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A Group-Based, Six-Lesson Healthy Eating Curriculum for Individuals With Serious Mental Illnesses: Development and Implementation. 针对严重精神疾病患者的小组六课式健康饮食课程:开发与实施。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-06-12 DOI: 10.1007/s10597-024-01291-6
En Fu, Gabriella Farland, Dana Cohen, Cheryl Gerstler, Paul Margolies, Leah Pope, Merrill Rotter, Michael T Compton

As part of an intervention tailored to individuals with serious mental illnesses in residential settings that aimed to increase dietary intake of fresh vegetables and fruits, we developed and implemented a nutrition and cooking curriculum. To develop the curriculum, we assembled a Workgroup that consisted of professionals from multiple fields. The Workgroup held weekly discussions before drafting what would become the Workbook. Residential staff at partnering housing agencies taught the curriculum to residents. The curriculum Workbook contains six lessons, which are organized around two field trips to a mobile farmers market and a grocery store, and four cooking methods. The Workbook also includes instructions on using FreshConnect Checks at mobile farmers markets. The new curriculum distinguishes itself from other nutrition and culinary literacy curricula in that it delivers knowledge about fresh produce and skills in preparing fruits and vegetables in a way that is tailored to individuals with serious mental illnesses.

我们为居住环境中的重度精神病患者量身定制了一项干预措施,旨在增加新鲜蔬菜和水果的膳食摄入量,作为该措施的一部分,我们开发并实施了一套营养和烹饪课程。为了开发课程,我们组建了一个由多个领域的专业人士组成的工作组。工作组每周进行一次讨论,然后起草工作手册。合作住房机构的住户工作人员向住户教授课程。课程工作手册包含六节课,围绕两次实地考察流动农贸市场和一家杂货店以及四种烹饪方法展开。工作手册还包括在流动农贸市场使用 FreshConnect 支票的说明。新课程有别于其他营养和烹饪扫盲课程,它以适合重度精神病患者的方式传授有关新鲜农产品的知识和烹饪水果蔬菜的技能。
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引用次数: 0
The Correlates of Collective and Individual Trauma on Mental Health Outcomes Among Afghan Refugees: A Study of Sociodemographic Differences. 集体和个人创伤对阿富汗难民心理健康结果的影响:社会人口差异研究》。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-05-01 DOI: 10.1007/s10597-024-01283-6
Jaclyn Kirsch, Arati Maleku, Youn Kyoung Kim, Taqdeerullah Aziz, Shaima Dada, Hanna Haran, Katherine Kitchens

Following the U.S. military's departure from Afghanistan, a significant number of Afghan refugees have resettled in the United States, presenting complex mental health challenges exacerbated by extensive traumatic exposure. This demographic is particularly affected by collective trauma due to war, genocide, and the loss of homeland. However, detailed investigations into the correlations between collective trauma and mental health outcomes among Afghan refugees are limited. This study sought to explore the relationship between collective trauma and mental health outcomes within the Afghan refugee population in the United States, paying particular attention to the influence of sociodemographic factors. Identifying subgroups at greater risk allows for the development of more targeted mental health interventions. The study surveyed 173 Afghan refugees employing snowball sampling, utilizing a cross-sectional design. Data collection was facilitated through online and in-person surveys in English, Dari, and Pashto. Key measures included the Harvard Trauma Questionnaire for individual trauma experiences, the Historical Loss Scale for collective trauma, the Historical Loss Associated Symptoms Scale for collective trauma symptoms, the Afghan Symptom Checklist-22 for mental health symptoms, and the Post-Migration Living Difficulties Scale for post-migration stressors. Statistical analyses involved Pearson's correlation for variable associations, with nonparametric Mann-Whitney U and Kruskal-Wallis tests conducted to assess sociodemographic impacts due to data's non-normal distribution. The analysis revealed significant variations in collective trauma and mental health outcomes across subgroups. Afghan women, minoritized ethnic groups, those who experienced extended displacement, and refugees with uncertain visa statuses reported higher collective trauma levels and worse mental health outcomes. Statistical significance was noted in the correlations between collective trauma and mental health symptoms (r = .53, p < .01) and between post-migration difficulties and mental health (r = .33, p < .01). The disparities in mental health outcomes based on sociodemographic characteristics were significant, with nonparametric tests showing clear distinctions across different groups (Kruskal-Wallis H = 14.76, p < .05 for trauma experience by visa status). This study emphasizes the critical need for mental health interventions that account for the complex experiences of collective trauma among Afghan refugees, especially among identified subgroups. Tailoring mental health services to address the specific needs highlighted through disaggregated data can enhance support for Afghan refugees in the United States. This research contributes to a deeper understanding of the relationship between collective trauma and refugee mental health, advocating for nuanced care strategies in resettlement environments.

美军撤离阿富汗后,大量阿富汗难民在美国重新定居,他们面临着复杂的心理健康挑战,而广泛的创伤暴露又加剧了这一挑战。由于战争、种族灭绝和失去家园,这一人群尤其受到集体创伤的影响。然而,对阿富汗难民的集体创伤与心理健康结果之间关系的详细调查却很有限。本研究试图探讨在美国的阿富汗难民群体中集体创伤与心理健康结果之间的关系,尤其关注社会人口因素的影响。通过识别风险较大的亚群体,可以制定更有针对性的心理健康干预措施。该研究采用滚雪球式抽样,利用横断面设计对 173 名阿富汗难民进行了调查。数据收集通过在线和面对面调查的方式进行,语言包括英语、达里语和普什图语。主要测量指标包括:哈佛创伤问卷(用于调查个人创伤经历)、历史损失量表(用于调查集体创伤)、历史损失相关症状量表(用于调查集体创伤症状)、阿富汗症状清单-22(用于调查心理健康症状)以及移民后生活困难量表(用于调查移民后压力因素)。统计分析采用皮尔逊相关性分析变量之间的关联,并进行了非参数曼-惠特尼 U 检验和 Kruskal-Wallis 检验,以评估数据的非正态分布对社会人口学的影响。分析表明,不同亚群体在集体创伤和心理健康结果方面存在明显差异。阿富汗妇女、少数民族群体、经历过长期流离失所的人以及签证状态不确定的难民报告的集体创伤程度更高,心理健康结果更差。集体心理创伤与心理健康症状之间的相关性具有统计学意义(r = .53,p.
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引用次数: 0
Perspectives and Experiences of Stakeholders on Self-Disclosure of Peers in Mental Health Services. 利益相关者对心理健康服务中同伴自我披露的看法和经验。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-05-10 DOI: 10.1007/s10597-024-01287-2
Inbar Adler Ben-Dor, Eran Kraus, Yael Goldfarb, Alina Grayzman, Bernd Puschner, Galia S Moran

With the movement towards recovery-oriented mental health (MH) services, individuals with MH lived-experience are increasingly employed as peer providers (peers). Peers are unique in that they bring knowledge from experience and eye-level connection to service users that enhance the quality of services and humanize MH systems' culture. In Israel, hundreds of peers are employed in various roles and settings across the MH system. However, peer integration into MH services faces challenges. One issue involves the use of self-disclosure (SD) in MH services which varies with explicitness across roles and settings. This study sought to understand perspectives and experiences regarding peers' SD (use & sharing of knowledge from experience) among different stakeholders in MH health services. Six focus groups and 4 semi-structured interviews (N = 42) were conducted as a part of a larger international project (UPSIDES; ERC Horizon 2020, Moran et al., Trials 21:371, 2020). Data was transcribed verbatim and analyzed using thematic analysis. Four categories and 7 themes were identified regarding current perspectives and experiences with peers' SD in MH organizations: (i) Restrained or cautious organizational approach to SD; (ii) Attitudes of peers to SD approach; (iii) The influence of designated peer roles on SD; and (iv) Unwarranted SD of peers working in traditional roles. The findings reveal that peers' SD in MH services is a complex process. Organizational approaches were often controlling of non-designated peers' SD practices; participants had diverse attitudes for and against peers' SD; SD occurred according to personal preferences, specific peer role and the director's approach to peers' SD; Conflictual SD dilemmas emerged in relation to service users and staff. SD sometimes occurs unwarrantely due to ill mental health. The presence of peer-designated roles positively impacts peers' SD. We interpret the current mix of views and general conduct of peer SD practice in statutory MH services as related to three aspects: 1. The presence of a traditional therapeutic SD model vs. a peer SD model - with the former currently being dominant. 2. Insufficient proficiency and skill development in peers' SD. 3. Stigmatic notions about peer SD among service users and staff. Together, these aspects interrelate and sometimes create a negative cycle create tension and confusion.A need to develop professionalism of peer SD in statutory services is highlighted alongside enhancing staff and service user acknowledgement of the value of peer SD. Developing peer-designated roles can positively impacts peer SD in MH statutory services. Training, support, and organizational interventions are required to further support for peer-oriented SD and the enhancement of a person-centered and recovery orientation of MH services.

随着以康复为导向的心理健康(MH)服务的发展,拥有心理健康生活经验的个人越来越多地被聘为同伴服务提供者(同伴)。朋辈的独特之处在于,他们从经验中汲取知识,并与服务使用者保持密切联系,从而提高服务质量,并使精神健康系统的文化人性化。在以色列,有数以百计的同伴受雇于整个精神卫生系统的各种角色和环境。然而,将同伴融入保健服务面临着挑战。其中一个问题涉及到在精神健康服务中使用自我披露(SD)的问题,不同的角色和环境对自我披露的明确程度也不尽相同。本研究旨在了解 MH 健康服务中不同利益相关者对同伴自我披露(经验知识的使用和分享)的看法和经验。作为一个大型国际项目(UPSIDES;ERC Horizon 2020,Moran 等人,《试验》21:371,2020 年)的一部分,进行了 6 次焦点小组讨论和 4 次半结构式访谈(N = 42)。对数据进行了逐字转录,并采用主题分析法对其进行了分析。针对目前医疗卫生组织中同伴自毁行为的观点和经验,确定了四个类别和七个主题:(i) 组织对自毁行为的限制或谨慎态度;(ii) 同伴对自毁行为的态度;(iii) 指定同伴角色对自毁行为的影响;(iv) 在传统角色中工作的同伴不必要的自毁行为。研究结果表明,同伴在心理健康服务中的自毁是一个复杂的过程。组织方法往往控制着非指定同伴的自毁行为;参与者对同伴自毁行为持不同的支持和反对态度;自毁行为根据个人喜好、特定同伴角色和主任对同伴自毁行为的处理方法而发生;在服务使用者和工作人员之间出现了冲突性的自毁行为困境。有时,由于心理健康状况不佳,自毁行为会在未经许可的情况下发生。同伴指定角色的存在对同伴的 SD 有积极影响。我们认为,目前在法定的精神健康服务中,朋辈自毁行为的观点和一般行为与三个方面有关:1.传统的治疗性 SD 模式与朋辈 SD 模式--前者目前占主导地位。2.同伴持续发展的熟练程度和技能发展不足。3.服务使用者和工作人员对同伴持续发展的成见。这些方面相互关联,有时会形成一个消极的循环,造成紧张和混乱。发展同伴指定角色可以对法定医疗卫生服务中的同伴持续发展产生积极影响。需要通过培训、支持和组织干预来进一步支持以同伴为导向的 SD,加强以人为本和康复为导向的 MH 服务。
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引用次数: 0
Evaluating the Experience of Teen-to-Teen Crisis Line Volunteers: A Pilot Study. 评估青少年危机热线志愿者的经验:试点研究。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-06-04 DOI: 10.1007/s10597-024-01298-z
Catherine R Glenn, Taylor Kalgren, Sandipan Dutta, Raksha Kandlur, Kelsie K Allison, Annie Duan, Cheryl Karp Eskin, Morgan Leets, Madelyn S Gould

Teen-to-teen (t2t) crisis lines are a special type of crisis service where youth volunteers help their peers. Although prior research has examined the experience of adult crisis line responders, no research has examined the experience of adolescents who do this work. In collaboration with two of the largest t2t lines in the U.S., this pilot study is the first examination of t2t crisis line work. Volunteers (ages 14-20) reported: their primary motivation for joining the crisis lines was to help others and give back to the community; responding to a range of peers' problems on the t2t crisis line, including high-risk suicide contacts; and a range of ways the crisis line work impacted their lives. Findings provide preliminary information about the experience of adolescents engaging in t2t crisis line work. Additional research is needed in larger and more diverse samples to understand the impact of crisis line work for youth.

青少年对青少年(t2t)危机热线是一种特殊的危机服务,由青少年志愿者帮助他们的同龄人。虽然之前的研究已经考察了成人危机热线响应者的经验,但还没有研究考察过从事这项工作的青少年的经验。本试点研究与美国最大的两条 t2t 线路合作,首次对 t2t 危机线路的工作进行了考察。志愿者(14-20 岁)报告说:他们加入危机专线的主要动机是帮助他人和回馈社会;在 t2t 危机专线上应对一系列同龄人的问题,包括高危自杀接触;以及危机专线工作对他们生活的一系列影响。研究结果提供了青少年参与 t2t 危机热线工作经历的初步信息。要了解危机热线工作对青少年的影响,还需要在更大范围、更多样化的样本中进行更多研究。
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引用次数: 0
Strengths, Struggles, and Strategies: How Adults with Serious Mental Illness Navigate Long-Term Romantic Relationships. 优势、挣扎和策略:患有严重精神疾病的成年人如何处理长期恋爱关系》(How Adults with Serious Mental Illness Navigate Long-Term Romantic Relationships)。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-05-07 DOI: 10.1007/s10597-024-01288-1
Catherine H Stein, Rachel A Redondo, Sharon Simon, Zachary J Silverman

Married individuals and those in committed romantic relationships generally report having better mental health outcomes than their single or divorced counterparts. However, studies of romantic relationships for adults with mental illness have often ignored rewarding aspects of romantic relationships and have focused primarily on relationship difficulties. In this study, 23 adults with serious mental illness in long-term romantic relationships described their relationship strengths and struggles in small focus group discussions. Content analysis was used to characterize themes from participant accounts. Overall, participants described deep emotional bonds with their partners, a mutual willingness to work on their relationship, and good communication skills as relationship strengths. Mental health symptoms and internalized stigma were identified as major contributors to relationship struggles. Participants spontaneously identified intentional strategies that they used to navigate mental health challenges in their relationship that included self-directed, partner-directed, and couple-directed actions. Implications of findings for research and practice are discussed.

与单身或离异的同龄人相比,已婚人士和有稳定恋爱关系的人一般都会有更好的心理 健康状况。然而,针对成年精神疾病患者的恋爱关系研究往往忽视了恋爱关系中的有益方面,而主要关注恋爱关系中的困难。在这项研究中,23 名长期恋爱关系中的重性精神病患者在小型焦点小组讨论中描述了他们在恋爱关系中的优势和挣扎。研究采用了内容分析法来描述参与者叙述的主题。总的来说,参与者将与伴侣之间深厚的情感纽带、双方都愿意为他们的关系付出努力以及良好的沟通技巧描述为他们关系中的优势。心理健康症状和内在化的耻辱感被认为是导致关系挣扎的主要因素。参与者们自发地找出了他们用来应对关系中的心理健康挑战的有意策略,其中包括自我导向、伴侣导向和情侣导向的行动。本文讨论了研究结果对研究和实践的影响。
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引用次数: 0
Occupational Therapy in Psychiatric Short-Term Hospitalization Units: Scoping Review. 精神病短期住院病房的职业疗法:范围审查。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-05-09 DOI: 10.1007/s10597-024-01286-3
Uxia García-Gestal, Miguel-Ángel Talavera-Valverde, Ana-Isabel Souto-Gómez

Given the context, the overarching aim is to identify scientific publications on occupational therapy in Psychiatric-Short-Term-Hospitalization-Units. Specific objectives include: (a) Analyzing the historical development of this research area; (b) Synthesizing existing evidence on the nature of documentary sources on occupational therapy in in Psychiatric-Short-Term-Hospitalization-Units; (c) Detailing the volume of scientific literature on occupational therapy in these units; (e) Evaluating available evidence on occupational therapy interventions to improve functionality, quality of life, and recovery in individuals admitted to in Psychiatric-Short-Term-Hospitalization-Units. A scoping review method was employed to conduct a historical mapping of research on in Psychiatric-Short-Term-Hospitalization-Units. The review proceeded in five stages following PRISMA guidelines. After applying selection criteria, the search identified 446 references. Findings are presented under three headings: (a) Historical trends in the scientific literature on occupational therapy and in Psychiatric-Short-Term-Hospitalization-Units; (b) Nature and volume of articles included in the occupational therapy synthesis in Psychiatric Short-Term Hospitalization Units; (c) Data extraction on methodological variables in the research of occupational therapy articles in in Psychiatric-Short-Term-Hospitalization-Units; and (d) Data extraction on research outcome variables of occupational therapy articles in Psychiatric Short-Term Hospitalization Units. The growth of occupational therapy in in Psychiatric-Short-Term-Hospitalization-Units is emphasized, with an increase in qualitative studies. Occupational therapy is underscored as an integral part of care, supporting the diversity and effectiveness of interventions. Common diagnoses include schizophrenia and depressive disorders. Group interventions and the spiritual dimension positively influence the quality of care and meaningful routines for recovery in in Psychiatric-Short-Term-Hospitalization-Units.

鉴于这一背景,总体目标是确定有关精神病短期住院病房职业疗法的科学出版物。具体目标包括(a) 分析这一研究领域的历史发展;(b) 综合有关精神病短期住院病房职业疗法文献来源性质的现有证据;(c) 详细说明有关这些病房职业疗法的科学文献数量;(e) 评估有关职业疗法干预措施的现有证据,以改善精神病短期住院病房收治人员的功能、生活质量和康复情况。我们采用了范围审查法,对精神病短期住院病房的研究进行了历史梳理。综述按照 PRISMA 指南分五个阶段进行。在应用了选择标准后,搜索确定了 446 篇参考文献。研究结果分为三个标题:(a)有关职业疗法和精神病短期住院病房的科学文献的历史趋势;(b)纳入精神病短期住院病房职业疗法综述的文章的性质和数量;(c)精神病短期住院病房职业疗法文章研究方法变量的数据提取;以及(d)精神病短期住院病房职业疗法文章研究成果变量的数据提取。强调了职业疗法在精神病短期住院病房中的发展,以及定性研究的增加。强调职业疗法是护理工作不可或缺的一部分,支持干预措施的多样性和有效性。常见的诊断包括精神分裂症和抑郁症。小组干预和精神层面对精神病短期住院病房的护理质量和有意义的康复常规产生了积极影响。
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引用次数: 0
Understanding Barriers and Facilitators of Primary Care Use Among Assertive Community Treatment Teams Via Qualitative Analysis of Clients and Clinicians. 通过对客户和临床医生的定性分析,了解支持性社区治疗小组使用初级保健的障碍和促进因素。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-05-03 DOI: 10.1007/s10597-024-01284-5
Sophia Zhao, Walter Mathis

Individuals with severe mental illness and substance use disorders face complex barriers to achieving physical health. This study aims to explore the barriers and facilitators of primary care access among an Assertive Community Treatment (ACT) team. Semi-structured qualitative interviews were conducted with 14 clients and 7 clinicians from an ACT team at a community mental health center in Connecticut. Data analysis followed a grounded theory approach, with codes and themes emerging iteratively during the interview process. The study identified multifaceted barriers to accessing primary care, including economic challenges, homelessness, and the prioritization of mental health and substance use symptoms over healthcare. The conceptual framework consists of nine dominant themes: clients' attitudes, knowledge, mental health, and motivations ("Client-Level Barriers and Facilitators"); ACT team-directed care coordination and relationship-building as well as primary care provider communication ("Provider-Level Barriers and Facilitators"); and clients' experiences with medical care and socioeconomic status ("Systemic-Level Barriers and Facilitators"). This research provides valuable insights into the various barriers faced by ACT clients in accessing primary care. Improving primary care access for individuals with severe mental illness and substance use disorders is crucial for reducing health disparities in this vulnerable population.

患有严重精神疾病和药物使用障碍的人在获得身体健康方面面临着复杂的障碍。本研究旨在探讨协助性社区治疗(ACT)团队在获得初级保健服务方面遇到的障碍和促进因素。研究人员对康涅狄格州一家社区心理健康中心 ACT 小组的 14 名客户和 7 名临床医生进行了半结构化定性访谈。数据分析采用了基础理论方法,在访谈过程中反复出现代码和主题。研究发现了获得初级医疗服务的多方面障碍,包括经济困难、无家可归、心理健康和药物使用症状优先于医疗保健。概念框架由九个主导主题组成:客户的态度、知识、心理健康和动机("客户层面的障碍和促进因素");ACT 团队指导的护理协调和关系建立以及初级保健提供者的沟通("提供者层面的障碍和促进因素");客户的医疗保健经验和社会经济地位("系统层面的障碍和促进因素")。这项研究为了解 ACT 患者在获得初级医疗服务时所面临的各种障碍提供了宝贵的见解。改善患有严重精神疾病和药物使用障碍的个人获得初级医疗服务的机会,对于减少这一弱势群体的健康差距至关重要。
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引用次数: 0
Exploring LGBT2Q+ Intracategorical Factors in Mental Health Service Utilization: Differences in Gender Modalities, Sexual Orientations, and Ethnoracial Groups in Canada. 探索 LGBT2Q+ 心理健康服务使用中的分类内因素:加拿大性别模式、性取向和种族群体的差异。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-06-08 DOI: 10.1007/s10597-024-01299-y
Samson Tse, Kenny Chee, Todd A Coleman, Simon Coulombe, Robb Travers

LGBT2Q+ (lesbian, gay, bisexual, transgender, Two-Spirit, queer, plus) Canadians face minority stressors that lead to higher mental health inequalities such as worse self-reported mental health and increased risk of mental health issues when compared to their heterosexual/straight and cisgender counterparts. However, there are within-group (intracategorical) differences within a community as large as LGBT2Q+ peoples. Guided by the Andersen Model of Healthcare Utilization, we sought to explore intracategorical differences in LGBT2Q+ Canadian predisposing, enabling, and need factors in mental health service utilization within the past year. Using data from the 2020 LGBT2Q+ Health Survey (N = 1542), modified Poisson logistic regression found that more polysexual respondents and trans/gender-diverse respondents were more likely to have utilized mental health services within the past year than their gay, lesbian, and cis male counterparts. As well, compared to White respondents, Indigenous respondents were more likely to have utilized mental health services, while other racialized respondents were associated with less utilization. Backwards elimination of Andersen model of healthcare utilization factors predicting mental health service utilization retained two predisposing factors (ethnoracial groups and gender modality) and two need factors (self-reporting living with a mood disorder and self-reporting living with an anxiety disorder). Results suggest that polysexual, trans and gender-diverse, and racialized LGBT2Q+ peoples have an increased need for mental health services due to increased specific minority stressors that cisgender, White, monosexual peoples do not face. Implications for healthcare providers are discussed on how to improve service provision to LGBT2Q+ peoples.

加拿大的 LGBT2Q+(女同性恋、男同性恋、双性恋、变性人、双灵人、同性恋者、加人)面临着少数群体的压力,这些压力导致了更大的心理健康不平等,例如与异性恋/直男和同性别的人相比,自我报告的心理健康状况更差,出现心理健康问题的风险更高。然而,在像 LGBT2Q+ 这样一个庞大的群体中,也存在着群体内部(类别内)的差异。在安徒生医疗保健利用模型的指导下,我们试图探索 LGBT2Q+ 加拿大人在过去一年中利用心理健康服务的倾向因素、有利因素和需求因素的类别内差异。通过使用来自 2020 年 LGBT2Q+ 健康调查(N = 1542)的数据,修正泊松逻辑回归发现,与男同性恋、女同性恋和同性男性受访者相比,更多的多性受访者和变性/跨性别受访者更有可能在过去一年内利用过心理健康服务。此外,与白人受访者相比,土著受访者更有可能利用心理健康服务,而其他种族受访者的利用率较低。对预测心理健康服务利用率的安徒生医疗保健利用率因素模型进行反向消除,保留了两个诱发因素(种族群体和性别模式)和两个需求因素(自述患有情绪障碍和自述患有焦虑症)。研究结果表明,多性人、变性人、性别多样性人和种族化的 LGBT2Q+ 人对心理健康服务的需求增加了,这是因为他们面临着更多特殊的少数群体压力,而顺性人、白人和单性恋人则不会面临这些压力。本研究还讨论了如何改善为 LGBT2Q+ 群体提供的服务对医疗保健提供者的影响。
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引用次数: 0
A Universal Program to Improve Mental Health among Youth from Low-Income Predominantly Minority Communities: Implementation of Advocates 4 ALL Youth (ALLY). 改善低收入少数民族社区青少年心理健康的普及计划:实施 "倡导所有青少年 "计划(ALLY)。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-05-27 DOI: 10.1007/s10597-024-01292-5
Adefunke Dadematthews, Melissa M Pangelinan, Anne E Bowen, Stacey L Simon, Jessica L Chandrasekhar, Rashelle Musci, Jill L Kaar

Disparities in mental health care and access to care disproportionately affect youth from minoritized and low-income communities. School-based prevention programs have the potential to offer a non-stigmatized approach to mental health care as well as the ability to reach many students simultaneously. Advocates 4 All Youth (ALLY) is a program developed for 5-6th grade students aimed at improving self-efficacy and resilience via individualized sessions with a trusted adult (ALLYs). The feasibility of delivering ALLY in a racially and minoritized low-income community is discussed and modifications required to implement the program documented. Students completed questionnaires and sessions with an ALLY. Aspects of program delivery deemed feasible included training ALLYs to delivery program, stakeholder buy-in regarding missing class time, and students attending the sessions. Further modifications included adjustments to materials due to lower reading level and health literacy related-educational needs. Programs designed in one demographic setting may not work in a different setting.

心理健康护理和获得护理方面的差异对来自少数民族和低收入社区的青少年造成了极大的影响。以学校为基础的预防项目有可能提供一种非污名化的心理健康护理方法,并能同时覆盖许多学生。倡导所有青少年(ALLY)是一个针对 5-6 年级学生开发的项目,旨在通过与可信赖的成年人(ALLYs)进行个性化的交流,提高学生的自我效能感和适应能力。本文讨论了在种族和少数族裔低收入社区实施该计划的可行性,并记录了实施该计划所需的修改。学生们填写了调查问卷,并与 ALLY 进行了交流。被认为可行的计划实施方面包括对 ALLY 进行培训以实施计划、利益相关者对缺课时间的认可以及学生参加课程。进一步的修改包括根据较低的阅读水平和与健康素养相关的教育需求对材料进行调整。在一个人口环境中设计的计划在不同的环境中可能行不通。
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引用次数: 0
Mobile Crisis Teams' Implementation in the Context of new Medicaid Funding Opportunities: Results from a National Survey. 移动危机小组在新的医疗补助资助机会背景下的实施情况:全国调查的结果。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-06-03 DOI: 10.1007/s10597-024-01296-1
Rachel Odes, Preston Looper, Deepa Manjanatha, Megan McDaniel, Matthew L Goldman

This cross-sectional survey study describes characteristics of mobile crisis teams (MCTs) in the United States. Mobile crisis teams (MCTs) are increasingly recognized as essential responders to help those experiencing mental health crises get urgent and appropriate care. Recent enhanced federal funding is designed to promote adoption of MCTs, but little is known about their current structure and function and whether teams meet new Medicaid rules governing their utilization. Survey participants (N = 554) are a convenience sample of MCT representatives recruited through professional organizations, listservs, and individual email contacts from October 2021 - May 2022. Respondents most frequently identified themselves as MCT program director/manager (N = 237, 43%). 63% (N = 246) of respondents reported billing insurance for services provided (including Medicaid), while 25% (N = 98) rely on state or county general funds only. Nearly all respondents (N = 390, 98%) reported including behavioral health clinicians on their teams, and 71% (N = 281) reported operating on a 24/7 basis, both of which are required by Medicaid's enhanced reimbursement. Just over half of respondents (N = 191, 52%) reported being staffed with 11 or more FTE staff members, our estimated number required for adequate 2-person coverage on a 24/7 basis. MCTs are a popular policy initiative to reduce reliance on law enforcement to handle mental health emergencies, and enhanced federal funding is likely to expand their utilization. Federal rule makers have a role in establishing guidelines for best practices in staffing, billing, and outcomes tracking, and can help ensure that stable financing is available to improve stability in service delivery.

这项横断面调查研究描述了美国流动危机处理小组(MCTs)的特点。人们越来越认识到,流动危机处理小组(MCTs)是帮助那些遭遇心理健康危机的人们获得紧急和适当护理的重要响应者。最近,联邦加大了对移动危机处理小组的资助力度,旨在促进移动危机处理小组的采用,但人们对其目前的结构和功能以及小组是否符合医疗补助计划关于其使用的新规定却知之甚少。调查参与者(N = 554)是在 2021 年 10 月至 2022 年 5 月期间通过专业组织、列表服务器和个人电子邮件联系招募的 MCT 代表的便利抽样。受访者最常自称为 MCT 项目主任/经理(N = 237,43%)。63%的受访者(N = 246)称所提供的服务要向保险机构付费(包括医疗补助),25%的受访者(N = 98)仅依靠州或县级普通基金。几乎所有的受访者(N = 390,98%)都表示他们的团队中有行为健康临床医生,71%(N = 281)的受访者表示他们的团队每周 7 天每天 24 小时都在工作,而这两项都是医疗补助加强报销所要求的。略多于一半的受访者(N = 191,52%)称其团队配备了 11 名或更多的全职员工,这是我们估计的全天候充足的 2 人覆盖所需的人数。MCT 是一项广受欢迎的政策措施,旨在减少对执法部门处理心理健康突发事件的依赖,而联邦资 助的增加很可能会扩大 MCT 的使用范围。联邦规则的制定者可以在制定人员配备、账单和结果跟踪方面的最佳实践指南方面发挥作 用,并可以帮助确保提供稳定的资金,以提高服务提供的稳定性。
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Community Mental Health Journal
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