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Online Group Psychotherapy: A Systematic Review. 在线团体心理治疗:系统回顾
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-11-01 Epub Date: 2024-07-06 DOI: 10.1007/s10597-024-01304-4
Katrina Andrews, Dyann Ross, Tenelle L Maroney

Introduction: There is a need within counselling and psychotherapy to ensure their ability to respond to endemic presences such as the COVID-19 pandemic, by utilising rapid technological advances without compromising effectiveness. To do so, existing research about online group therapy must be built upon to provide a comprehensive understanding of the efficacious delivery of this therapy modality. Thus, a systematic review was conducted to collate what is currently known in the published and grey literature on online group therapy, using the PRISMA framework. Thirty-three articles were identified as including information regarding facilitating group therapy online. After appraising each article using appropriate quality appraisal tools, a thematic analysis was conducted on the papers, arriving at seven main themes summarising the main findings regarding online versus in-person groups, group planning, counselling micro skills, group processes, ethics, technology, and unique online therapy issues. There is a growing but incomplete body of knowledge that informs the group therapist regarding the ethical delivery of groups online. A more comprehensive review can enable group therapists to feel confident they are across best practice guidelines. Limitations and research implications are considered.

导言:咨询和心理治疗需要在不影响疗效的前提下,利用快速发展的技术,确保有能力应对 COVID-19 等流行病。为此,必须以现有的在线团体治疗研究为基础,全面了解这种治疗方式的有效性。因此,我们采用 PRISMA 框架进行了一次系统性回顾,以整理目前已发表和灰色文献中有关在线团体治疗的内容。结果发现有 33 篇文章包含了有关促进在线团体治疗的信息。在使用适当的质量评估工具对每篇文章进行评估后,我们对论文进行了主题分析,总结出七大主题,分别涉及在线团体与面对面团体、团体计划、微观辅导技能、团体过程、伦理、技术以及独特的在线治疗问题。有越来越多的知识可以为团体治疗师提供有关在线团体伦理的信息,但这些知识并不完整。通过更全面的审查,可以让团体治疗师确信他们遵循了最佳实践指南。我们还考虑了局限性和研究意义。
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引用次数: 0
Certified Peer Support in the Field of Homelessness: Stories Behind the Work. 无家可归领域的认证同伴支持:工作背后的故事。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-11-01 Epub Date: 2024-07-02 DOI: 10.1007/s10597-024-01315-1
Margriet de Zeeuw Wright, Candice Morgan

Certified peer support specialists (CPSS) are used as a paraprofessional workforce to engage hard-to-reach populations, including people experiencing homelessness. Thematic analysis was used to explore with CPSS (N = 7) what contributed to their effectiveness when working with this population. Participants were recruited at a HUD lead organization in the southeastern United States. Open-ended semi-structured questions were used in online, synchronous interviews. Themes related to three areas, experience, competence, and the organization, contributed to participants being effective. Specifically, interviewees observed that their lived experiences and abilities to speak a common language with clients contributed to their effectiveness. They identified how personal qualities and unique skillsets suited them for the work. Participants also valued the training they received; certification helped them to develop competencies and to balance vulnerability, empathy, and connection. Finally, participants attributed their effectiveness to clarity about their roles within the organization, supervision, attention to self-care, and co-worker support. Findings from this study may have implications for the value of lived and learned knowledge coexisting in organizations serving those who experience homelessness.

经认证的同伴支持专家(CPSS)是一支辅助专业队伍,用于帮助包括无家可归者在内的难以接触人群。我们采用主题分析法,与 CPSS(7 人)一起探讨在与这一人群合作时,是什么促成了他们的工作成效。参与者是在美国东南部的一家住房和城市发展部牵头机构招募的。在线同步访谈中使用了开放式半结构化问题。访谈主题涉及三个方面,即经验、能力和组织,这三个方面有助于参与者提高工作效率。具体来说,受访者认为,他们的生活经验和与客户使用共同语言的能力有助于提高他们的工作效率。他们指出了个人素质和独特技能如何使他们胜任这项工作。参与者还重视他们所接受的培训;认证有助于他们发展能力,平衡脆弱性、同理心和联系。最后,参与者认为他们的工作效率归功于他们在组织中角色的明确性、监督、对自我保健的关注以及同事的支持。这项研究的结果可能会对服务于无家可归者的组织中生活知识和学习知识并存的价值产生影响。
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引用次数: 0
Global Burden Disease Estimates for Major Depressive Disorders (MDD): A review of diagnostic instruments used in studies of prevalence. 重度抑郁症(MDD)的全球疾病负担估算:流行率研究中使用的诊断工具回顾。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-11-01 Epub Date: 2024-07-01 DOI: 10.1007/s10597-024-01302-6
Lisa Cosgrove, Petra Brhlikova, Rosanna Lyus, Farahdeba Herrawi, Gianna D'Ambrozio, Elia Abi-Jaoude, Allyson M Pollock

Global Burden of Disease (GBD) estimates have significant policy implications nationally and internationally. Disease burden metrics, particularly for depression, have played a critical role in raising governmental awareness of mental health and in calculating the economic cost of depression. Recently, the World Health Organization ranked depression as the single largest contributor to global disability. The main aim of this paper was to assess the basis upon which GBD prevalence estimates for major depressive disorder (MDD) were made. We identify the instruments used in the 2019 GBD estimates and provide a descriptive assessment of the five most frequently used instruments. The majority of country studies, 356/566 (62.9%), used general mental health screeners or structured/semi-structured interview guides, 98/566 (17.3%) of the studies used dedicated depression screeners, and 112 (19.8%) used other tools for assessing depression. Thus, most of the studies used instruments that were not designed to make a diagnosis of depression or assess depression severity. Our results are congruent with and extend previous research that has identified critical flaws in the data underpinning the GBD estimates for MDD. Despite the widespread promotion of these prevalence estimates, caution is needed before using them to inform public policy and mental health interventions. This is particularly important in lower-income countries where resources are scarce.

全球疾病负担(GBD)估算对国家和国际政策具有重大影响。疾病负担指标,尤其是抑郁症的疾病负担指标,在提高政府对心理健康的认识和计算抑郁症的经济成本方面发挥了至关重要的作用。最近,世界卫生组织将抑郁症列为导致全球残疾的最大因素。本文的主要目的是评估 GBD 对重度抑郁障碍(MDD)患病率估计的依据。我们确定了 2019 年 GBD 估算中使用的工具,并对最常用的五种工具进行了描述性评估。大多数国家的研究(356/566,占 62.9%)使用了一般心理健康筛查工具或结构化/半结构化访谈指南,98/566(占 17.3%)的研究使用了专门的抑郁筛查工具,112(占 19.8%)的研究使用了其他抑郁评估工具。因此,大多数研究使用的工具并非用于诊断抑郁症或评估抑郁症的严重程度。我们的研究结果与之前的研究结果一致,并对之前的研究进行了扩展,这些研究发现,GBD 对 MDD 的估计值所依据的数据存在严重缺陷。尽管这些患病率估计值得到了广泛推广,但在使用它们为公共政策和心理健康干预提供信息之前仍需谨慎。这一点在资源匮乏的低收入国家尤为重要。
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引用次数: 0
"And Now that I Feel Safe…I'm Coming Out of Fight or Flight": A Qualitative Exploration of Challenges and Opportunities for Residents' Mental Health in Substance Use Recovery Housing. 现在我感到安全了......我正从 "战斗或逃跑 "中走出来:药物使用康复住房中居民心理健康的挑战与机遇的定性探索》。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-11-01 Epub Date: 2024-06-01 DOI: 10.1007/s10597-024-01301-7
Hannah L N Stewart, J Michael Wilkerson, Kathryn R Gallardo, I Niles Zoschke, Danielle Gillespie, Serena A Rodriguez, Sheryl A McCurdy

Co-occurring mental health concerns are prevalent among substance use recovery housing residents. We sought to explore how residents with co-occurring mental health and substance use needs experience recovery housing. We conducted semi-structured interviews with residents (N = 92) in recovery homes across Texas and developed themes through thematic analysis. Residents note that living in a group home can exacerbate anxiety and paranoia, especially during periods of high turnover. Overwhelmingly, however, residents believe recovery housing improves their mental health. Residents use their shared lived experiences to support one another. Residents also express appreciation for the transition period offered by recovery housing, allowing them to solidify their recoveries before fully re-entering society. Participants describe recovery homes as a critical support for their co-occurring mental health and substance use concerns. These results provide key insights on how to better support mental health in recovery housing.

在药物使用康复住房的居民中,并发精神健康问题非常普遍。我们试图探究精神健康和药物使用需求共存的居民是如何体验康复之家的。我们对德克萨斯州各地康复之家的居民(92 人)进行了半结构化访谈,并通过主题分析确定了访谈主题。居民们指出,住在集体之家会加剧焦虑和偏执,尤其是在人员流动频繁的时期。不过,绝大多数居民都认为康复之家能改善他们的心理健康。居民们利用他们共同的生活经历相互支持。居民们还对康复之家提供的过渡期表示赞赏,这让他们能够在完全重新融入社会之前巩固自己的康复成果。参与者认为,康复之家是对他们同时存在的精神健康和药物使用问题的重要支持。这些结果为如何在康复住房中更好地支持心理健康提供了重要启示。
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引用次数: 0
Disparities in Access to Mental Health Services Among Children Diagnosed with Anxiety and Depression in the United States. 美国被诊断患有焦虑症和抑郁症的儿童在获得心理健康服务方面的差异。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-11-01 Epub Date: 2024-06-22 DOI: 10.1007/s10597-024-01305-3
Asos Mahmood, Satish Kedia, Hassan Arshad, Xichen Mou, Patrick J Dillon

Child and adolescent mental health are major public health concerns in the US. Overall, 20% of US children have a reported mental health condition, while an estimated 40% will be diagnosed with one by age 18. Despite these concerns, little is known about factors associated with access to mental health services among children and adolescents. We analyzed data from a sample of 6655 children (aged 6 to 17 years) with either anxiety and/or depression drawn from the 2020-2021 National Survey of Children's Health (NSCH). A multivariable logistic regression model was fit to investigate predisposing, enabling, and need factors associated with caregiver's (i.e., parent or other guardian) perceived access to mental health services for their children. Approximately 50.8% of caregivers perceived obtaining mental health services for their children to be somewhat difficult, very difficult, or impossible. Children meeting criteria for having a medical home had lower odds of experiencing such difficulties (adjusted [a]OR = 0.38; 95% CI: 0.30-0.49). Further, compared to children who sometimes or never had health insurance coverage for mental or behavioral health needs, children who were always insured (aOR: 0.19; 95% CI 0.14, 0.25) and those who usually had coverage (aOR: 0.38; 95% CI 0.28, 0.51) had lower odds of experiencing perceived difficulties in obtaining care. The results indicate several enabling and need predictors of perceived access to mental health services--highlighting potential structural barriers to care access. Efforts to address access challenges should adopt a multifaceted approach and be tailored to families living in poverty, those with limited health coverage, and minoritized children with less than optimal general health.

儿童和青少年心理健康是美国主要的公共卫生问题。总体而言,20% 的美国儿童据报告患有精神疾病,而估计有 40% 的儿童到 18 岁时会被诊断出患有精神疾病。尽管存在这些问题,但人们对儿童和青少年获得心理健康服务的相关因素知之甚少。我们分析了从 2020-2021 年全国儿童健康调查(NSCH)中抽取的 6655 名患有焦虑症和/或抑郁症的儿童(6 至 17 岁)的样本数据。我们建立了一个多变量逻辑回归模型,以调查与照顾者(即父母或其他监护人)认为其子女获得心理健康服务相关的倾向性因素、有利因素和需求因素。大约 50.8%的看护人认为为其子女获得心理健康服务有些困难、非常困难或不可能。符合医疗之家标准的儿童遇到此类困难的几率较低(调整后的 OR = 0.38;95% CI:0.30-0.49)。此外,与有时或从未享受过精神或行为健康医疗保险的儿童相比,一直享受保险(aOR:0.19;95% CI 0.14,0.25)和通常享受保险(aOR:0.38;95% CI 0.28,0.51)的儿童在获得护理方面遇到困难的几率较低。研究结果表明,一些有利因素和需求因素可以预测心理健康服务的可及性,这也凸显了获得医疗服务的潜在结构性障碍。要解决获得医疗服务方面的挑战,应采取多方面的方法,并针对贫困家庭、医疗保险范围有限的家庭以及总体健康状况不尽如人意的少数民族儿童。
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引用次数: 0
An Umbrella Review of Systematic Reviews on Trauma Informed Approaches. 创伤知情方法系统综述》。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-11-01 Epub Date: 2024-07-24 DOI: 10.1007/s10597-024-01317-z
Daryl Mahon

Trauma and adversity significantly impact on morbidity and mortality. Hence, trauma-informed care is proliferating practice and research contexts. However, the evidence base for organisational wide trauma-informed care is far from conclusive, with the extant literature providing low quality and conflicting evidence. The purpose of this umbrella review of systematic reviews, is to summarise the existing evidence on trauma-informed care implemented at the organisational level. The preferred reporting items for systematic review and meta-analyses (PRISMA) was used to conduct an umbrella review. Six databases were searched; Academic Search Complete, APA Psych Articles, Cochrane Library, Embase, Scopus, and the Web of Science, supplemented with bibliography searches. Articles were included if they were peer reviewed in the English language from inception to 2024 and reported on trauma-informed care with an implementation context. The Joanne Briggs Institute Critical Appraisal Checklist for Systematic Reviews and Research Syntheses was used to assess the quality of the included reviews. Findings are mapped to the 10 trauma-informed care implementation domains described by the Substance Use and Mental Health Service Administration (SAMHSA) and reported using a narrative synthesis. The search strategy yielded 5,297 articles, of which (N = 14) systematic reviews are included. The reviews had a combined study count of (N = 311), with a total sample size of (N = 157,724). Most reviews used a narrative synthesis to report results, with no meta-analyses. Critical appraisal categorised the reviews as 28% high quality, 22% moderate quality, and 50% as low quality. Most reviews (50%), were conducted on youth populations, with school settings being the most studied context. There was a great deal of heterogeneity across the reviews, with 62 different models of trauma informed approaches discussed. The composition of the individual studies included in each systematic review were generally of low quality with mixed findings of effectiveness and implementation. Findings are discussed for moving forward with trauma-informed care implementation. Trauma-informed care is proposed as a system wide intervention to improve outcomes for service users, however the research base is still under scrutiny. Emerging research identifies the benefit of using the 10 trauma-informed implementation domains to shift cultural practices. Further research needs to be undertaken in various contexts with different populations.

创伤和逆境对发病率和死亡率有重大影响。因此,创伤知情护理在实践和研究中不断涌现。然而,关于组织范围内的创伤知情护理的证据基础还远远没有定论,现有文献提供的证据质量不高且相互矛盾。本系统综述旨在总结在组织层面实施创伤知情护理的现有证据。本综述采用了系统综述和荟萃分析的首选报告项目(PRISMA)。共检索了六个数据库:Academic Search Complete、APA Psych Articles、Cochrane Library、Embase、Scopus 和 Web of Science,并辅以书目检索。从开始到 2024 年,以英语进行同行评议的文章均被收录,这些文章报告了创伤知情护理的实施情况。琼安-布里格斯研究所的系统综述和研究综述批判性评估核对表用于评估所收录综述的质量。研究结果与美国物质使用和心理健康服务管理局(SAMHSA)描述的 10 个创伤知情护理实施领域进行了映射,并使用叙述性综合方法进行了报告。搜索策略共获得 5297 篇文章,其中包括(N = 14 篇)系统性综述。这些综述的合并研究数为 (N = 311),总样本量为 (N = 157,724) 。大多数综述采用叙述性综述来报告结果,没有进行荟萃分析。批判性评价将 28% 的综述归为高质量,22% 为中等质量,50% 为低质量。大多数综述(50%)的研究对象是青少年,研究最多的是学校环境。这些综述存在很大的异质性,共讨论了 62 种不同的创伤知情方法模式。每篇系统性综述中包含的单项研究的质量普遍较低,研究结果的有效性和实施情况参差不齐。本文讨论了在实施创伤知情护理方面的研究结果。建议将创伤知情护理作为一种全系统干预措施,以改善服务使用者的结果,但研究基础仍在审查之中。新近的研究表明,利用 10 个创伤知情护理实施领域来转变文化习俗是有益的。进一步的研究需要在不同人群的不同环境中进行。
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引用次数: 0
Utilization and Perceived Need for Mental Health Services Among Homeless Seniors. 无家可归的老年人对心理健康服务的利用和认知需求。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-11-01 Epub Date: 2024-07-16 DOI: 10.1007/s10597-024-01314-2
Ingyu Moon, Kwi Kim Yun, Mark Jennings

Homeless seniors confront distinct challenges regarding their mental health needs and service access. This study aims to illuminate the mental health landscape of homeless seniors by examining the prevalence of mental illness, utilization of mental health services, and perceived need for mental health care. The study comprises 177 homeless seniors in New York, NY. Findings indicate 10.2% experiencing depression, 10.2% schizophrenia, and 5.7% bipolar disorder. Despite high prevalence, there is a significant gap between diagnosed mental health conditions and service utilization, with only 50% of those with depression seeking care. Perceived need for mental health services emerges as a critical aspect of the study, with over half of those suffering from depression (61.1%; n = 11), PTSD (75%; n = 3), schizophrenia (77.8%; n = 14), and other mental illnesses (100%; n = 1) expressing a need for mental health care. Also, mental health conditions, loneliness, and levels of social support play significant roles in a need for mental health services.

无家可归的老年人在心理健康需求和获得服务方面面临着独特的挑战。本研究旨在通过考察无家可归老年人的精神疾病患病率、对精神健康服务的利用率以及对精神健康护理的认知需求,来揭示无家可归老年人的精神健康状况。研究对象包括纽约州纽约市 177 名无家可归的老年人。结果显示,10.2% 的人患有抑郁症,10.2% 的人患有精神分裂症,5.7% 的人患有躁郁症。尽管患病率很高,但在确诊的精神健康状况和服务利用率之间却存在很大差距,只有 50%的抑郁症患者会寻求治疗。对心理健康服务的需求感是本研究的一个重要方面,一半以上的抑郁症患者(61.1%;n = 11)、创伤后应激障碍患者(75%;n = 3)、精神分裂症患者(77.8%;n = 14)和其他精神疾病患者(100%;n = 1)都表示需要心理健康护理。此外,精神健康状况、孤独感和社会支持水平在心理健康服务需求中也起着重要作用。
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引用次数: 0
Correction: Global Burden Disease Estimates for Major Depressive Disorders (MDD): A Review of Diagnostic Instruments used in Studies of Prevalence. 更正:重度抑郁症(MDD)的全球疾病负担估算:流行率研究中使用的诊断工具综述》。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-11-01 DOI: 10.1007/s10597-024-01338-8
Lisa Cosgrove, Petra Brhlikova, Rosanna Lyus, Farahdeba Herrawi, Gianna D'Ambrozio, Elia Abi-Jaoude, Allyson M Pollock
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引用次数: 0
Prevalence of Four Types of Social Support and Their Relation to Mental Health among low-income U.S. Veterans: Implications for Community Health. 美国低收入退伍军人中四种社会支持的普遍性及其与心理健康的关系:对社区健康的影响》。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-11-01 Epub Date: 2024-07-11 DOI: 10.1007/s10597-024-01318-y
Jack Tsai, Yuan Li, Vahed Maroufy

To provide a comprehensive examination of different types of social support and associations with mental health among U.S. military veterans, a group vulnerable to psychosocial dysfunction. Using a nationally representative sample of 1,004 low-income U.S. veterans, this study examined the prevalence and mental health correlates of emotional, informational/tangible, positive social interaction, and affectionate social support. In the sample, 49-60% of participants perceived the four types of social support "most of the time" with the lowest prevalence being positive social interaction and the highest being affectionate support. Multivariable analyses found higher levels of all four types of social support were significantly associated with being married and greater mental health functioning. Some types of social support were uniquely associated with income level and positive screens for specific psychiatric disorders. Low social support is common among low-income U.S. veterans, and there is a need for community health interventions that target different types of social support to improve mental health and community integration.

对美国退伍军人这一容易出现心理社会功能障碍的群体中不同类型的社会支持及其与心理健康的关系进行全面研究。本研究使用了一个具有全国代表性的 1004 名低收入美国退伍军人样本,考察了情感、信息/有形、积极社会互动和亲情社会支持的普遍性和心理健康相关性。在样本中,49%-60% 的参与者 "大部分时间 "感知到这四种类型的社会支持,其中积极的社会互动支持感知率最低,亲情支持感知率最高。多变量分析发现,所有四种类型的社会支持水平越高,与已婚和心理健康功能越强有很大关系。某些类型的社会支持与收入水平和特定精神障碍的阳性筛查有独特的关联。美国低收入退伍军人普遍缺乏社会支持,因此需要针对不同类型的社会支持采取社区健康干预措施,以改善心理健康和社区融合。
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引用次数: 0
Community Mental Health Workers: Their Workplaces, Roles, and Impact. 社区心理健康工作者:他们的工作场所、角色和影响。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-11-01 Epub Date: 2024-06-19 DOI: 10.1007/s10597-024-01306-2
Elizabeth Heetderks-Fong, Anna Bobb

Mental health care in the U.S. is at a critical crisis, compounded with a severe shortage of providers. The cost burden is immense, with severe disparity seen in traditionally marginalized communities and rural populations. Community health workers have been used to increase access to physical health care in the U.S. for over seventy years-and have been used abroad for centuries. Their use in mental health care is more recent and can increase access, but raises policy, reimbursement, triage, and scopes-of-practice considerations. They are especially beneficial for many at-risk populations including communities of color, those with serious mental illness, rural communities, the elderly, and youth. This literature review searched PubMed, EMBASE, and Google Scholar and provides a broad review of the different types of community mental health workers (community health workers/promotores de salud, peer support, peer navigators, and lay counselors), how they increase access to care, skill sets, practice locations, and uses for specific at-risk populations. Increasing and expanding the use of community mental health workers expands much needed mental health care to those at risk by task-shifting the burden on the traditional professional workforce, offering a solution to both the workforce shortage and the lack of equity in mental health care.

美国的精神卫生保健正处于严重危机之中,加之医疗服务提供者严重短缺。费用负担沉重,在传统的边缘化社区和农村人口中存在严重的差距。七十多年来,美国一直在使用社区卫生工作人员来提高身体保健的可及性,在国外也已经使用了几个世纪。他们在精神卫生保健方面的应用是最近才开始的,可以增加就医机会,但也提出了政策、报销、分流和执业范围等方面的问题。它们对许多高危人群尤其有益,包括有色人种社区、严重精神疾病患者、农村社区、老年人和青少年。本文献综述搜索了 PubMed、EMBASE 和 Google Scholar,广泛综述了不同类型的社区心理健康工作者(社区健康工作者/健康促进者、同伴支持、同伴导航员和非专业顾问)、他们如何提高医疗服务的可及性、技能组合、执业地点以及在特定高危人群中的应用。增加和扩大社区心理健康工作者的使用,通过分担传统专业劳动力的工作负担,将急需的心理健康护理扩展到高危人群,为劳动力短缺和心理健康护理缺乏公平性提供了解决方案。
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引用次数: 0
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Community Mental Health Journal
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