Gadermann Anne, Gagné Petteni Monique, Magee Carly, Janus Magdalena, Georgiades Katholiki, Sassi Roberto, Guhn Martin, Puyat Joseph H
Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
Centre for Advancing Health Outcomes, Providence Health Care Research Institute, Vancouver, British Columbia, Canada.
Can J Psychiatry. 2025 Sep 26:7067437251372189. doi: 10.1177/07067437251372189.
ObjectiveUnderstanding differences in outpatient care before and after mental health hospitalization for adolescents from diverse backgrounds is critical to ensuring effective and responsive care. The objective of the current study was to examine outpatient mental health care in the two years before and 30 days after a mental health hospitalization for adolescents from immigrant, refugee and non-immigrant backgrounds.MethodThis retrospective, population-based cohort study, conducted in British Columbia (BC), Canada, analyzed linked health service utilization data (practitioner billings, hospitalizations) and migration records to track outpatient care before and after mental health hospitalization. The study included adolescents (ages 10-18) with an unscheduled/urgent mental health hospitalization between January 1, 2008 and December 31, 2016 (n = 5,314) from a cohort of adolescents in 10 of the largest school districts in BC (between 1996 and 2016). The main analyses examined outpatient mental health visits (e.g., general practitioner/psychiatrist) (i) in the two years before hospitalization and (ii) in the 30 days after discharge. Sub-analyses focused on outpatient visits with psychiatrists.ResultsOverall, 30.4% had no outpatient mental health visit in the two years before hospitalization and 45.1% had none in the 30 days following discharge. First-generation immigrants and refugees and second-generation immigrant adolescents were significantly less likely than non-immigrants to have had an outpatient mental health visit in the two years before mental health hospitalization (aOR = 0.79, 95% CI, 0.63 to 0.98; aOR = 0.75, 95% CI, 0.61 to 0.93; aOR = 0.40, 95% CI, 0.26 to 0.64). Second-generation immigrant adolescents were significantly more likely than non-immigrants to have had any outpatient mental health visit in the 30 days following hospitalization (aOR = 1.34, 95% CI, 1.09 to 1.65).ConclusionsResults suggest outpatient care before and after mental health hospitalizations is limited for many adolescents in BC and differed by migration background. Implications for meeting standards of care are discussed.
目的
了解不同背景青少年心理健康住院前后门诊护理的差异，对于确保提供有效且有针对性的护理至关重要。本研究的目的是调查来自移民、难民和非移民背景的青少年在心理健康住院前两年及住院后30天的门诊心理健康护理情况。
方法
这项基于人群的回顾性队列研究在加拿大不列颠哥伦比亚省（BC）开展，分析了相关的卫生服务利用数据（从业者计费、住院情况）和移民记录，以追踪心理健康住院前后的门诊护理情况。该研究纳入了2008年1月1日至2016年12月31日期间在BC省10个最大学区（1996年至2016年）的青少年队列中因计划外/紧急心理健康状况住院的青少年（年龄10 - 18岁）（n = 5314）。主要分析考察了（i）住院前两年以及（ii）出院后30天内的门诊心理健康就诊情况（如全科医生/精神科医生）。亚组分析聚焦于精神科医生的门诊就诊情况。
结果
总体而言，30.4%的青少年在住院前两年没有门诊心理健康就诊记录，45.1%的青少年在出院后30天内没有此类记录。第一代移民和难民以及第二代移民青少年在心理健康住院前两年进行门诊心理健康就诊的可能性显著低于非移民青少年（校正比值比[aOR]=0.79，95%置信区间[CI]，0.63至0.98；aOR = 0.75，95% CI，0.61至0.93；aOR = 0.40，95% CI，0.26至0.64）。第二代移民青少年在住院后30天内进行任何门诊心理健康就诊的可能性显著高于非移民青少年（aOR = 1.34，95% CI，1.09至1.65）。
结论
结果表明，BC省许多青少年心理健康住院前后的门诊护理有限，且因移民背景而异。文中讨论了其对达到护理标准的影响。
