儿童心理健康服务使用中的人口统计学因素。
Demographic factors in the use of children's mental health services.
作者信息
Cohen P, Hesselbart C S
机构信息
New York State Psychiatric Institute, NY 10032.
出版信息
Am J Public Health. 1993 Jan;83(1):49-52. doi: 10.2105/ajph.83.1.49.
OBJECTIVES
This study was designed to (1) determine mental health service use by children of varying age, sex, socioeconomic status, and urbanicity of residence; (2) compare the prevalence of mental disorder in children in these groups; and (3) determine the extent to which differences in service use are consonant with the prevalence differences.
METHODS
Data on psychiatric diagnoses and service use were taken from a random longitudinal sample of 760 children. Information was gathered by interviews of mothers and of youth aged 12 to 21.
RESULTS
Significant lags in mental health service use were found for youth 18 to 21 years of age, for those living in rural and semirural areas, and for those in middle-income families. To some extent, these service use differences paralleled differences in diagnostic rates. However, when diagnostic differences were controlled, the same patterns of service use inequalities were present.
CONCLUSIONS
Mental health service use rates for youth vary by age, urbanicity, and family income. The underservice of middle-income and rural children may reasonably be ascribed to access problems; we explore explanations for the underservice of older youth.
目的
本研究旨在（1）确定不同年龄、性别、社会经济地位和居住城市程度的儿童对心理健康服务的使用情况；（2）比较这些群体中儿童精神障碍的患病率；（3）确定服务使用差异在多大程度上与患病率差异相一致。
方法
关于精神疾病诊断和服务使用的数据取自760名儿童的随机纵向样本。通过对母亲以及12至21岁青少年的访谈收集信息。
结果
发现18至21岁的青少年、生活在农村和半农村地区的青少年以及中等收入家庭的青少年在心理健康服务使用方面存在显著滞后。在某种程度上，这些服务使用差异与诊断率差异相似。然而，当控制诊断差异时，相同的服务使用不平等模式依然存在。
结论
青少年心理健康服务使用率因年龄、城市程度和家庭收入而异。中等收入和农村儿童服务不足可能合理地归因于获得服务的问题；我们探讨了年龄较大青少年服务不足的原因。
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