Utilization of mental health and substance abuse services among homeless adults in Los Angeles
Utilization of mental health and substance abuse services among homeless adults in Los Angeles
复制标题
DOI：
10.1097/00005650-199903000-00010
复制
发表时间：
1999-03-01
期刊：
影响因子：
3
通讯作者：
Wenzel, S
中科院分区：
文献类型：
--
作者：
Koegel, P;Sullivan, G;Wenzel, S
目标.尽管精神疾病在无家可归者中的比例很高，但人们对无家可归者因这些问题接受治疗的程度或与接受治疗有关的因素知之甚少。本文探讨利用和预测的心理健康和物质滥用治疗之间的社区为基础的概率样本无家可归的成年人。本文分析的数据是通过与1，563名无家可归者的面对面访谈收集的。双变量分析研究了无家可归的男子和妇女在以下方面的差异：（1）主要精神疾病和物质依赖的患病率;（2）有具体诊断的人对住院和门诊治疗服务的利用率。Logistic回归分析确定了慢性精神疾病患者的心理健康治疗和近期物质依赖者的物质滥用治疗的预测因素。这些无家可归的成年人中有三分之二符合慢性物质依赖的标准，而22%符合慢性精神疾病的标准，这两种疾病之间存在大量重叠：77%的慢性精神疾病患者也是慢性物质滥用者。这两组中只有五分之一的人报告在过去60天内接受了这些疾病的治疗。心理健康服务利用率主要由与需求、诊断、承认心理健康问题相关的因素预测，而物质滥用服务利用率则由无数其他因素预测，部分反映了这些护理系统的组织和筹资方面的关键差异。必须更多地关注如何更好地向无家可归的成年人提供适当的心理健康和药物滥用服务。
OBJECTIVES. Even though psychiatric disorders are disproportionately present among the homeless, little is known about the extent to which homeless people receive treatment for those problems or the factors that are associated with receiving treatment. This article examines utilization and predictors of mental health and substance abuse treatment among a community-based probability sample of homeless adults.METHODS. The data analyzed here were collected through face-to-face interviews with 1,563 homeless individuals. Bivariate analyses examined differences between homeless men and women in (1) the prevalence of major mental illnesses and substance dependence and (2) utilization of inpatient and outpatient treatment services for those with specific diagnoses. Logistic regression analyses identified predictors of mental health treatment among those with chronic mental illness and substance abuse treatment among those with recent substance dependence.RESULTS. Two-thirds of these homeless adults met criteria for chronic substance dependence, whereas 22% met criteria for chronic mental illness, with substantial overlap between those two disorders: 77% of those with chronic mental illness were also chronic substance abusers. Only one-fifth of each of those two groups reported receiving treatment for those disorders within the last 60 days. Mental health service utilization was predicted largely by factors related to need leg, diagnosis, acknowledgment of a mental health problem), whereas substance abuse service utilization was predicted by myriad additional factors, reflecting, in part, critical differences in the organization and financing of these systems of care.CONCLUSIONS. More attention must be directed at how to better deliver appropriate mental health and substance abuse services to homeless adults.