Outpatient Care of Young People after Emergency Treatment of Deliberate Self-Harm

Autor/inn/en	Bridge, Jeffrey A.; Marcus, Steven C.; Olfson, Mark
Titel	Outpatient Care of Young People after Emergency Treatment of Deliberate Self-Harm
Quelle	In: Journal of the American Academy of Child & Adolescent Psychiatry, 51 (2012) 2, S.213-222 (10 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0890-8567
DOI	10.1016/j.jaac.2011.11.002
Schlagwörter	Health Services; Substance Abuse; Poverty; Socioeconomic Influences; Racial Differences; Ethnicity; Hispanic Americans; Place of Residence; Cohort Analysis; Mental Disorders; Adolescents; Patients; Self Destructive Behavior; Predictor Variables; Hospitals; Clinics; Social Services; Longitudinal Studies; Preadolescents; Risk + Suchen Sie Ihr Suchwort? Health service; Gesundheitsdienst; Gesundheitswesen; Drug use; Drug consomption; Drogenkonsum; Armut; Sozioökonomischer Faktor; Rassenunterschied; Ethnizität; Hispanic; Hispanoamerikaner; Wohnort; Kohortenanalyse; Mental illness; Geisteskrankheit; Adolescent; Adolescence; Adoleszenz; Jugend; Jugendalter; Jugendlicher; Patient; Self destrucive behaviour; Selbstzerstörung; Prädiktor; Krankengymnast; Krankenhaus; Social service; Soziale Dienstleistung; Soziale Dienste; Longitudinal study; Longitudinal method; Longitudinal methods; Längsschnittuntersuchung; Pre-adolescence; Präadoleszenz; Risiko
Abstract	Objective: Little is known about the mental health care received by young people after an episode of deliberate self-harm. This study examined predictors of emergency department (ED) discharge, mental health assessments in the ED, and follow-up outpatient mental health care for Medicaid-covered youth with deliberate self-harm. Method: A retrospective longitudinal cohort analysis was conducted of national 2006 Medicaid claims data supplemented with the Area Resource File and a Substance Abuse and Mental Health Services Administration Medicaid policy survey of state policy characteristics focusing on ED treatment episodes by youth 10 to 19 years old for deliberate self-harm (n = 3,241). Rates and adjusted risk ratios (ARR) of discharge to the community, mental health assessments in the ED, and outpatient visits during the 30 days after the ED visit were assessed. Results: Most patients (72.9%) were discharged to the community. Discharge was inversely related to recent psychiatric hospitalization (ARR 0.75, 99% confidence interval [CI] 0.63-0.90). Thirty-nine percent of discharged patients received a mental health assessment in the ED and a roughly similar percentage (43.0%) received follow-up outpatient mental health care. Follow-up mental health care was directly related to recent outpatient (ARR 2.58, 99% CI 2.27-2.94) and inpatient (ARR 1.33, 99% CI 1.14-1.56) mental health care and inversely related to Hispanic ethnicity (ARR 0.78, 99% CI 0.64-0.95) and residence in a county with medium-to-high poverty rates (ARR 0.84, 99% CI 0.73-0.97). Conclusions: A substantial proportion of young Medicaid beneficiaries who present to EDs with deliberate self-harm are discharged to the community and do not receive emergency mental health assessments or follow-up outpatient mental health care. (Contains 5 tables.) (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10