A mixed-methods investigation of parental burden and adolescent service use following discharge from psychiatric hospitalization

项目总结/摘要 青少年（12-17岁）受到心理健康挑战的严重影响。自杀是导致 这一年龄组的死亡率，精神病住院服务的使用率自2005年以来一直在增加。 2000年代中期青少年精神病住院治疗可能对家庭和住院后的时期造成创伤 与重复自杀企图和再住院的风险增加有关。在此期间风险增加 部分原因可能是后续服务使用率低。在青少年服务中扮演重要角色的一个因素 使用是父母的负担（即，被认为是由儿童的精神症状引起或加剧的困难）。 然而，研究尚未探讨父母负担如何与产后随访服务的使用有关。 住院时间，或差异如何影响这种关系。家庭社会经济地位（SES）可能 在这种情况下，特别需要考虑。低收入家庭面临着无数的障碍， SES影响获得精神卫生保健的机会和质量。本研究报告力求填补这些空白 使用混合方法设计。本研究的第一个目的是调查 父母负担和青少年服务使用随时间的推移从精神病院出院后。第二 本研究旨在探讨社会经济地位如何影响父母负担与青少年服务使用之间的纵向关系。 第三个目的是比较252位母亲的生活经历， 青少年从高和低SES背景，重点是负担的看法。广义上讲，这家伙的 与拟议的研究和长期职业计划相关的培训目标是： 有关文献的知识，如创伤后成长过程和家庭压力，健康 差异，以及对服务不足的青年和家庭的文化敏感的护理; 混合方法和先进的定量统计设计和分析;并改善研究传播 skills.这将通过课程作业，参加有针对性的研讨会，动手研究和 临床经验，指导阅读，和定期指导会议。在一个专门的和 经验丰富的导师团队，这项研究学习和培训计划将为研究员的长期发展奠定基础 研究目标是进行文化上敏感的、了解创伤情况的和以家庭为基础的治疗研究。

Project Summary/Abstract Adolescents (age 12-17) are disproportionally impacted by mental health challenges. Suicide is a leading cause of death among this age group, with rates of psychiatric inpatient service use consistently increasing since the mid-2000s. Youth psychiatric hospitalization can be traumatic for families and the period following hospitalization is associated with increased risk of repeat suicide attempts and rehospitalization. Increased risk during this time may be due, in part, to low rates of follow-up service use. One factor that plays a substantial role in youth service use is parental burden (i.e., difficulties perceived to be caused or exacerbated by a child's psychiatric symptoms). However, research has not yet explored how parental burden is related to follow-up service use in the post- hospitalization period, or how disparities may influence this relation. Familial socioeconomic status (SES) may be particularly important to consider in this context. There exists a myriad of barriers faced by families of lower SES that impact access to and quality of mental health care. The present study seeks to address these gaps using a mixed methods design. The first aim of this study is to investigate the bidirectional associations between parental burden and youth service use over time following discharge from psychiatric hospitalization. The second aim is to examine how SES impacts the longitudinal relations between parental burden and youth service use. The third aim is to compare the lived experiences of 252 mothers with a recently psychiatrically hospitalized adolescent from high and low SES backgrounds, with a focus on perceptions of burden. Broadly, the fellow’s training goals associated with the proposed study and long-term career plans are to: develop comprehensive knowledge of relevant literatures, such as processes of post-traumatic growth and stress in families, health disparities, and culturally responsive care with underserved youth and families; develop proficiency in qualitative, mixed-methods, and advanced quantitative statistical design and analysis; and improve research dissemination skills. This will be accomplished through coursework, attendance at targeted workshops, hands-on research and clinical experience, directed readings, and regular mentorship meetings. With the support of a dedicated and experienced mentorship team, this research study and training plan will set the stage for the fellow’s long term research goal, which is to conduct culturally responsive, trauma-informed, and family-based treatment research.