GATEWAYS AND PATHWAYS PROJECT (GAPP)

描述（改编自申请人的摘要）：先前的研究是 令人惊讶的是，关于为什么大多数患有精神疾病的青少年 健康问题得不到心理健康服务，即使成年人 认识到他们有问题，并可以提供一个“网关”的照顾。 Stiffman博士的初步研究表明，网关提供商无法 帮助年轻人，并与他们的知识水平沮丧， 结构性限制（组织、管理、融资）， 必须操作。 为了了解精神卫生服务的途径，我们正在建立在 目前资助的青年服务项目（YSP）（R24 MH 50857）。 我们探索 心理健康服务使用模型，包括调节效应 网关提供商的看法和结构，组织因素， 青少年使用心理健康服务与 需要、诱发特征和使能特征 （可用性、可及性、可接受性和可负担性）。 我们用四组独立但相互关联的数据来检验这个服务模型： 1)来自青年服务项目的二级数据，其中包括：a）796 青少年报告的倾向和需要的特点，服务的使用， 护理途径，以及B）有关青年社区的人口普查数据; 2） 与青年“门户”提供者访谈的主要数据 关于：a）提供者;评估青少年的倾向和需要 特性，和B）提供者;对有利特性的看法 3）来自病历的原始数据 审查;和4）来自公共记录的有关结构的主要数据， 组织和资助供应商的“门户”部门。 本研究 提供了第一次机会来测试一个广泛的途径模型， 从供应商和客户的角度来看服务使用。 我们将描述1）需求和知识感知的差异 将精神病青年与精神病患者联系起来的门户提供者之间的服务 卫生服务和那些谁没有; 2）在可用性的差异， 可达性、可负担性、可接受性，以及结构性 精神卫生服务的特点，解释提供者的行动， 将青少年与心理健康服务联系起来;以及3） 网关的组织结构（支持、灵活性、资源） 提供者解释提供者;将青年与服务联系起来的行动。

DESCRIPTION (Adapted from Applicant's Abstract): Previous research is surprisingly uninformative about why the majority of adolescents with mental health problems fail to receive mental health services, even when adults recognize they have a problem and could provide a "gateway" to care. Initial studies by Dr. Stiffman reveal that gateway providers are unable to help the youths, and frustrated with their level of knowledge, and the structural constraints (organization, management, financing) in which they must operate. To understand the pathway to mental health services, we are building upon the currently funded Youth Services Project (YSP) (R24 MH50857). We explore a model of mental health services use which includes the moderating effect of gateway providers' perceptions and structural, organizational factors on the relationship between adolescents' use of mental health services and need, predisposing characteristics, and enabling characteristics (availability, accessibility, acceptability, and affordability). We examine this service model with four separate but linked sets of data: 1) Secondary data from the Youth Services Project which contains: a) 796 youths' reports of predisposing and need characteristics, service use, and pathways to care, and b) census data concerning youths' neighborhoods; 2) Primary data from interviews with the youths' "gateway" providers concerning: a) providers; assessments of the youths' predisposing and need characteristics, and b) providers; perceptions of enabling characteristics and the structure of the service system; 3) Primary data from case record reviews; and 4) Primary data from public records concerning the structure, organization and financing of providers' "gateway" sectors. This study provides the first opportunity to test an extensive model of pathways to service use from both provider and client perspectives. We will characterize 1) differences in the perception of need and knowledge of services between gateway providers who link mentally ill youth to mental health services and those who do not; 2) differences in the availability, accessibility, affordability, acceptability, and to the structural characteristics of mental health services that explain providers' actions in linking youths to mental health services; and 3) differences in the organizational structure (support, flexibility, resources) of gateway providers that explain providers; actions in linking youths to services.