Sullivan G, Jackson C A, Spritzer K L
Social Policy Department, Rand Corporation, Santa Monica, California 90407, USA.
Psychiatr Serv. 1996 Jan;47(1):57-61. doi: 10.1176/ps.47.1.57.
Data from a cross-sectional survey of 210 current or former inpatients at Mississippi State Hospital and 197 informants, usually patients' family members, were used to compare the demographic, clinical, and service use characteristics of patients living in rural areas with those of patients living in nonrural areas.
All subjects completed structured face-to-face interviews. Information on recent use of community mental health center (CMHC) services was obtained from CMHC records. Characteristics of rural patients (N = 107) and nonrural patients (N = 103) were compared using chi square and t tests.
Rural patients were less likely to have completed high school and more likely to be living with family members. Although rural and nonrural subjects were clinically similar, rural subjects were less likely to have received certain community mental health services such as case management and day treatment and were more likely to have used physical health services and to have been involved with the criminal justice system.
Differences between rural and nonrural patients in patterns of service use are most likely a reflection of less availability or accessibility of mental health services in rural areas, resulting in spillover into physical health and criminal justice sectors. Rural community mental health centers need to formally incorporate families, local medical providers, and law enforcement officials into their network of care.
对密西西比州立医院的210名现住院患者或曾住院患者以及197名信息提供者（通常为患者家属）进行横断面调查，以比较农村地区患者与非农村地区患者的人口统计学、临床和服务使用特征。
所有受试者均完成结构化面对面访谈。社区心理健康中心（CMHC）服务近期使用情况的信息来自CMHC记录。使用卡方检验和t检验比较农村患者（N = 107）和非农村患者（N = 103）的特征。
农村患者完成高中学业的可能性较小，与家人同住的可能性较大。尽管农村和非农村受试者在临床上相似，但农村受试者接受某些社区心理健康服务（如病例管理和日间治疗）的可能性较小，使用身体健康服务以及涉及刑事司法系统的可能性较大。
农村和非农村患者在服务使用模式上的差异很可能反映出农村地区心理健康服务的可获得性或可及性较低，从而导致向身体健康和刑事司法部门的溢出。农村社区心理健康中心需要将家庭、当地医疗服务提供者和执法官员正式纳入其护理网络。
