Examining Patterns of Psychotherapy Service Utilization Among Medicaid-Enrolled Adolescents.

Autor:	Dir AL; Adolescent Behavioral Health Research Program, Department of Pediatrics (Dir, Pederson, Schwartz, Aalsma), Department of Psychiatry (Dir), Department of Pediatrics, Section of Adolescent Medicine (Pederson, Schwartz, Aalsma), Department of Biostatistics (Ouyang, Monahan), and Department of Pediatrics (Wiehe), Indiana University School of Medicine, Indianapolis., Pederson CA; Adolescent Behavioral Health Research Program, Department of Pediatrics (Dir, Pederson, Schwartz, Aalsma), Department of Psychiatry (Dir), Department of Pediatrics, Section of Adolescent Medicine (Pederson, Schwartz, Aalsma), Department of Biostatistics (Ouyang, Monahan), and Department of Pediatrics (Wiehe), Indiana University School of Medicine, Indianapolis., Ouyang F; Adolescent Behavioral Health Research Program, Department of Pediatrics (Dir, Pederson, Schwartz, Aalsma), Department of Psychiatry (Dir), Department of Pediatrics, Section of Adolescent Medicine (Pederson, Schwartz, Aalsma), Department of Biostatistics (Ouyang, Monahan), and Department of Pediatrics (Wiehe), Indiana University School of Medicine, Indianapolis., Monahan PO; Adolescent Behavioral Health Research Program, Department of Pediatrics (Dir, Pederson, Schwartz, Aalsma), Department of Psychiatry (Dir), Department of Pediatrics, Section of Adolescent Medicine (Pederson, Schwartz, Aalsma), Department of Biostatistics (Ouyang, Monahan), and Department of Pediatrics (Wiehe), Indiana University School of Medicine, Indianapolis., Schwartz K; Adolescent Behavioral Health Research Program, Department of Pediatrics (Dir, Pederson, Schwartz, Aalsma), Department of Psychiatry (Dir), Department of Pediatrics, Section of Adolescent Medicine (Pederson, Schwartz, Aalsma), Department of Biostatistics (Ouyang, Monahan), and Department of Pediatrics (Wiehe), Indiana University School of Medicine, Indianapolis., Wiehe SE; Adolescent Behavioral Health Research Program, Department of Pediatrics (Dir, Pederson, Schwartz, Aalsma), Department of Psychiatry (Dir), Department of Pediatrics, Section of Adolescent Medicine (Pederson, Schwartz, Aalsma), Department of Biostatistics (Ouyang, Monahan), and Department of Pediatrics (Wiehe), Indiana University School of Medicine, Indianapolis., Aalsma MC; Adolescent Behavioral Health Research Program, Department of Pediatrics (Dir, Pederson, Schwartz, Aalsma), Department of Psychiatry (Dir), Department of Pediatrics, Section of Adolescent Medicine (Pederson, Schwartz, Aalsma), Department of Biostatistics (Ouyang, Monahan), and Department of Pediatrics (Wiehe), Indiana University School of Medicine, Indianapolis.
Jazyk:	angličtina
Zdroj:	Psychiatric services (Washington, D.C.) [Psychiatr Serv] 2023 Apr 01; Vol. 74 (4), pp. 374-380. Date of Electronic Publication: 2023 Jan 04.
DOI:	10.1176/appi.ps.202100513
Abstrakt:	Objective: Adolescents with behavioral health disorders (i.e., mental health disorders and substance use) often experience frequent recurrence of symptoms, suggesting a need for an ongoing behavioral health intervention, rather than a single course of treatment. However, little is known about mental health care service use among adolescents over longer periods. The authors examined longitudinal patterns of outpatient behavioral health service utilization in a large sample of adolescents. Methods: Medicaid claims for 8,197 adolescents (ages 10.0-13.9 years, mean±SD=11.5±1.2; 61% male) from one Indiana county between 2006 and 2017 were examined, with a focus on outpatient psychotherapy visits. Latent class analysis (LCA) was used to detect clusters of longitudinal patterns of outpatient psychotherapy visits across 5 years, beginning with an adolescent's first behavioral health visit. Results: A five-class LCA model emerged with unique classes of service use based on duration and level of engagement (frequency) of monthly outpatient psychotherapy visits. Most adolescents fell in the nonuse class (38.7% of the sample). Additional classes were defined as late-onset low engagement (17.1%), early-onset high engagement (15.5%), early-onset moderate engagement (16.7%), and continuously high engagement (11.9%). Statistically significant differences were found across the classes in average duration and frequency of involvement (p<0.001), as well as in demographic characteristics (race, age, gender, and ethnicity) and behavioral health diagnoses (p<0.001). Conclusions: These findings confirm that adolescents with behavioral health diagnoses do not follow a uniform pattern of psychotherapy utilization. The distinct patterns of service use point toward the need to identify appropriate long-term service recommendations for adolescents.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu