Mental Health Service Use in Schools and Non-School-Based Outpatient Settings: Comparing Predictors of Service Use.
Mental Health Service Use in Schools and Non-School-Based Outpatient Settings: Comparing Predictors of Service Use.
复制标题
DOI：
10.1007/s12310-015-9146-z
复制
发表时间：
2015-09-01
影响因子：
2.6
通讯作者：
Hough RL
中科院分区：
文献类型：
--
作者：
Langer DA;Wood JJ;Wood PA;Garland AF;Landsverk J;Hough RL
研究人员一直在记录大量符合精神健康障碍标准并伴有重大相关损害的美国青年与接受服务的相对较少的青年之间的差距。以学校为基础的精神卫生保健可以通过向有需要的青年更公平地提供服务来解决需求-服务差距，而不考虑家庭经济资源、交通工具的可用性以及其他可能阻碍获得社区诊所的因素。然而，仅靠诊断并不能完全反映个人心理健康状况和对服务需求的严重程度。只研究与诊断有关的服务使用可能会限制我们对服务使用反映服务需求的程度的理解，并抑制我们比较学校和非学校为基础的门诊设置对服务需求的响应的能力。本研究评估了在学校和社区环境中对在两个公共护理部门中有活跃病例的青年使用精神卫生服务的预测因素，将根据经验得出的青年精神卫生服务需求和损害评级的维度测量与非需要变量(例如种族、收入)进行了比较。确定了青少年心理健康服务需求的三个维度。心理健康服务需求变量和非需求变量对心理健康服务需求均有显著的预测作用。父母评估的损害是基于需求的跨设置服务使用的最强预测因素。不需要变量的影响因服务环境而异，父母收入对校本服务的影响尤为显著。随着时间的推移，以前的服务使用和损害都显著地预测了未来的服务使用。
Researchers have consistently documented a gap between the large number of US youth meeting criteria for a mental health disorder with significant associated impairment, and the comparatively few youth receiving services. School-based mental health care may address the need–services gap by offering services more equitably to youth in need, irrespective of family economic resources, availability of transportation, and other factors that can impede access to community clinics. However, diagnoses alone do not fully capture the severity of an individual's mental health status and need for services. Studying service use only in relation to diagnoses may restrict our understanding of the degree to which service use is reflective of service need, and inhibit our ability to compare school and non-school-based outpatient settings on their responsiveness to service need. The present study evaluated predictors of mental health service use in school- and community-based settings for youth who had had an active case in one of two public sectors of care, comparing empirically-derived dimensional measurements of youth mental health service need and impairment ratings against non-need variables (e.g., ethnicity, income). Three dimensions of youth mental health service need were identified. Mental health service need and non-need variables each played a significant predictive role. Parent-rated impairment was the strongest need-based predictor of service use across settings. The impact of non-need variables varied by service setting, with parental income having a particularly noticeable effect on school-based services. Across time, preceding service use and impairment each significantly predicted future service use.