Mental health service use among Hurricane Katrina survivors in the eight months after the disaster
Mental health service use among Hurricane Katrina survivors in the eight months after the disaster
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DOI：
10.1176/appi.ps.58.11.1403
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发表时间：
2007-11-01
影响因子：
3.8
通讯作者：
Kessler, Ronald C.
中科院分区：
文献类型：
--
作者：
Wang, Philip S.;Gruber, Michael J.;Kessler, Ronald C.
目的：本研究调查了卡特里娜飓风的成年幸存者使用心理健康服务的情况，以提高对灾害对精神障碍患者影响的认识。研究方法：2006年1月19日至3月31日，对1,043名18岁及以上的流离失所和非流离失所的讲英语的卡特里娜飓风幸存者进行了一次具有地域代表性的电话调查。使用K6非特异性心理困扰量表确定在过去30天内报告严重和轻中度情绪和焦虑障碍的幸存者以及没有此类障碍的幸存者。服务的使用、系统部门和治疗以及不寻求治疗或辍学的原因都被记录下来。研究了使用服务与辍学的相关性。结果：估计有31%的受访者（N= 319）在采访时有情绪或焦虑障碍的证据。在这些人中，只有32%的人在灾难发生后使用过任何心理健康服务，其中包括46%的严重疾病患者。在使用服务的人中，60%已经停止使用服务。普通医疗部门和药物治疗是最常用的，尽管心理健康专业部门和心理治疗发挥了重要作用，特别是对患有严重疾病的受访者而言。许多处理的强度和频率较低。治疗不足是最大的受访者谁是年轻，老年人，从未结婚，种族或少数民族群体的成员，没有保险，和中等手段。结构、财政和态度障碍是得不到护理的常见原因。结论：很少有精神障碍的卡特里娜飓风幸存者得到充分的照顾;未来的救灾工作将需要及时提供服务，以解决幸存者面临的障碍。
Objective: This study examined use of mental health services among adult survivors of Hurricane Katrina in order to improve understanding of the impact of disasters on persons with mental disorders. Methods: A geographically representative telephone survey was conducted between January 19 and March 31, 2006, with 1,043 displaced and nondisplaced English-speaking Katrina survivors aged 18 and older. Survivors who reported serious and mild-moderate mood and anxiety disorders in the past 30 days and those with no such disorders were identified by using the K6 scale of nonspecific psychological distress. Use of services, system sectors, and treatments and reasons for not seeking treatment or dropping out were recorded. Correlates of using services and dropping out were examined. Results: An estimated 31% of respondents (N= 319) had evidence of a mood or anxiety disorder at the time of the interview. Among these only 32% had used any mental health services since the disaster, including 46% of those with serious disorders. Of those who used services, 60% had stopped using them. The general medical sector and pharmacotherapy were most commonly used, although the mental health specialty sector and psychotherapy played important roles, especially for respondents with serious disorders. Many treatments were of low intensity and frequency. Undertreatment was greatest among respondents who were younger, older, never married, members of racial or ethnic minority groups, uninsured, and of moderate means. Structural, financial, and attitudinal barriers were frequent reasons for not obtaining care. Conclusions: Few Katrina survivors with mental disorders received adequate care; future disaster responses will require timely provision of services to address the barriers faced by survivors.