Acceptance of New Clients by Mental Health Clinicians in Massachusetts: Findings From a Representative Survey.
Acceptance of New Clients by Mental Health Clinicians in Massachusetts: Findings From a Representative Survey.
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马萨诸塞州心理健康临床医生对新客户的接受程度：代表性调查的结果。
DOI：
10.1176/appi.ps.201900072
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发表时间：
2020
影响因子：
3.8
通讯作者：
Lauren E. W. Olsho
中科院分区：
文献类型：
--
作者：
S. McClellan;J. Sirkin;Sue Pfefferle;Meaghan Hunt;Lauren E. W. Olsho
目标
目的是评估马萨诸塞州有执照的心理健康临床医生接受的新客户数量以及与接受的新客户相关的临床医生特征。
方法
有关客户获得门诊精神卫生保健服务的调查是针对在马萨诸塞州执业的 2,250 名有执照的精神卫生临床医生（精神科医生、心理学家、有执照的社会工作者、有执照的独立临床社会工作者、有执照的心理健康咨询师以及有执照的婚姻和家庭治疗师）的分层随机样本进行的。该调查于 2016 年 9 月至 2017 年 3 月期间进行，采用邮件调查、网页推送设计和电话跟进的方式进行。最终调整后的响应率为 28% (N=413)。结果经过加权以反映抽样设计和无应答情况，并代表马萨诸塞州所有持证心理健康临床医生。
结果
平均而言，临床医生每月接受七名新客户。尽管大多数临床医生报告每月接受一名或多名新客户，但有一半临床医生报告每月接受四名或更少的新客户。在调整其他因素后，分析显示，与个体私人诊所的临床医生相比，医院或卫生系统拥有的诊所的临床医生平均每月多接受 8 个新客户（p<0.05）。据报告，私人团体诊所的临床医生平均每月比单独私人诊所的临床医生多接受两名新客户（p<0.05）。每周工作时间少于 30 小时以及在当前职位任职超过 1 年与接受新客户呈负相关。
结论
新客户的接受程度因实践环境而异，但不因临床医生的类型而异。这些发现可以为精神卫生系统和劳动力规划提供信息，以改善获得精神卫生服务的机会。
OBJECTIVE
The objective was to assess the number of new clients accepted by licensed mental health clinicians in Massachusetts and clinician characteristics associated with new clients accepted.
METHODS
Surveys about client access to outpatient mental health care were sent to a stratified random sample of 2,250 licensed mental health clinicians (psychiatrists, psychologists, licensed certified social workers, licensed independent clinical social workers, licensed mental health counselors, and licensed marriage and family therapists) practicing in Massachusetts. The survey was administered from September 2016 to March 2017 by using a mail survey with a push-to-Web design and telephone follow-up. The final adjusted response rate was 28% (N=413). Results were weighted to reflect the sampling design and for nonresponse and are representative of all licensed mental health clinicians in Massachusetts.
RESULTS
On average, clinicians accepted seven new clients per month. Although most clinicians reported accepting one or more new clients per month, half reported accepting four or fewer new clients per month. After adjustment for other factors, the analysis showed that clinicians in practices owned by hospitals or health systems reported accepting eight more new clients per month, on average, than clinicians in solo private practices (p<0.05). Clinicians in private group practices reported accepting two more new clients per month on average than clinicians in solo private practices (p<0.05). Working fewer than 30 hours per week and tenure of more than 1 year in one's current position were negatively associated with acceptance of new clients.
CONCLUSIONS
New client acceptance varied by practice setting but not by type of clinician. These findings can inform mental health system and workforce planning to improve access to mental health services.