Double whammy? Rural youth with serious emotional disturbance and the transition to adulthood.
Double whammy? Rural youth with serious emotional disturbance and the transition to adulthood.
复制标题
双重打击？
DOI：
10.1111/j.1748-0361.2009.00251.x
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Hoffman,Cheri
中科院分区：
文献类型：
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作者：
Heflinger,CraigAnne;Hoffman,Cheri
所有青年，特别是那些有严重情绪障碍（SED）的青年，在向成年过渡的过程中都面临着挑战。很少有人知道农村青年在风险的transition problems.PurposeTo研究过渡年龄的青年谁使用公共资助的服务在农村和城市/郊区的位置在田纳西州，以描述青年在风险的过渡困难谁需要政策和服务planning.MethodsUsing医疗补助登记和索赔/遭遇数据，青年在高风险的过渡困难被确定在以下群体：SED，处于寄养/州监管的风险或在寄养/州监管中，密集或频繁的精神卫生服务用户，或诊断为严重精神障碍，行为障碍，精神发育迟滞或物质使用。对生活在农村和城市/郊区县的青年在这些群体中的成员进行了比较。多变量回归被用来检查多组membership.FindingsRural青年相关的因素更有可能是在高风险的群体过渡到成年的问题，并参加医疗补助为无保险/不可保，相比，他们的城市同行。与多个风险组成员的最强因素是在国家监护/寄养和接受补充保障收入（SSI）.ConclusionsServices需要支持过渡到成年的青年在高风险的行为和调整问题。需要支持协调规划和问责制的系统，包括人口和服务数据以及过渡年龄青年的研究。
ContextAll youth, especially those with serious emotional disturbances (SED), face challenges as they transition to adulthood. Little is known about rural youth at risk for transition problems.PurposeTo examine transition‐age youth who use publicly funded services in rural and urban/suburban locations in Tennessee in order to describe youth at risk for transition difficulties who need policy and service planning.MethodsUsing Medicaid enrollment and claims/encounter data, youth at high risk for transition difficulties were identified in the following groups: SED, at risk of or in foster care/state custody, intensive or frequent mental health services users, or diagnosed with major mental disorders, behavior disorders, mental retardation, or substance use. Membership in these groups was compared between youth living in rural and urban/suburban counties. Multivariate regression was used to examine factors related to multiple group membership.FindingsRural youth were more likely to be in groups at high risk for problems transitioning to adulthood, and enrolled in Medicaid as uninsured/uninsurable, compared to their urban counterparts. The strongest factors associated with multiple risk group membership were being in state custody/foster care and receiving Supplemental Security Income (SSI).ConclusionsServices are needed to support the transition to adulthood for youth at high risk of behavioral and adjustment problems. Systems to support coordinated planning and accountability are needed, including data on populations and services, and research on transition‐age youth.