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设有围产期项目的物质使用障碍和精神健康障碍治疗机构的特点。

Characteristics of substance use disorder and mental health disorder treatment facilities with perinatal programs.

作者信息

Lombardi Brooke N, Parisi Anna B, Newton Helen, Lombardi Brianna M

机构信息

Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd., CB# 7590, Chapel Hill, NC 27516, United States of America; School of Social Work, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd., CB# 7590, Chapel Hill, NC 27516, United States of America.

Department of Social Work, George Mason University, 4400 University Drive, MSN IF8, Fairfax, VA 22030, United States of America.

出版信息

J Subst Use Addict Treat. 2025 Sep;176:209722. doi: 10.1016/j.josat.2025.209722. Epub 2025 May 29.

Abstract

BACKGROUND

Substance use disorders (SUD) and mental health disorders (MHD) are major health concerns during the perinatal period (conception to one year postpartum). However, many individuals with perinatal SUD or MHD do not receive adequate treatment, and most treatment facilities do not offer services tailored to this population's unique needs. This study examines the proportion of treatment facilities in the United States (US) providing perinatal services, as well as facility- and state-level factors associated with offering such services.

METHODS

Data were drawn from the 2022 National Substance Use and Mental Health Services Survey, an annual cross-sectional survey of all known public and private SUD and MHD treatment facilities in the US. The sample consisted of 6995 facilities providing SUD treatment (SUD-only) and 9134 facilities offering combined SUD and MHD treatment. Descriptive statistics, bivariate analyses, and multilevel logistic regression models examined treatment facility characteristics and the impact of facility- and state-level factors on the likelihood of offering perinatal services.

RESULTS

Only 32.7% of SUD-only treatment facilities and 31.1% of combined SUD/MHD treatment facilities offered perinatal programs. More than half of these treatment facilities provided services critical to the perinatal population, including transportation assistance, social service support, trauma-informed therapy, and telehealth. Payment type (i.e., Medicaid acceptance, offer of free or low-cost treatment), for-profit treatment facility ownership, and receipt of state and federal grant funding were associated with a significantly increased likelihood of the treatment facility providing perinatal services.

CONCLUSIONS

Findings indicate there is a pressing need for SUD and MHD treatment facilities to expand their services to include care for individuals in the perinatal period, as well as increase the availability of essential services (e.g., integrated primary care) and ancillary services (e.g., childcare). Further research is needed to understand at which timepoint(s) facilities provide treatment (i.e., pregnancy and/or the postpartum period) and which types of essential and ancillary services are most beneficial during the perinatal period.

摘要

背景

物质使用障碍(SUD)和精神健康障碍(MHD)是围产期(从受孕到产后一年)主要的健康问题。然而,许多患有围产期SUD或MHD的个体未得到充分治疗,并且大多数治疗机构并未提供针对该人群独特需求的服务。本研究调查了美国提供围产期服务的治疗机构的比例,以及与提供此类服务相关的机构和州层面的因素。

方法

数据取自2022年全国物质使用和精神健康服务调查,这是一项对美国所有已知的公立和私立SUD及MHD治疗机构进行的年度横断面调查。样本包括6995家提供SUD治疗(仅SUD)的机构和9134家提供SUD与MHD联合治疗的机构。描述性统计、双变量分析和多级逻辑回归模型用于研究治疗机构的特征以及机构和州层面因素对提供围产期服务可能性的影响。

结果

仅32.7%的仅SUD治疗机构和31.1%的SUD/MHD联合治疗机构提供围产期项目。这些治疗机构中超过一半提供了对围产期人群至关重要的服务,包括交通援助、社会服务支持、创伤知情疗法和远程医疗。支付类型(即接受医疗补助、提供免费或低成本治疗)、营利性治疗机构所有权以及获得州和联邦拨款资金与治疗机构提供围产期服务的可能性显著增加相关。

结论

研究结果表明,SUD和MHD治疗机构迫切需要扩大其服务范围,将围产期个体的护理纳入其中,并增加基本服务(如综合初级保健)和辅助服务(如儿童保育)的可及性。需要进一步研究以了解机构在哪个时间点提供治疗(即孕期和/或产后时期),以及在围产期哪些类型的基本和辅助服务最为有益。

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