Impact of the COVID-19 Pandemic on Child and Adolescent Mental Health Policy and Practice Implementation.
Impact of the COVID-19 Pandemic on Child and Adolescent Mental Health Policy and Practice Implementation.
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DOI：
10.3390/ijerph18189622
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发表时间：
2021-09-13
影响因子：
--
通讯作者：
Hoagwood KE
中科院分区：
文献类型：
--
作者：
Palinkas LA;De Leon J;Salinas E;Chu S;Hunter K;Marshall TM;Tadehara E;Strnad CM;Purtle J;Horwitz SM;McKay MM;Hoagwood KE
背景资料：2019年冠状病毒大流行对全球数百万人心理健康的影响已被充分记录，但其对预防和治疗心理和行为健康状况的影响尚不清楚。2019冠状病毒病大流行也为在与常规护理根本不同的条件下实施医疗保健政策和计划带来了许多挑战和机遇。方法：我们进行了一项定性研究，以确定COVID-19大流行对州精神卫生当局（SMHA）实施循证政策和实践的影响为预防和治疗儿童和青少年的心理健康问题。半结构化的访谈进行了29 SMHA代表随机选择的21个国家分层的冠状病毒阳性率和未满足的服务需求率。与SMHA利益相关者进行的数据分析使用了快速评估程序-知情社区人种学方法中嵌入的程序。结果：在大流行期间，对服务的需求增加，主要是由于家庭压力和与同伴分离。报告需求增加的州的冠状病毒阳性率很高，未满足的服务需求也很高。最大的影响是减少了家庭外服务，增加了远程保健的使用。远程医疗服务的障碍包括互联网和技术的访问有限、家庭偏好面对面服务、缺乏隐私、难以与需要药物使用治疗的幼儿和青少年一起使用、寻找健康保险携带和责任法案（HIPAA）-符合平台、培训提供商和客户以及报销挑战。政策变化，使报销，互联网接入，培训和供应商许可导致大大减少预约取消或不显示，更多的家庭参与，减少旅行时间，增加了生活在偏远地区的人的访问，并增加了供应商的沟通和协作。冠状病毒阳性率高和需求未满足率高的州最有可能在大流行后继续使用远程医疗。尽管存在这些挑战，各国报告成功实施了旨在促进虚拟服务提供的政策，并可能在实践中产生长期变化。结论：大流行期间的政策实施为未来公共卫生紧急情况的规划和准备提供了重要的经验教训。成功的政策执行需要决策者之间以及与提供者之间不断的合作。
Background: The impact of the 2019 coronavirus pandemic on the mental health of millions worldwide has been well documented, but its impact on prevention and treatment of mental and behavioral health conditions is less clear. The COVID-19 pandemic also created numerous challenges and opportunities to implement health care policies and programs under conditions that are fundamentally different from what has been considered to be usual care. Methods: We conducted a qualitative study to determine the impact of the COVID-19 pandemic on implementation of evidence-based policy and practice by State Mental Health Authorities (SMHA) for prevention and treatment of mental health problems in children and adolescents. Semi-structured interviews were conducted with 29 SMHA representatives of 21 randomly selected states stratified by coronavirus positivity rate and rate of unmet services need. Data analysis with SMHA stakeholders used procedures embedded in the Rapid Assessment Procedure—Informed Community Ethnography methodology. Results: The need for services increased during the pandemic due primarily to family stress and separation from peers. States reporting an increase in demand had high coronavirus positivity and high unmet services need. The greatest impacts were reduced out-of-home services and increased use of telehealth. Barriers to telehealth services included limited access to internet and technology, family preference for face-to-face services, lack of privacy, difficulty using with young children and youth in need of substance use treatment, finding a Health Insurance Portability and Accountability Act (HIPAA)-compliant platform, training providers and clients, and reimbursement challenges. Policy changes to enable reimbursement, internet access, training, and provider licensing resulted in substantially fewer appointment cancellations or no-shows, greater family engagement, reduction in travel time, increased access for people living in remote locations, and increased provider communication and collaboration. States with high rates of coronavirus positivity and high rates of unmet need were most likely to continue use of telehealth post-pandemic. Despite these challenges, states reported successful implementation of policies designed to facilitate virtual services delivery with likely long-term changes in practice. Conclusions: Policy implementation during the pandemic provided important lessons for planning and preparedness for future public health emergencies. Successful policy implementation requires ongoing collaboration among policy makers and with providers.
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影响因子：
13.8
作者：
Czeisler MÉ;Lane RI;Wiley JF;Czeisler CA;Howard ME;Rajaratnam SMW
通讯作者：
Rajaratnam SMW
DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
DOI：
10.1080/00952990.2021.1903023
发表时间：
2021-07-04
期刊：
The American journal of drug and alcohol abuse
影响因子：
--
作者：
Andraka-Christou B;Bouskill K;Haffajee RL;Randall-Kosich O;Golan M;Totaram R;Gordon AJ;Stein BD
通讯作者：
Stein BD
影响因子：
5.2
作者：
Means, Arianna Rubin;Wagner, Anjuli D.;Weiner, Bryan J.
通讯作者：
Weiner, Bryan J.
在Covid-19期间从过渡到远程医疗的实施课程：对青年心理健康服务的临床医生和年轻人的调查。
影响因子：
11.3
作者：
Nicholas, Jennifer;Bell, Imogen H.;Thompson, Andrew;Valentine, Lee;Simsir, Pinar;Sheppard, Holly;Adams, Sophie
通讯作者：
Adams, Sophie