Attitudes, Practices, and Barriers to Adolescent Suicide and Mental Health Screening
Attitudes, Practices, and Barriers to Adolescent Suicide and Mental Health Screening
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青少年自杀和心理健康筛查的态度、做法和障碍
DOI：
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发表时间：
2012
影响因子：
3.6
通讯作者：
Susan Schrand
中科院分区：
文献类型：
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作者：
G. Diamond;Alana O'Malley;Matthew Wintersteen;Sherry Peters;Suzanne Yunghans;Virginia Biddle;Connell O'Brien;Susan Schrand
目的：确定初级保健提供者对青少年自杀和精神健康问题的筛查率以及促进或阻碍这种做法的因素。患者和方法：总体而言，671名医疗专业人员（即儿科医生，家庭医生，执业护士，医生助理）完成了电子调查。这53个项目的重点是（1）态度，知识和舒适与一般的心理和自杀筛查和（2）目前的做法和障碍，有关筛查和转介到行为健康服务。结果：40%的患者在过去一年中有过自杀企图，7.7%的患者有6次或6次以上的自杀企图。在良好的访问中，67%的人进行了心理健康筛查，35.2%的人进行了自杀风险筛查。大多数（61.1%）初级保健提供者很少筛查自杀或只有当它被指示。只有14.2%的初级保健提供者经常使用标准化的自杀筛查工具。与筛查相关的因素包括了解自杀风险、女性、在城市环境中工作以及有过自杀患者。只有3.0%的人报告这些做法得到了足够的补偿，44%的人同意初级保健提供者经常使用身体健康账单代码进行行为健康服务。近90%的人说，如果青少年要坚持转介到心理健康服务机构，父母的参与是必要的。只有21%的人在转诊后经常从行为健康提供者那里得到反馈。结论：促进初级保健提供者心理健康教育的政策，为心理健康筛查提供报销，并鼓励更好的服务整合，可以增加自杀筛查，节省医疗费用和患者的生命。
Objective: To determine primary care providers’ rates of screening for suicide and mental health problems in adolescents and the factors that promote or discourage this practice. Patients and Methods: Overall, 671 medical professionals (ie, pediatricians, family physicians, nurse practitioners, physician assistants) completed an electronic survey. The 53 items focused on (1) attitudes, knowledge, and comfort with general psychosocial and suicide screening and (2) current practices and barriers regarding screening and referrals to behavioral health services. Results: Forty percent had a patient attempt suicide in the past year, and 7.7% had 6 or more patients attempt suicide. At a well visit, 67% screened for mental health, and 35.2% screened for suicide risk. Most (61.1%) primary care providers rarely screened for suicide or only when it was indicated. Only 14.2% of primary care providers often used a standardized suicide screening tool. Factors associated with screening were being knowledgeable about suicide risk, being female, working in an urban setting, and having had a suicidal patient. Only 3.0% reported adequate compensation for these practices, and 44% agreed that primary care providers frequently use physical health billing codes for behavioral health services. Nearly 90% said parent involvement was needed if adolescents were to follow through with referrals to mental health services. Only 21% frequently heard back from the behavioral health providers after a referral was made. Conclusion: Policy that promotes mental health education for primary care providers, provides reimbursement for mental health screening, and encourages better service integration could increase suicide screening and save healthcare costs and patients’ lives.