Disruption of existing mental health treatments and failure to initiate new treatment after Hurricane Katrina.
Disruption of existing mental health treatments and failure to initiate new treatment after Hurricane Katrina.
复制标题
卡特里娜飓风过后，现有的心理健康治疗受到干扰，并且未能启动新的治疗。
DOI：
10.1176/appi.ajp.2007.07030502
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发表时间：
2008
期刊：
影响因子：
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通讯作者：
Kessler,RonaldC
中科院分区：
文献类型：
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作者：
Wang,PhilipS;Gruber,MichaelJ;Powers,RichardE;Schoenbaum,Michael;Speier,AnthonyH;Wells,KennethB;Kessler,RonaldC
作者调查了卡特里娜飓风过后，既往精神障碍患者正在进行的治疗中断以及新发精神障碍患者未能启动治疗的情况。方法2006年1月至3月，1,043名讲英语的成年卡特里娜飓风幸存者接受电话调查。这项调查评估了既往精神障碍患者和飓风后新发精神障碍患者在飓风后对情绪问题和治疗障碍的治疗情况。结果在飓风前一年报告使用精神卫生服务的既往精神障碍患者中，22.9%的人在卡特里娜飓风后减少或终止治疗。在那些没有先前存在的精神障碍的受访者中，在飓风过后出现新发障碍的人中，18.5%的人接受了某种形式的情绪问题治疗。在先前存在的病例中未能继续治疗的原因主要是治疗的结构性障碍，而在新发病例中未能寻求治疗的原因主要是人们对治疗的需求较低。在卡特里娜飓风后接受治疗的受访者中，大多数(64.5%)接受了普通医疗提供者的治疗，接受了药物治疗，但没有接受心理治疗。新发病例的治疗与年龄和收入呈正相关，而既往病例的持续治疗与种族/民族(非西班牙裔白人)和是否有医疗保险呈正相关。结论许多患有精神障碍的卡特里娜飓风幸存者经历了未得到满足的治疗需求，包括现有护理的频繁中断和对新发疾病的普遍未能启动治疗。未来的灾害管理计划应预见到这两种类型的治疗需求。
ObjectiveThe authors examined the disruption of ongoing treatments among individuals with preexisting mental disorders and the failure to initiate treatment among individuals with new-onset mental disorders in the aftermath of Hurricane Katrina.MethodsEnglish-speaking adult Katrina survivors (N=1,043) responded to a telephone survey administered between January and March of 2006. The survey assessed posthurricane treatment of emotional problems and barriers to treatment among respondents with preexisting mental disorders as well as those with new-onset disorders posthurricane.ResultsAmong respondents with preexisting mental disorders who reported using mental health services in the year before the hurricane, 22.9% experienced reduction in or termination of treatment after Katrina. Among those respondents without preexisting mental disorders who developed new-onset disorders after the hurricane, 18.5% received some form of treatment for emotional problems. Reasons for failing to continue treatment among preexisting cases primarily involved structural barriers to treatment, while reasons for failing to seek treatment among new-onset cases primarily involved low perceived need for treatment. The majority (64.5%) of respondents receiving treatment post-Katrina were treated by general medical providers and received medication but no psychotherapy. Treatment of new-onset cases was positively related to age and income, while continued treatment of preexisting cases was positively related to race/ethnicity (non-Hispanic whites) and having health insurance.ConclusionsMany Hurricane Katrina survivors with mental disorders experienced unmet treatment needs, including frequent disruptions of existing care and widespread failure to initiate treatment for new-onset disorders. Future disaster management plans should anticipate both types of treatment needs.