Rosen B M
Med Care. 1977 Aug;15(8):647-61.
Because of the difficulty of measuring mental health status and the lack of systematic and longitudinal data reflecting economic status and mental health, and arbitrary definition is used for this paper: changes in the accessibility to and utilization of psychiatric services by the poor compared with that of the nonpoor will be interpreted as changes in mental health status. Patterns of utilization of mental health facilities in the United States and in Monroe County, New York, by economic variables and/or by race, for periods spanning the Great Society programs, are descirbed. In addition, the location and availability of services provided by community mental health centers since their development are examined. Although these data indicate increased accessibility to facilities by the poor, there continue to be differences in the ways different economic groups use psychiatric facilities. In addition to a discussion of the implications of the findings for service delivery, definitional limitations are cited and additional information needed for making any judgements totward planning future mental health programs are explored.
由于衡量心理健康状况存在困难，且缺乏反映经济状况和心理健康的系统纵向数据，本文采用了一种任意定义：将贫困人群与非贫困人群相比，在精神科服务可及性和利用方面的变化解释为心理健康状况的变化。描述了在美国和纽约门罗县，在“伟大社会”计划实施期间，按经济变量和/或种族划分的心理健康设施利用模式。此外，还研究了社区心理健康中心自发展以来所提供服务的地点和可及性。尽管这些数据表明贫困人群对设施的可及性有所提高，但不同经济群体在使用精神科设施的方式上仍存在差异。除了讨论这些发现对服务提供的影响外，还列举了定义上的局限性，并探讨了为规划未来心理健康项目做出任何判断所需的额外信息。
