Role of Referrals in Mental Health Service Disparities for Racial and Ethnic Minority Youth
Role of Referrals in Mental Health Service Disparities for Racial and Ethnic Minority Youth
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DOI：
10.1016/j.jaac.2012.05.005
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发表时间：
2012-07-01
影响因子：
13.3
通讯作者：
Kessler, Ronald C.
中科院分区：
文献类型：
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作者：
Alegria, Margarita;Lin, Julia Y.;Kessler, Ronald C.
目的：调查教师和其他成年人对父母寻求儿童精神问题治疗的认同和/或鼓励的种族/民族差异，并评估认同/鼓励是否与服务使用相关。方法：在国家合并症调查青少年补充资料中，获得了 6,112 名青少年（13-17 岁）的外在障碍（即注意力缺陷/多动障碍、对立违抗障碍和/或品行障碍）和内在障碍（即重性抑郁发作/心境恶劣和/或分离焦虑障碍）寻求治疗和所使用服务的数据。研究了拉丁裔、非拉丁裔黑人和非拉丁裔白人的种族/民族差异。结果：青少年认同/鼓励率以及认同/鼓励与服务使用的关系方面几乎没有种族/民族差异。与具有相同特征的非拉丁裔白人青年相比，只有患有轻度内化障碍的非拉丁裔黑人青年不太可能被识别/鼓励寻求服务（比值比 [OR] = 0.4，95% 置信区间 [CI] = [0.2-0.7]）。认同/鼓励增加了所有青少年寻求外化和内化疾病服务的可能性。然而，与非拉丁裔白人同行相比，在调整识别/鼓励、临床和社会人口学特征后，符合内化障碍标准的非拉丁裔黑人青年似乎不太可能使用任何服务（OR = 0.4，95%，CI = 0.2-0.7）。与非拉丁裔白人同行相比，患有内化障碍且没有认同/鼓励的非拉丁裔黑人青年使用特殊护理部门的可能性较小。结论：在这项针对具有全国代表性的青少年样本的研究中，几乎没有发现认同/鼓励方面存在民族/种族差异。然而，认同/鼓励可能会增加所有青少年对服务的使用。 J. Am.阿卡德。儿童青少年。精神病学，2012；51(7)：703-711。
Objective: To investigate racial/ethnic differences in teachers' and other adults' identification and/or encouragement of parents to seek treatment for psychiatric problems in their children and to evaluate if and whether identification/encouragement is associated with service use. Method: Data on identification/encouragement to seek treatment for externalizing disorders (i.e., attention-deficit/hyperactivity disorder, oppositional-defiant disorder, and/or conduct disorder) and internalizing disorders (i.e., major depressive episode/dysthymia and/or separation anxiety disorder) and services used were obtained for 6,112 adolescents (13-17 years of age) in the National Comorbidity Survey Adolescent Supplement. Racial/ethnic differences were examined for Latinos, non-Latino blacks, and non-Latino whites. Results: There were few racial/ethnic differences in rates of youth identification/encouragement and how identification/encouragement related to service use. Only non-Latino black youth with low severity internalizing disorders were less likely to be identified/encouraged to seek services compared with non-Latino white youth with the same characteristics (odds ratio [OR] = 0.4, 95% confidence interval [CI] = [0.2-0.7]). Identification/encouragement increased the likelihood of seeking services for externalizing and internalizing disorders for all youth. However, compared with their non-Latino white counterparts, non-Latino black youth who met criteria for internalizing disorders appeared less likely to have used any services (OR = 0.4, 95%, CI = 0.2-0.7), after adjusting for identification/encouragement, clinical, and sociodemographic characteristics. Non-Latino black youth with internalizing disorders and without identification/encouragement were less likely to use the specialty care sector than their non-Latino white counterparts. Conclusions: In this study of a nationally representative sample of adolescents, almost no ethnic/racial differences in identification/encouragement were found. However, identification/encouragement may increase service use for all youth. J. Am. Acad. Child Adolesc. Psychiatry, 2012;51(7):703-711.