Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Northwestern University Feinberg School of Medicine, Chicago, Illinois.
J Am Acad Child Adolesc Psychiatry. 2024 Apr;63(4):422-432. doi: 10.1016/j.jaac.2023.07.005. Epub 2023 Jul 27.
To examine: (1) if youth who have mental health disorders receive needed services after they leave detention-and as they age; and (2) inequities in service use, focusing on demographic characteristics and type of disorder.
We used data from the Northwestern Juvenile Project, a longitudinal study of 1,829 youth randomly sampled from detention in Chicago, Illinois in 1995. Participants were re-interviewed up to 13 times through 2015. Interviewers assessed disorders using structured diagnostic interviews and assessed service use using the Child and Adolescent Service Assessment and the Services Assessment for Children and Adolescents.
Less than 20% of youth who needed services received them, up to median age 32 years. Female participants with any disorder had nearly twice the odds of receiving services compared with male participants (OR: 1.82; 95% CI: 1.41, 2.35). Compared with Black participants with any disorder, non-Hispanic White and Hispanic participants had 2.14 (95% CI: 1.57, 2.90) and 1.50 (95% CI: 1.04, 2.15) times the odds of receiving services. People with a disorder were more likely to receive services during childhood (< age 18) than during adulthood (OR: 2.29; 95% CI: 1.32, 3.95). Disorder mattered: participants with an internalizing disorder had 2.26 times and 2.43 times the odds of receiving services compared with those with a substance use disorder (respectively, 95% CI: 1.26, 4.04; 95% CI: 1.49, 3.97).
Few youth who need services receive them as they age; inequities persist over time. We must implement evidence-based strategies to reduce barriers to services.
研究：（1）患有心理健康障碍的年轻人在离开拘留所后以及随着年龄增长是否获得了所需的服务；（2）服务利用方面的不平等，重点关注人口统计学特征和障碍类型。
我们使用了西北少年项目的数据，这是一项对 1995 年从伊利诺伊州芝加哥拘留中随机抽取的 1829 名青少年进行的纵向研究。参与者通过 2015 年的 13 次重新访谈。访谈者使用结构化诊断访谈评估障碍，并使用儿童和青少年服务评估和儿童和青少年服务评估评估服务使用情况。
不到 20%需要服务的年轻人获得了服务，直到中位数年龄 32 岁。与男性参与者相比，任何障碍的女性参与者获得服务的可能性几乎是男性参与者的两倍（OR：1.82；95% CI：1.41，2.35）。与任何障碍的黑人参与者相比，非西班牙裔白人和西班牙裔参与者获得服务的可能性分别为 2.14（95% CI：1.57，2.90）和 1.50（95% CI：1.04，2.15）倍。在童年（<18 岁）期间，有障碍的人比成年后（OR：2.29；95% CI：1.32，3.95）更有可能获得服务。障碍很重要：与物质使用障碍者相比，患有内化障碍的参与者获得服务的可能性分别高出 2.26 倍和 2.43 倍（分别为 95% CI：1.26，4.04；95% CI：1.49，3.97）。
随着年龄的增长，很少有需要服务的年轻人获得服务；随着时间的推移，不平等现象持续存在。我们必须实施基于证据的策略来减少服务障碍。
