Armbruster P, Schwab-Stone M E
Child Study Center, Yale University School of Medicine, New Haven, CT 06520.
Hosp Community Psychiatry. 1994 Aug;45(8):804-8. doi: 10.1176/ps.45.8.804.
This study examined the characteristics of families who dropped out and families who maintained contact with a children's psychiatric outpatient clinic through various phases of intake and treatment.
One year after intake, the authors examined the status of all patients (N = 555) who had sought treatment at an urban, university-affiliated children's psychiatric outpatient clinic over a two-year period and had completed the intake process. Factors associated with dropout were identified at four points in the clinic process: during intake, during evaluation, at completion of evaluation, and during treatment.
Urban residence, minority status, single-parent status, and Medicaid status were related to dropout at intake and during evaluation but not at subsequent clinic phases. Nonminority, two-parent, suburban families of higher socioeconomic status were more likely to drop out at the completion of the evaluation.
These results indicate that factors associated with attrition vary with the clinic phase. Further investigations of the clinical course of minority children and families involved with children's mental health services are necessary to understand the needs of this population and to design interventions such as increasing minority staff and providing training in multi-cultural competence.
本研究考察了那些退出治疗的家庭以及那些在儿童精神科门诊接受治疗的各个阶段（包括 intake 和治疗阶段）都保持联系的家庭的特征。
在 intake 一年后，作者考察了在两年时间里到一所城市的、隶属于大学的儿童精神科门诊寻求治疗并完成 intake 流程的所有患者（N = 555）的状况。在门诊治疗过程中的四个时间点确定与退出治疗相关的因素：intake 期间、评估期间、评估结束时以及治疗期间。
城市居住、少数族裔身份、单亲身份以及医疗补助状态与 intake 期间和评估期间的退出治疗有关，但在后续门诊阶段则无关。社会经济地位较高的非少数族裔、双亲、郊区家庭在评估结束时更有可能退出治疗。
这些结果表明，与治疗中断相关的因素因门诊阶段而异。有必要对涉及儿童心理健康服务的少数族裔儿童及其家庭的临床过程进行进一步调查，以了解这一人群的需求，并设计干预措施，如增加少数族裔工作人员以及提供多元文化能力方面的培训。
