OBJECTIVE Treatment guidelines on borderline personality disorder (BPD) recommend day-hospital or residential treatments for patients with BPD who cannot tolerate outpatient treatment (American Psychiatric Association, 2010; National Health & Medical Research Council, 2013). However, the current literature suggests that evidence-based treatment for BPD may be difficult to access (Lohman et al., 2017). The present study aims to characterize the accessibility of dialectical behavioral therapy (DBT) in day-treatment and residential programs in the United States in the last 7 years and examines whether day-treatment and residential programs that accept state benefits (i.e., Medicaid) are significantly less likely to offer DBT. METHOD Using mixed logistic regression, we examined trends in the National Mental Health Services Survey data from 2014 to 2021, a survey of U.S. mental health facilities which tracks whether facilities provide DBT. RESULTS We found that the likelihood that a residential or day-hospital facility offers DBT has been growing over time at the national level (ORday-treatment = 1.07, SE = .03, z = 1.90, p = .05; ORresidential = 1.08, SE = .05, z = 1.77, p = .08). We also found significant variability in these trends at the state level. In addition, we found that facilities accepting state benefits were less likely to offer DBT (ORday-treatment = .66, SE = .021, z = -1.93, p = .05; ORresidential = .67, SE = .21, z = -1.91, p = .06). CONCLUSION Consistent with previous literature, our study suggests that these programs are very scarce across the United States and difficult to access for those with Medicaid.guidelines on borderline personality disorder (BPD) recommend day-hospital or residential treatments for patients with BPD who cannot tolerate outpatient treatment (American Psychiatric Association, 2010; National Health & Medical Research Council, 2013). However, the current literature suggests that evidence-based treatment for BPD may be difficult to access (Lohman et al., 2017). The present study aims to characterize the accessibility of dialectical behavioral therapy (DBT) in day-treatment and residential programs in the United States in the last 7 years and examines whether day-treatment and residential programs that accept state benefits (i.e., Medicaid) are significantly less likely to offer DBT. METHOD Using mixed logistic regression, we examined trends in the National Mental Health Services Survey data from 2014 to 2021, a survey of U.S. mental health facilities which tracks whether facilities provide DBT. RESULTS We found that the likelihood that a residential or day-hospital facility offers DBT has been growing over time at the national level (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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辩证行为疗法在边缘性人格障碍部分住院和住院服务中的可用性：2014年至2021年国家心理健康服务调查的探索性纵向研究。


目的 边缘性人格障碍 (BPD) 治疗指南建议对无法耐受门诊治疗的 BPD 患者进行日间医院或住院治疗（美国精神病学协会，2010 年；国家健康与医学研究委员会，2013 年）。然而，目前的文献表明，BPD 的循证治疗可能很难获得（Lohman 等人，2017）。本研究旨在描述过去 7 年美国日间治疗和住院项目中辩证行为疗法 (DBT) 的可及性，并检验接受国家福利（即医疗补助）的日间治疗和住院项目是否提供 DBT 的可能性显着降低。方法 使用混合逻辑回归，我们研究了 2014 年至 2021 年国家心理健康服务调查数据的趋势，这是一项针对美国心理健康机构的调查，追踪机构是否提供 DBT。结果 我们发现，随着时间的推移，全国范围内住院或日间医院提供 DBT 的可能性一直在增加（ORday-treatment = 1.07，SE = .03，z = 1.90，p = .05；ORresidential = 1.08， SE = .05，z = 1.77，p = .08）。我们还发现州一级的这些趋势存在显着差异。此外，我们发现接受国家福利的机构不太可能提供 DBT（ORday-treatment = .66，SE = .021，z = -1.93，p = .05；ORresidential = .67，SE = .21，z = -1.91，p = .06）。结论 与之前的文献一致，我们的研究表明，这些计划在美国非常稀缺，并且对于那些拥有医疗补助的人来说很难获得。边缘性人格障碍 (BPD) 指南建议对无法耐受门诊治疗的 BPD 患者进行日间医院或住院治疗（美国精神病学协会，2010 年；国家健康与医学研究委员会，2013 年）。然而，目前的文献表明，BPD 的循证治疗可能很难获得（Lohman 等人，2017）。本研究旨在描述过去 7 年美国日间治疗和住院项目中辩证行为疗法 (DBT) 的可及性，并检验接受国家福利（即医疗补助）的日间治疗和住院项目是否提供 DBT 的可能性显着降低。方法 使用混合逻辑回归，我们研究了 2014 年至 2021 年国家心理健康服务调查数据的趋势，这是一项针对美国心理健康机构的调查，追踪机构是否提供 DBT。结果 我们发现，随着时间的推移，在国家层面上，住宅或日间医院提供 DBT 的可能性一直在增加（PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。