Philip R. Lee Institute for Health Policy Studies & Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
Public Health and Preventive Medicine Residency Program, California Department of Public Health, Berkeley, California.
Am J Prev Med. 2024 Nov;67(5):650-657. doi: 10.1016/j.amepre.2024.06.004. Epub 2024 Jun 12.
Youth experience significant mental health (MH) needs, and gender- and racially/ethnically-diverse youth are less likely than peers to receive care. School-based health centers (SBHCs) are a healthcare delivery model that may decrease disparities. This study examined the role of SBHCs in reducing disparities in MH care receipt among SBHC clients.
Data from electronic health records of 5,396 youth ages 12 to 21 years who visited 14 SBHCs in one California county from 2021 to 2023 were analyzed in 2023-2024 using multiple logistic regression to assess disparities in MH care receipt and depression screenings.
Receipt of MH care from SBHCs varied significantly by gender but not age, sexual orientation, or race/ethnicity. Compared to female clients, males had reduced odds (AOR: 0.50) and gender-diverse clients had higher odds (AOR: 2.70) of receiving MH care. For receipt of depression screenings, male clients had reduced odds (AOR: 0.86); Latino clients had higher odds than white clients (AOR: 1.80); and older adolescents and young adults had higher odds than younger adolescents (AORs: 1.44 and 1.45, respectively). Receipt of follow-up MH care after a positive depression result varied only by gender, with male clients having reduced odds (AOR: 0.63).
SBHCs may reach youth who are traditionally less likely to seek care in other settings, including racially/ethnically- and gender-diverse youth. As in other settings, engaging males in healthcare is an area for improvement. These findings help to demonstrate the potential of SBHCs for decreasing disparities in mental health care.
年轻人有很大的心理健康（MH）需求，而在性别、种族和民族方面多样化的年轻人比同龄人更不可能获得医疗服务。学校保健中心（SBHC）是一种医疗保健提供模式，可以减少差异。本研究探讨了 SBHC 在减少 SBHC 客户中 MH 护理接受方面的差异中的作用。
2023-2024 年，对 2021 年至 2023 年期间来自加利福尼亚县的 14 个 SBHC 就诊的 5396 名 12 至 21 岁的年轻人的电子健康记录数据进行了分析，使用多逻辑回归来评估 MH 护理接受和抑郁筛查方面的差异。
从 SBHC 获得 MH 护理的情况因性别而有显著差异，但与年龄、性取向或种族/民族无关。与女性客户相比，男性客户获得 MH 护理的可能性较低（AOR：0.50），性别多样化的客户获得 MH 护理的可能性较高（AOR：2.70）。对于接受抑郁筛查，男性客户获得的可能性较低（AOR：0.86）；拉丁裔客户比白人客户的可能性更高（AOR：1.80）；年龄较大的青少年和年轻人比年龄较小的青少年的可能性更高（AORs：1.44 和 1.45）。在阳性抑郁结果后接受后续 MH 护理的情况仅因性别而异，男性客户的可能性较低（AOR：0.63）。
SBHC 可能会接触到那些传统上不太可能在其他环境中寻求护理的年轻人，包括种族和民族多样化的年轻人和性别多样化的年轻人。与其他环境一样，让男性参与医疗保健是一个需要改进的领域。这些发现有助于证明 SBHC 在减少心理健康护理差异方面的潜力。
