Organizational Capacity and Readiness to Provide Medication for Individuals with Co-Occurring Alcohol Use Disorders in Public Mental Health Settings.
Organizational Capacity and Readiness to Provide Medication for Individuals with Co-Occurring Alcohol Use Disorders in Public Mental Health Settings.
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DOI：
10.1007/s10488-020-01103-5
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Ober AJ
中科院分区：
文献类型：
--
作者：
Watkins KE;Hunter SB;Cohen CC;Leamon I;Hurley B;McCreary M;Ober AJ
精神疾病患者的酒精使用障碍（AUD）基本上没有得到治疗。本研究的目的是确定在组织能力和准备提供药物的AUD在门诊公共精神卫生诊所的差距。我们选择了一个有目的的样本，由洛杉矶县精神卫生部经营的八个公共资助的门诊精神卫生诊所;诊所的选择，以最大限度地提高异质性。在组织能力和准备理论以及在初级和专科护理治疗环境中采用药物治疗AUD的研究的指导下，我们与管理员，提供者和工作人员进行了半结构化访谈和焦点小组，并对结果进行了定性分析。受访者描述了为AUD提供药物治疗的重要组织能力和行为准备限制。这两个群体都表达了这样一种看法，即精神卫生诊所的设计并不是为了提供同时发生的AUD治疗，因为大量的病例、人员配置和时间限制不支持提供适当的治疗，以及缺乏协议和工作流程。我们记录了组织能力和准备的限制，阻碍了药物治疗的AUD在一个大型的精神卫生系统。虽然有些制约因素有直接的解决办法，但其他制约因素需要对提供护理的方式进行结构性改革，以及国家一级的资金和政策改革。
Alcohol use disorders (AUD) in individuals with mental illness are largely untreated. The purpose of this study was to identify gaps in organizational capacity and readiness to provide medications for AUD in outpatient public mental health clinics. We selected a purposive sample of eight publicly funded outpatient mental health clinics operated by the Los Angeles County Department of Mental Health; clinics were chosen to maximize heterogeneity. Guided by theories of organizational capacity and readiness and research on the adoption of pharmacotherapy for AUD in primary and specialty care treatment settings, we conducted semi-structured interviews and focus groups with administrators, providers and staff, and a qualitative analysis of the results. Respondents described significant organizational capacity and behavioral readiness constraints to providing medication treatment for AUD. Both groups articulated a perception that mental health clinics were not designed to provide co-occurring AUD treatment because of large caseloads, staffing configurations, and time constraints that did not support the delivery of appropriate treatment, and a lack of protocols and workflow procedures. We documented organizational capacity and readiness constraints which impede the delivery of medication treatment for AUD in a large mental health system. While some constraints have straightforward solutions, others require structural changes to the way care is delivered, and state-level funding and policy changes.
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影响因子：
1.9
作者：
Dickey, B;Dembling, B;Normand, SLT
通讯作者：
Normand, SLT
DOI：
10.1007/s11414-020-09706-4
发表时间：
2020-10
期刊：
The journal of behavioral health services & research
影响因子：
--
作者：
Jacobson N;Horst J;Wilcox-Warren L;Toy A;Knudsen HK;Brown R;Haram E;Madden L;Molfenter T
通讯作者：
Molfenter T
影响因子：
3.9
作者：
Ding, Kele;Yang, Jingzhen;Skinstad, Anne Helene
通讯作者：
Skinstad, Anne Helene
影响因子：
5.7
作者：
Holt, Daniel T.;Helfrich, Christian D.;Weiner, Bryan J.
通讯作者：
Weiner, Bryan J.
影响因子：
12.7
作者：
Guerrero, Erick G.;Aarons, Gregory A.;Palinkas, Lawrence A.
通讯作者：
Palinkas, Lawrence A.