机构间协调管理并发的智力和发育障碍及精神健康问题。

IF 3.3 3区 医学 Q1 HEALTH POLICY & SERVICES Psychiatric services Pub Date : 2024-08-01 Epub Date: 2024-05-21 DOI:10.1176/appi.ps.20230451
Elizabeth M Stone, Andrew D Jopson, Danielle German, Alexander D McCourt, Emma E McGinty
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引用次数: 0

摘要

目标:作者旨在确定各州智力和发育障碍(IDD)或精神健康机构之间协调工作的障碍和支持策略,以满足同时患有智力和发育障碍及精神健康问题的人的精神健康需求:在 2022 年 4 月至 2023 年 4 月期间,对美国 11 个拥有独立的 IDD 和精神健康机构的州立机构以及倡导和服务提供组织的 49 名员工进行了访谈。采用主题分析法对数据进行了分析:受访者称,IDD 和精神健康机构之间的关系既有竞争也有协调,协调主要是在应对危机事件时进行的。机构间协调的障碍包括:各机构对目标人群的关注范围狭窄、州内机构结构的差异以及对同时存在的 IDD 和精神健康状况缺乏了解。受访者还描述了行政管理(如谅解备忘录)和机构文化(如注重全人关怀)方面的策略,这些策略已经或可以用来改善协调,为同时患有 IDD 和精神疾病的人提供心理健康服务:应优先考虑支持州立机构从危机应对转向关注全人关怀的策略,以支持对同时患有 IDD 和精神疾病的个人的精神健康服务的协调。
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Interagency Coordination to Manage Co-Occurring Intellectual and Developmental Disabilities and Mental Health Conditions.

Objective: The authors aimed to identify barriers to and strategies for supporting coordination between state agencies for intellectual and developmental disability (IDD) or mental health to meet the mental health needs of people with co-occurring IDD and mental health conditions.

Methods: Forty-nine employees of state agencies as well as advocacy and service delivery organizations across 11 U.S. states with separate IDD and mental health agencies were interviewed between April 2022 and April 2023. Data were analyzed with a thematic analysis approach.

Results: Interviewees reported that relationships between the IDD and mental health agencies have elements of both competition and coordination and that coordination primarily takes place in response to crisis events. Barriers to interagency coordination included a narrow focus on the populations targeted by each agency, within-state variation in agency structures, and a lack of knowledge about co-occurring IDD and mental health conditions. Interviewees also described both administrative (e.g., memorandums of understanding) and agency culture (e.g., focusing on whole-person care) strategies that are or could be used to improve coordination to provide mental health services for people with both IDD and a mental health condition.

Conclusions: Strategies that support state agencies in moving away from crisis response toward a focus on whole-person care should be prioritized to support coordination of mental health services for individuals with co-occurring IDD and mental health conditions.

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来源期刊
Psychiatric services
Psychiatric services 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.80
自引率
7.90%
发文量
295
审稿时长
3-8 weeks
期刊介绍: Psychiatric Services, established in 1950, is published monthly by the American Psychiatric Association. The peer-reviewed journal features research reports on issues related to the delivery of mental health services, especially for people with serious mental illness in community-based treatment programs. Long known as an interdisciplinary journal, Psychiatric Services recognizes that provision of high-quality care involves collaboration among a variety of professionals, frequently working as a team. Authors of research reports published in the journal include psychiatrists, psychologists, pharmacists, nurses, social workers, drug and alcohol treatment counselors, economists, policy analysts, and professionals in related systems such as criminal justice and welfare systems. In the mental health field, the current focus on patient-centered, recovery-oriented care and on dissemination of evidence-based practices is transforming service delivery systems at all levels. Research published in Psychiatric Services contributes to this transformation.
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