 BHCC 最佳实践的可能性显著较高,与公有制(调整后的比值比 [AOR]=1.95)、接受自付费用(AOR=3.18)、接受医疗保险(AOR=2.68)和获得任何赠款资金(AOR=2.45)有关。
尽管 SAMHSA 指南建议全面采用 BHCC 服务,但只有少数机构完全采用了 BHCC 最佳实践。需要努力促进全国范围内广泛采用 BHCC 最佳实践。