ABSTRACT

This study investigated whether children/youth in Ontario triaged to residential services showed a higher intensity of need than those referred to outpatient services, and whether residential treatment gains were sufficient for transition to community services. Participants included 2053 children/youth assessed at 23 diverse mental health agencies across Ontario using the interRAI™ Child and Youth Mental Health (ChYMH) instrument. Various presenting problems were examined utilizing scales including: Disruptive/Aggressive Behavior, Hyperactive/Distraction, Social Disengagement, Anxiety, and Sleep Difficulties. Analyses were conducted separately for boys and girls.

Notable differences were found in the initial assessment, with residential boys scoring higher on all scales than outpatient boys, and residential girls scoring higher on the externalizing scales (Disruptive/Aggressive Behavior, Hyperactive/Distraction) than outpatient girls. Treatment gains at residential discharge included improvements in Anxiety, Social Disengagement, Hyperactive/Distraction and Sleep Difficulties for boys and girls to levels at or below the initial scores of outpatient peers. Disruptive/Aggressive Behavior is still a high need following residential services.

The results highlight differences in severity of mental health presentation between children/youth receiving residential and outpatient services, and how multiple agencies in Ontario are providing services that successfully reduce the severity of mental health needs.

摘要

本研究调查了安大略省分流到住院服务的儿童/青少年是否表现出比门诊服务更高的需求强度，以及住院治疗的收益是否足以过渡到社区服务。参与者包括在安大略省 23 个不同的心理健康机构使用 interRAI™ 儿童和青少年心理健康 (ChYMH) 工具评估的 2053 名儿童/青少年。使用量表检查了各种呈现的问题，包括：破坏性/攻击性行为、多动/分心、社会脱离、焦虑和睡眠困难。对男孩和女孩分别进行分析。

在初步评估中发现了显着差异，住院男孩在所有量表上的得分都高于门诊男孩，而住院女孩在外化量表（破坏性/攻击性行为、多动/分心）上的得分高于门诊女孩。出院时的治疗收益包括男孩和女孩的焦虑、社交脱离、多动/分心和睡眠困难的改善，达到或低于门诊同龄人的初始分数。在住宅服务之后，破坏性/攻击性行为仍然是一个很高的需求。

结果突出了接受住院和门诊服务的儿童/青少年之间心理健康表现严重程度的差异，以及安大略省的多个机构如何提供成功降低心理健康需求严重程度的服务。