Ethnic Differences in Referral Routes to Youth Mental Health Services
Ethnic Differences in Referral Routes to Youth Mental Health Services
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DOI：
10.1016/j.jaac.2018.07.906
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发表时间：
2019-03-01
影响因子：
13.3
通讯作者：
Patalay, Praveetha
中科院分区：
文献类型：
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作者：
Edbrooke-Childs, Julian;Patalay, Praveetha
目的：探讨青少年心理健康服务的转诊途径是否存在种族差异。方法：这是对在英国接受心理健康服务的 14,588 名年轻人（平均 [SD] 年龄 = 12.28 [3.75] 岁，54% 女性；64% 英国白人）定期收集的全国数据进行分析。种族由年轻人和护理人员自行报告，转诊路线由服务记录。结果：在考虑了服务水平差异并控制年龄、性别、问题类型和背景因素后，种族与转诊路线显着相关。与英国白人年轻人相比，黑人年轻人（比值比 [OR] = 2.90，95% CI = 2.07-4.06）和混血年轻人（OR = 2.66，95% CI = 1.91-3.72）通过社会关怀/青年司法转介的可能性是通过初级保健转介的两倍多。与英国白人年轻人相比，亚裔年轻人（OR = 1.85，95% CI = 1.34-2.54）通过社会关怀/青年司法转介的可能性几乎是通过初级保健转介的可能性的两倍。我们进行了敏感性分析，以检验在考虑服务区剥夺的情况下，转诊途径的种族差异是否会减弱，并且上述影响仅部分减弱。结论：英国青少年心理健康服务的转诊途径存在种族差异，来自少数族裔背景的年轻人更有可能通过不太可能是自愿的途径转诊。了解这些差异的原因对于减少不平等和改善获得精神卫生保健的途径至关重要。
Objective: To examine whether there are ethnic differences in referral route to youth mental health services.Method: This was an analysis of national, routinely collected data from 14,588 young people (mean [SD] age = 12.28 [3.75] years, 54% female; 64% white British) accessing mental health services in the United Kingdom. Ethnicity was self-reported by young people and carers, and referral route was recorded by services.Results: After accounting for service-level variation and controlling for age, sex, problem type, and contextual factors, ethnicity was significantly associated with referral route. Compared to white British young people, black young people (odds ratio [OR] = 2.90, 95% CI = 2.07-4.06) and mixed-race young people (OR = 2.66, 95% CI = 1.91-3.72) were more than twice as likely to be referred through social care/youth justice than through primary care. Compared to white British young people, Asian young people (OR = 1.85, 95% CI = 1.34-2.54) were almost twice as likely to be referred through social care/youth justice than through primary care. We conducted a sensitivity analysis to examine whether ethnic differences in referral route were attenuated when also accounting for service area deprivation, and the above effects were only partially attenuated.Conclusion: There are ethnic differences in referral route to youth mental health services in the United Kingdom, and young people from minority ethnic backgrounds are more likely to be referred through routes that are less likely to be voluntary. Understanding the reasons for these differences is critical for reducing inequalities and improving pathways to mental health care access.