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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >Determinants of treatment disengagement among those at risk of suicide referred to primary mental health care services in Western Sydney, Australia
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Determinants of treatment disengagement among those at risk of suicide referred to primary mental health care services in Western Sydney, Australia

机译：在澳大利亚西部悉尼西部的自杀风险的治疗脱离决定因素

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Objective: Continued engagement with primary mental health services has been associated with the prevention of subsequent suicidal behaviour; however, there are few studies that identify determinants of treatment disengagement among those at risk of suicide in primary care settings. This study investigated determinants of treatment disengagement of those at risk of suicide who were referred to primary mental health care services in Western Sydney, Australia. Method: This study used routinely collected data of those referred for suicide prevention services provided through primary mental health care services between July 2012 and June 2018. Associations between sociodemographic, diagnostic, referral- and service-level factors and treatment non-attendance and early treatment cessation were investigated using a series of multivariable generalised estimation equations. Results: There were 1654 suicidal referrals for 1444 people during the study period. Those identified with a risk of suicide were less likely to never attend treatments (16.14% vs 19.77%), but were more likely to disengage earlier from subsequent service sessions (16.02% vs 12.41%), compared to those with no risk of suicide. A higher likelihood of non-attendance to any primary mental health care service sessions was associated with those aged 25–44, lower socioeconomic status, a presentation for substance use and a referral from acute care (either emergency department or hospital). Among those who attended an initial treatment session, younger age (18–24?years) and a longer waiting time for an initial follow-up appointment were associated with a higher likelihood of early treatment cessation from primary mental health care services. Conclusion: These findings can inform potential strategies in routine primary mental health care practice to improve treatment engagement among those at risk of suicidal behaviour. Youth-specific interventions, behavioural engagement strategies and prompt access to services are policy and service priorities.
机译：目标：继续参与初级精神卫生服务与预防后续自杀行为有关；然而，很少有研究确定初级保健机构中有自杀风险的人脱离治疗的决定因素。这项研究调查了在澳大利亚西悉尼接受初级精神卫生保健服务的自杀风险患者脱离治疗的决定因素。方法：本研究使用了2012年7月至2018年6月期间通过初级精神卫生保健服务提供的自杀预防服务转诊者的常规收集数据。使用一系列多变量广义估计方程，研究了社会人口统计学、诊断、转诊和服务水平因素与治疗不出勤和早期治疗停止之间的关联。结果：在研究期间，1444人中有1654人被转介自杀。与没有自杀风险的人相比，那些被确认有自杀风险的人不太可能从未参加过治疗（16.14%对19.77%），但更可能提前退出后续服务（16.02%对12.41%）。未参加任何初级精神卫生保健服务课程的可能性更高，与年龄在25-44岁之间、社会经济地位较低、药物使用情况介绍和急症室（急诊室或医院）转诊有关。在参加初次治疗的患者中，年龄较小（18-24岁）和初次随访预约的等待时间较长与初级精神卫生保健服务提前停止治疗的可能性较高相关。结论：这些发现可以为日常初级精神卫生保健实践中的潜在策略提供信息，以提高自杀行为风险人群的治疗参与度。针对青年的干预措施、行为参与战略和迅速获得服务是政策和服务的优先事项。

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