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

项目摘要/摘要 青少年(12-17岁)不成比例地受到心理健康挑战的影响。自杀是主要原因 这一年龄段的死亡率，精神科住院使用率自#年以来一直在上升 2000年代中期。青少年精神科住院对家庭和住院后的一段时间可能是一种创伤 与重复自杀企图和再次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较低。在青年服务中发挥重要作用的一个因素 使用是父母的负担(即，被认为是由儿童的精神症状造成或加剧的困难)。 然而，研究尚未探索父母负担与后继服务使用之间的关系。 住院时间，或差异可能如何影响这种关系。家庭社会经济地位(SES)可能 在这种情况下考虑这一点尤为重要。低收入家庭面临着无数的障碍 影响获得精神卫生保健的机会和质量的自杀性心理障碍。本研究试图解决这些差距。 采用混合方法进行设计。这项研究的第一个目的是调查两国之间的双向联系 出院后一段时间内父母负担和青少年服务使用情况。第二 目的是考察社会经济地位如何影响父母负担和青少年服务使用之间的纵向关系。 第三个目的是比较252位母亲和一位最近在精神科住院的母亲的生活经历。 来自高和低社会保障背景的青少年，重点关注负担感。大体上来说，这家伙的 与拟议的学习和长期职业计划相关的培训目标是：制定全面的 了解相关文献，如创伤后成长过程和家庭压力、健康 差距，以及对未得到充分服务的青年和家庭的文化响应关怀；发展精通质量， 混合方法和先进的定量统计设计和分析；并改进研究传播 技能。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、定向阅读和定期的导师会议。在一个专门的和 经验丰富的导师团队，这项研究性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，即进行文化响应、创伤信息和基于家庭的治疗研究。

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.