How a stressed local public system copes with people in psychiatric crisis.
How a stressed local public system copes with people in psychiatric crisis.
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DOI：
10.1007/s11126-012-9245-z
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发表时间：
2013-06
影响因子：
3.5
通讯作者：
Blouin, Rachel
中科院分区：
文献类型：
--
作者：
Wells, Rebecca;La, Elizabeth Holdsworth;Morrissey, Joseph;Hall, Marissa;Lich, Kristen Hassmiller;Blouin, Rachel
为了加强公共心理健康安全网，我们必须首先了解这些系统在日常生活中是如何运作的。本研究探讨了如何在一个主要城市美国县的个人属性和组织的相互依赖性影响个人的需要在精神病危机的反应。我们采访了危机应对网络中的临床医生和管理人员，了解精神病住院治疗的直接风险，他们在危机期间发生了什么，以及影响所提供服务的因素（N = 94个人和9个机构）。社交网络图描绘了机构之间的转介模式。迭代编码的采访成绩单被用来语境化的社会网络的调查结果。各机构往往能将危机解决。然而，供应商也限制了他们服务的人群类型，使许多人处于危机之中。这项研究说明了如何属性的个人与精神疾病，服务提供者和他们的相互作用，以及国家和联邦政策相交，以塑造个人在精神病危机的轨迹。了解当前地方系统的结构及其背景可能有助于为我们社会中一些最脆弱的成员提供更人道和更强大的安全网。
In order to bolster the public mental health safety net, we must first understand how these systems function on a day-to-day basis. This study explored how individual attributes and organizational interdependencies within one predominantly urban US county affected responses to individuals’ needs during psychiatric crises. We interviewed clinicians and managers within the crisis response network about people at immediate risk of psychiatric hospitalization, what had happened to them during their crises, and factors affecting services provided (N = 94 individuals and 9 agencies). Social network diagrams depicted patterns of referrals between agencies. Iterative coding of interview transcripts was used to contextualize the social network findings. Often, agencies saw crises through to resolution. However, providers also limited the types of people they served, leaving many people in crisis in limbo. This study illustrates how attributes of individuals with mental illness, service providers and their interactions, and state and federal policies intersect to shape the trajectories of individuals during psychiatric crises. Understanding both the structures of current local systems and their contexts may support continued evolution toward a more humane and robust safety net for some of our society’s most vulnerable members.
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