Dropping out of mental health treatment: Patterns and predictors among epidemiological survey respondents in the United States and Ontario
Dropping out of mental health treatment: Patterns and predictors among epidemiological survey respondents in the United States and Ontario
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DOI：
10.1176/appi.ajp.159.5.845
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发表时间：
2002-05-01
影响因子：
17.7
通讯作者：
Kessler, RC
中科院分区：
文献类型：
--
作者：
Edlund, MJ;Wang, PS;Kessler, RC
目的：作者采访了个人治疗的自我描述的精神健康问题，在前一年检查模式和预测与辍学的treatment.Method：主题是从受访者进行社区流行病学调查的代表性样本的美国和安大略人口。脱落者是指那些在前一年因症状改善以外的原因而离开精神卫生治疗的人。调查还评估了潜在的脱落相关因素：社会人口学特征、对精神卫生保健的态度、障碍类型、提供者类型和接受的治疗。美国（19.2%）和安大略（16.9%）之间的辍学率没有显着差异，两个样本之间的预测因素的影响也没有显着差异。与治疗退出相关的社会人口学特征包括低收入，年轻，以及在美国，缺乏精神健康治疗的保险。与辍学相关的患者态度包括认为心理健康治疗相对无效，以及对看到心理健康提供者感到尴尬。受访者接受药物治疗和谈话治疗是不太可能辍学比那些谁收到单一模态treatment.Conclusions：心理健康治疗辍学是一个严重的问题，特别是在低收入，年轻，缺乏保险的患者，只提供单一模态的治疗，并对心理健康护理的消极态度。需要针对这些群体采取具有成本效益的干预措施，以增加完成适当疗程的患者比例。
Objective: The authors interviewed individuals treated for self-described mental health problems in the preceding year to examine patterns and predictors associated with dropping out of treatment.Method: Subjects were drawn from respondents to community epidemiological surveys carried out in representative samples of the United States and Ontario populations. Dropouts were those who had left mental health treatment during the prior year for reasons other than symptom improvement, The surveys also assessed potential dropout correlates: sociodemographic characteristics, attitudes about mental health care, disorder type, provider type, and treatment received.Results: The proportion of dropouts did not significantly differ between the United States (19.2%) and Ontario (16.9%), nor did the effects of the predictors differ significantly between the two samples. Sociodemographic characteristics associated with treatment dropout included low income, young age, and, in the United States, lacking insurance coverage for mental health treatment. Patient attitudes associated with dropout included viewing mental health treatment as relatively ineffective and embarrassment about seeing a mental health provider. Respondents who received both medication and talk therapy were less likely to drop out than those who received single-modality treatments.Conclusions: Mental health treatment dropout is a serious problem, especially among patients who have low income, are young, lack insurance, are offered only single-modality treatments, and have negative attitudes about mental health care. Cost-effective interventions targeting these groups are needed to increase the proportion of patients who complete an adequate course of treatment.