Mental health services use among school-aged children with disabilities: The role of sociodemographics, functional limitations, family burdens, and care coordination
Mental health services use among school-aged children with disabilities: The role of sociodemographics, functional limitations, family burdens, and care coordination
复制标题
DOI：
10.1111/j.1475-6773.2003.00187.x
复制
发表时间：
2003-12-01
影响因子：
3.4
通讯作者：
Riley, AW
中科院分区：
文献类型：
--
作者：
Witt, WP;Kasper, JD;Riley, AW
Objective.研究6 - 17岁社区残疾儿童心理健康服务的使用情况和接受服务的相关因素。数据来自1994年和1995年国家健康访谈调查残疾补充（NHIS-D），由国家健康统计中心进行。研究样本为4，939名残疾儿童，代表全国约800万残疾儿童。16岁以下儿童的父母报告（17岁的自我报告）的健康，情绪和行为问题，心理健康服务的使用，以及谁，如果有人，协调儿童的医疗保健。在心理社会适应能力差的残疾儿童中（11.5%），只有41.8%在过去一年接受了心理健康服务。多变量logistic回归分析显示，服务使用与不良的心理社会适应;沟通，社会和学习相关的功能障碍;公共医疗保险;和家庭经济负担。年幼和黑人残疾儿童接受心理健康服务的可能性较小。服务使用的几率更大的参与卫生专业人员在协调护理，相比之下，没有人或家庭。此外，如果残疾儿童的护理由家庭成员和卫生专业人员共同协调，则他们更有可能使用门诊心理健康服务，而不是卫生专业人员单独工作。与住院和门诊治疗相比，种族和家庭负担与特殊教育学校心理健康咨询的可能性无关。研究结果表明，只有五分之二的残疾儿童与穷人的心理社会调整接受心理健康服务。年龄、种族和保险覆盖范围的差异表明，存在获得机会的不平等。然而，在学校环境中，残疾儿童获得心理健康服务的一些障碍可能会减少。研究还表明，卫生专业人员参与护理协调与残疾儿童获得更多精神卫生保健有关。这些发现强调了在护理过程中让医疗保健专业人员和家庭参与的重要性。
Objective. To examine the use of mental health services and correlates of receiving services among community-dwelling children with disabilities, ages 6 to 17 years.Study Design. Data are from the 1994 and 1995 National Health Interview Survey Disability Supplements (NHIS-D), conducted by the National Center for Health Statistics. The study sample is 4,939 children with disabilities, representing an estimated eight million children with disabilities nationwide. Parents of children under 16 years of age reported (17-year-olds self-reported) on health, emotional and behavioral problems, mental health services use, and who, if anyone, coordinated the child's health care.Principal Findings. Among disabled children with poor psychosocial adjustment (11.5 percent), only 41.8 percent received mental health services in the past year. Multivariate logistic regression analysis showed service use was associated with poor psychosocial adjustment; communication, social, and learning-related functional impairments; public health insurance; and financial family burdens. Younger and black disabled children were less likely to receive mental health services. The odds of service use were greater with the involvement of a health professional in coordinating care, in contrast to no one or family only. Moreover, children with disabilities were more likely to use outpatient mental health services if their care was jointly coordinated by a family member and a health professional, compared to a health professional working alone. In contrast to inpatient and outpatient care, race and family burden were not associated with the likelihood of mental health counseling in special education school settings.Conclusions. Findings indicate that only two in five disabled children with poor psychosocial adjustment receive mental health services. Differences by age, race, and insurance coverage suggest that inequalities to access exist. However, the school setting may be one in which some barriers to mental health services for disabled children are reduced. The study also shows that the involvement of health professionals in care coordination is associated with greater access to mental health care for disabled children. These findings underscore the importance of engaging both health care professionals and the family in the care process.