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青少年住院及住院式治疗精神科床位:2010 - 2022年全国趋势及潜在因果因素

Youth Inpatient and Residential Treatment Psychiatric Beds: National Trends and Potential Causal Factors, 2010-2022.

作者信息

Ghose Sushmita Shoma, Beehler Sarah, Pinals Debra A, Crocker Laura, Hoey Tabitha, Masiakowski N Phil, Goldman Howard, Karakus Mustafa, Thomas Tison, Patel Nikhil A

机构信息

Westat, Rockville, Maryland (Ghose, Beehler, Crocker, Hoey, Masiakowski, Karakus); National Association of State Mental Health Program Directors Research Institute, Falls Church, Virginia, and Department of Psychiatry, University of Michigan, Ann Arbor (Pinals); Department of Psychiatry, University of Maryland, College Park (Goldman); Center for Mental Health Services (Thomas) and Office of the Assistant Secretary for Mental Health and Substance Use (Patel), Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, Maryland.

出版信息

Psychiatr Serv. 2025 Apr 1;76(4):343-349. doi: 10.1176/appi.ps.20240200. Epub 2025 Jan 30.

Abstract

OBJECTIVE

Youth inpatient and residential treatment psychiatric services are essential components of the continuum of care. Concern has grown about the diminished availability of these services and the increasing need for them. This study aimed to examine the number of youths treated at inpatient and residential psychiatric facilities over a 12-year period and to assess the perceptions of state mental health authorities (SMHAs) about the reasons for changes in availability.

METHODS

In this multimodal study, the authors conducted a secondary analysis of a national survey (including all 50 states, Washington, D.C., and Puerto Rico) of mental health facilities that was administered seven times between 2010 and 2022. In addition, the study relied on 2023 data from a survey of SMHAs (N=34 respondents).

RESULTS

Most states experienced a decline in the number of youths in inpatient (79%) and residential treatment psychiatric facilities (94%). Although some people posit that increased use of outpatient services may explain such declines, 81% of states had a reduction in community outpatient psychiatric care for youths during the study period. SMHAs reported that the impact of the COVID-19 pandemic and preexisting workforce shortages contributed to the reduction of youths treated.

CONCLUSIONS

These findings show a nationwide decline in the number of youths treated in inpatient and residential treatment psychiatric facilities over time. Determining causal factors in these declines is challenging, and it is critical to develop a monitoring and reporting system for the number of youths requiring services and the capacity within each state for addressing youth needs.

摘要

目的

青少年住院及住院式治疗精神科服务是连续护理体系的重要组成部分。人们越来越担心这些服务的可及性下降以及对其需求的不断增加。本研究旨在调查12年间在住院及住院式精神科设施接受治疗的青少年人数,并评估州精神卫生当局(SMHA)对服务可及性变化原因的看法。

方法

在这项多模式研究中,作者对2010年至2022年间进行了七次的全国精神卫生设施调查(包括所有50个州、华盛顿特区和波多黎各)进行了二次分析。此外,该研究还依赖于2023年对州精神卫生当局的调查数据(N = 34名受访者)。

结果

大多数州的青少年在住院精神科设施(79%)和住院式治疗精神科设施(94%)的人数有所下降。尽管有些人认为门诊服务使用增加可能解释了这种下降,但在研究期间,81%的州青少年社区门诊精神科护理有所减少。州精神卫生当局报告称,新冠疫情的影响和先前存在的劳动力短缺导致接受治疗的青少年人数减少。

结论

这些发现表明,随着时间的推移,全国范围内在住院及住院式治疗精神科设施接受治疗的青少年人数有所下降。确定这些下降的因果因素具有挑战性,为需要服务的青少年人数以及每个州满足青少年需求的能力建立监测和报告系统至关重要。

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