Segal S P, Silverman C, Temkin T
Center for Self-Help Research, Berkeley, CA 94612, USA.
Psychiatr Serv. 1995 Mar;46(3):269-74. doi: 10.1176/ps.46.3.269.
This study examined the characteristics of long-term members of self-help agencies managed and staffed by mental health clients, why they sought help from the agencies, and how they differed from clients of community mental health agencies.
A survey and assessment instruments were used to obtain information on the service utilization of 310 long-term agency members as well as on their resources, history of disability, functional status, psychological disability, health problems, and DSM-III-R diagnosis. Data from management information systems of the self-help and community mental health agencies were used to compare service populations.
The self-help agencies served a primarily African-American population (64 percent), many of whom were homeless (46 percent). Eighty-seven percent had confirmed DSM-III-R diagnoses, and 50 percent had dual diagnoses with moderate to severe substance or alcohol abuse or dependence. They had sought help from the self-help agencies primarily for resources such as food or clothing, for "a place to be," or because they were homeless. Obtaining counseling or help for substance or alcohol abuse was a less important reason for coming to the self-help agencies.
A high proportion of the persons served by the self-help agencies in the study were homeless and had a dual diagnosis of mental disorder and substance abuse. The self-help agencies provided their clients with material resources while community mental health agencies provided psychotherapeutic and medical care.
本研究调查了由心理健康服务对象管理并配备工作人员的自助机构长期成员的特征、他们寻求该机构帮助的原因,以及他们与社区心理健康机构服务对象的差异。
采用一项调查和评估工具,获取310名长期机构成员的服务利用情况、资源、残疾史、功能状态、心理残疾、健康问题及DSM-III-R诊断等信息。利用自助机构和社区心理健康机构管理信息系统中的数据对服务人群进行比较。
自助机构服务的主要是非洲裔美国人(64%),其中许多人无家可归(46%)。87%的人确诊患有DSM-III-R诊断的疾病,50%的人同时患有中度至重度药物或酒精滥用或依赖双重诊断。他们主要因食物或衣物等资源、“有个容身之所”或因无家可归而向自助机构寻求帮助。寻求药物或酒精滥用方面的咨询或帮助并非他们求助于自助机构的重要原因。
本研究中自助机构服务的对象很大一部分无家可归,且患有精神障碍和药物滥用双重诊断。自助机构为其服务对象提供物质资源,而社区心理健康机构提供心理治疗和医疗护理。