A unique model of care for youth in crisis: A pilot open trial.
A unique model of care for youth in crisis: A pilot open trial.
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照顾危机中青少年的独特模式：试点公开试验。
DOI：
10.1037/ser0000778
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发表时间：
2023
影响因子：
2.3
通讯作者：
McCauley,Elizabeth
中科院分区：
文献类型：
--
作者：
Adrian,Molly;Twohy,Eileen;Babeva,Kalina;Jenness,Jessica;Gurtovenko,Kyrill;Blossom,JenB;King,Sophie;McCartney,Leah;McCauley,Elizabeth
自杀是美国10-24岁人群的第二大死因，由于年轻人的自残思想和行为(SITB)而去急诊科就诊的人数在2016至2021年间大幅增加。尽管急诊服务对于有效的护理系统至关重要，但急诊设置通常不太适合对自杀危机中的青少年所需的SITB、治疗规划和护理协调进行全面、协作和治疗评估。因此，门诊精神病学需要一种旨在提供全面危机分诊和干预服务的精神卫生紧急护理模式。这项试点试验考察了一种简短的紧急护理模式--行为健康危机护理诊所(CCC)的可行性、可接受性和初步临床结果，该模式旨在提供全面的门诊分诊和干预服务，旨在降低处于危机中的青年的自杀风险。参与者是189名有自杀想法或行为的年轻人(10-20岁；62.4%女性；58%高加索人)和他们的照顾者。结果表明，CCC模型超过了基于服务满意度量表(M Score>；3.00)的可行性和可接受性基准。根据自杀倾向自杀状态协作性评估和管理表格，CCC护理与自我报告的自杀风险显著降低相关，在CCC护理期间(7.7%)和治疗后1个月(11.8%)使用ED的水平较低。在转诊时尚未建立门诊护理的患者中，超过88%的患者在CCC治疗期间与护理有关，几乎所有患者(95%)在结束CCC护理1个月后继续进行持续的心理健康护理。
Suicide is the second leading cause of death for those ages 10–24 years in the United States, and emergency department (ED) visits due to youth self-injurious thoughts and behaviors (SITB) and increased substantially between 2016 and 2021. Although ED services are essential for an effective system of care, the ED setting is typically not well-suited for the comprehensive, collaborative, and therapeutic evaluation of SITB; treatment planning; and care coordination that youth in a suicidal crisis need. As a result, an urgent care model for mental health designed to provide comprehensive crisis triage and intervention services is needed within outpatient psychiatry. This pilot trial examined the feasibility, acceptability, and preliminary clinical outcomes of a brief, urgent care model, the Behavioral Health Crisis Care Clinic (CCC), designed to provide comprehensive outpatient triage and intervention services aimed at reducing suicide risk for youth in crisis. Participants were 189 youth (ages 10–20; 62.4% females; 58% Caucasian) who had past-week suicidal ideation or behavior and their caregivers. The results demonstrated the CCC model exceeded feasibility and acceptability benchmarks based on the Service Satisfaction Scale (M score> 3.00). CCC care was associated with significant decreases in self-reported suicide risk based on the Collaborative Assessment and Management of Suicidality Suicide Status Form with low levels of ED usage during CCC care (7.7%) and 1-month posttreatment (11.8%). Over 88% of patients without established outpatient care at the time of referral were connected to care during CCC treatment, almost all of whom (95%) continued with ongoing mental health care 1 month after ending CCC care.