Predictors of Outpatient Mental Health Service Use by American Youth.
Predictors of Outpatient Mental Health Service Use by American Youth.
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DOI：
10.1037/1541-1559.5.3.251
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发表时间：
2008-08-01
影响因子：
2.3
通讯作者：
Rely, Kely
中科院分区：
文献类型：
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作者：
Alexandre, Pierre Kebreau;Stephens, Robbin M;Rely, Kely
在1至17岁的美国儿童和青少年中，12至17岁的青少年是门诊心理健康服务的最大用户。本研究利用了2005年全国药物使用和健康调查中该年龄组的全国代表性样本，阐明了三种治疗环境中服务使用的预测因素：日间治疗计划，心理健康诊所/中心和私人/家庭环境。单变量分析用于计算在这些环境中使用精神卫生服务的研究样本的百分比。在双变量分析中，作者估计了可用的易感因素、需求因素和促成因素与结果之间的关联强度。多元逻辑回归估计每个协变量对结果的独立影响。终生抑郁、终生焦虑、违法行为、药物依赖和医疗补助是三种治疗环境中服务使用的一致预测因素。在双变量分析中，其他几个因素与服务使用相关，但当作者调整其他混杂因素时，这些因素失去了大部分统计学意义。鉴于其潜在的局限性，本研究具有重要的研究和政策意义。
Among American children and adolescents aged 1 to 17 years, the 12- to 17-year-olds represent the largest users of outpatient mental health services. This study utilizes a nationally representative sample of this age group from the 2005 National Survey on Drug Use and Health to illuminate predictors of services use from three treatment settings: day treatment programs, mental health clinics/centers, and private/in-home settings. Univariate analyses were used to calculate the percentages of the study sample that used mental health services in these settings. In bivariate analyses, the authors estimated the strength of the associations between available predisposing, need, and enabling factors and the outcomes. Multiple logistic regressions estimated the independent effects of each covariate on the outcomes. Lifetime depression, lifetime general anxiety, delinquent behaviors, drug dependence, and Medicaid were consistent predictors of services use in the three treatment settings. Several other factors were associated with services use in bivariate analyses but lost most of their statistical significance when the authors adjusted for other confounders. Interpreted in light of its potential limitations, this study has important research and policy significance.