Use of instruments and scales in mental health research in China

Almost all mental health research involves the use of instruments or scales.These are employed to make diagnoses;to measure the severity of symptoms;to assess knowledge,attitudes and behaviors;and for a wide range of other purposes.Much of the reported mental health research in China employs Chinese versions of scales from the west,but in many cases the reliability and validity of the scales in China have not been adequately assessed so the validity of the reported results is in question.This paper discusses this issue and other aspects of using instruments and scales in China that have not been given sufficient attention by mental health researchers.     

当住院变得不再顺畅患者康复之路在何方?(英文)

The modern history of mental health services in China dates back to the founding of the first psychiatric hospital in Guangzhou by the missionary physician John Kerr in 1898.By the time of liberation in 1949 China’s population was already 500 million but there were only 10 mental health institutions,1 100 psychiatric beds and 50-60 psychiatrists in the country.Health services developed rapidly in the 1950s but by 1957 there were still only 70 psychiatric hospitals with 11 000 beds and     

“医院-社区一体化”模式是中国精神卫生服务改革的重要方向(英文)

Prior to 2005 China’s mental health services were provided in the same manner as the other types of health services in the country. The hospital was the center of the service delivery network so medica staff only provided services to those who came to the hospital and there was no continuity between hospita services and community services. This delivery system did not provide preventive services and was not flexible     

Operationalizing the involuntary treatment regulations of China＇s new mental health law

1. Introduction
Mental health legislation aims to find the right balance between the interests of mentally ill patients and the interests of the public. Sociocultural differences between nations result in different approaches to defining this balance in mental health laws and changes within nations over time lead to changes in the regulations used to operationalize these laws. There is general agreement in mental health laws from different jurisdictions about the importance of maintaining patients＇ autonomy and their right to receive appropriate treatment. But there are substantial differences across jurisdictions in the mechanisms developed to operationalize these principles.     

686项目对中国和全球精神卫生的重要意义(英文)

Quietly, with little apparent notice from even the strongest advocates for global mental health, China is undertaking the world’s largest - and arguably most important - mental health services demonstration project, a project focused on providing comprehensive care for persons with severe mental illnesses. As Professor Ma indicates in her short report,[1] the ’686 Project’ was launched as part of China’s commitment to rebuild its public health infrastructure following the SARS epidemic, and has now moved beyond the initial pilot phase into a process of scaling up community     

满足人群对精神卫生的需求——中国的服务模式(英文)

Moving from an institutional model of mental health care to a community oriented system of care has long been recognized as desirable because of the improved health and social outcomes generally achieved by avoiding institutionalization, and the enhanced stimulation possible in the community. But providing local comprehensive community care is a complex task, and while it is relatively straightforward to plan and implement small-scale demonstration projects, it is very challenging to undertake systematic implementation of such projects across a whole     

精神卫生法的贯彻实施需要有共识和操作规范(英文)

China’s new mental health law, which was passed by the Standing Committee of the National People’s Congress on 26 October 2012, will take effect on 1 May 2013.The primary goals of the law are to develop the field of mental health, to standardize mental health services and to protect the legal rights and interests     

Practical Answers are Needed to Respond to the Myth of Mental Health Services in Tibet

正The article by Liang Xie et al.examines the current situation of mental disorders and mental health services in the Tibet Autonomous Region(TAR)of China,the part of China where mental health resources are the most scarce.[5]For quite a long time,the most frequently asked questions by people who were concerned about the phenomenon of this impoverished environment     

精神医学科研方法(3):中国精神卫生研究中工具和量表的使用(英文)

Almost all mental health research involves the use of instruments or scales.These are employed to make diagnoses;to measure the severity of symptoms;to assess knowledge,attitudes and behaviors;and for a wide range of other purposes.Much of the reported mental health research in China employs Chinese versions of scales from the     

本期导读(英文)

This issue starts with a translated and annotated version of the ’Mental Health Law of the People’s Republic of China.’ [1] This law, the first national mental health law in China, was approved by the Standing Committee of the National People’s Congress on 26 October 2012 and will go into effect on 1 May 2013. Twenty-seven years in the making, the law will fundamentally change the trajectory of mental health services in the country over the coming decades. It covers a very wide range of issues including     

Resistance to alternatives to hospitalization

Hospitalization has endured as the predominant form of psychiatric treatment for serious mental illness, despite accumulated evidence that outpatient treatment, ranging from halfway houses to day programs to traditional clinics, is equal or superior to inpatient treatment. Reasons for the apparent reluctance to use alternatives to the hospital include social prejudice against community treatment, economic disincentives, administrative chaos, training, professional sociology, and the countertransference meanings of hospitalization. The foregoing is not an argument against hospitalization, but rather an argument for being very clear about policy objectives and treatment goals. If these objectives and goals are made explicit, proposals can be evaluated for their efficacy. If community tenure, the assumption of responsibility for him or herself, and relinquishment of the patient role are goals, then hospitalization must be examined more skeptically. For society, this means the assumption of more responsibility for the establishment of a system of mental health care, for enunciating national policy goals and implementing them consistently, and for committing the necessary funds and manpower to this endeavor. For the clinician, it means examining the clinical efficacy of his or her treatment recommendations and distinguishing between responsibility for the patient's treatment and responsibility for the patient's life. The abdication of social responsibility for the patient and the assumption of omnipotent clinical responsibility for him or her lead inexorably to more institutional and more restrictive treatment, even in the absence of evidence that such measures are therapeutically effective.     

Competency to Consent to Treatment

Competency to consent to treatment is an especially critical determination to make in the field of psychiatry. Psychiatric patients are often capable, despite their illness, of self-advocacy. Careful assessments are required to differentiate competent patients from incompetent patients. Moreover, the character of their illness, from psychosis to organic brain disease, has been found to correlate with a lack of competency. The presence of auditory hallucinations or delusions, however, are not pathognomonic of incompetency. Currently, there exists no standardized method to establish competency, either in psychiatric or in medical patients. This is a review of the several instruments developed by various researchers attempting to create one. It finds promise in several questionnaires that have good inter-rater reliability and validity.