精神分裂症社区精神卫生服务现状与发展策略初步研究

目的旨在探讨推行具有中国特色社区精神卫生服务的可行性举措。方法回顾国内外面向精神分裂症的社区精神卫生服务不同模式及其发展现状,分析我国社区精神卫生发展存在的问题。结果我国精神分裂症的社区精神卫生服务需要从建立健全精神卫生体系、加强社会宣传和促进多部门合作等方面入手进行研究、探索。结论顺应全球精神卫生服务模式转变,积极发展精神分裂症的社区精神卫生服务势在必行。     

精神分裂症社区服务现状与发展策略研究

目的旨在探讨推行具有中国特色社区精神卫生服务的可行性举措。方法回顾国内外面向精神分裂症的社区精神卫生服务不同模式及其发展现状,分析影响发展的因素。结果我国精神分裂症的社区精神卫生服务需要从建立健全精神卫生体系、加强社会宣传和促进多部门合作等方面入手进行研究、探索。结论顺应全球精神卫生服务模式转变,积极发展精神分裂症的社区精神卫生服务势在必行。     

成都市社区精神卫生服务现状调查

[目的]调查成都市社区精神卫生服务的现状,分析存在的问题,提出在新形势下,加强成都市社区精神卫生服务的具体建议,为促进城市社区精神卫生服务提供参考。[方法]随机抽取成都市2个区,以这2个区的所有社区卫生服务机构作为研究对象。通过问卷调查和深入访谈法收集相关资料。[结果]成都市社区卫生服务机构均开展了精神病患者系统管理和心理咨询服务,但仍处于起步阶段,缺乏相关专业人员,心理咨询服务开展较差,对精神病患者的管理缺乏标准,管理率较低,随访难以开展。[结论]①强调社区资源动员;②重视社区精神卫生的预防;③加强精神卫生人力资源的培养和开发;④尽快出台社区精神卫生服务标准。     

大庆市人民医院社区卫生服务工作的几点做法

大庆市人民医院作为一所三级综合医院,为适应广大社区居民健康的新需求和卫生改革的新形势,开设了万宝社区卫生服务中心,以及府明、东安、府园、五区4个社区卫生服务站。各站点坚持服务社区、奉献社会的原则,大力开展了贴近社区、贴近家庭、贴近生活、贴近群众的社会卫生服务,收到了比较满意的效果。1 加强管理,使卫生指导和医疗服务辐射社区 按照卫生部《关于发展城市社区卫生服务的若干意见》精神,市卫生局提出了“统一规则、合理布局、盘活资源、     

社区精神卫生服务领域相关文献计量学分析

目的随着社会的迅速发展,精神卫生问题越来越突出,造成严重的社会经济负担,回归社区为最终结局。本研究应用文献计量学方法分析国际社区精神卫生服务领域研究现状,挖掘该领域的研究热点,为我国社区精神卫生服务工作的开展提供参考。方法检索web of science数据库1999-2019年社区精神卫生服务领域的研究论文,利用文献计量学分析方法,分析该领域研究的年载文量、核心作者、核心机构、被引情况和研究热点等。结果共纳入866篇文献,文献发文量呈逐年上升趋势;美国发文量居首位,共235篇,中国居第12位,为18篇;Thornicroft Graham发文量和H指数均最高,分别为9和7;高频关键词为"mental illness""mental health""recovery""implementation"和"primary care";以关键词"community mental health services""mental health""mental illness"为中心节点分别形成3个热点研究领域;发文量排前3位的机构为伦敦国王学院、维罗纳大学和墨尔本大学,伦敦国王学院和维罗纳大学以及曼彻斯特大学均为高频发文机构且合作密切。结论社区精神卫生服务领域研究热度持续上升,Thornicroft Graham为该领域高产、高影响力作者,研究产出机构主要为大学,且高产机构相互间合作密切。精神健康、精神疾病、社区康复和早期干预为社区精神卫生服务领域的研究热点,社区精神卫生服务的相关研究、精神疾病的相关管理研究和精神健康促进方面的相关研究为热点研究领域。国内相关领域研究有待加强和深入,应加强高质量研究,为我国社区精神卫生服务体系的发展和探索提供支持。     

精神卫生发展滞后“瓶颈”亟待消除

改革开放以来,随着经济社会的持续快速发展,我国精神卫生工作取得了显著成绩。但从总体看,各地无论是精神卫生总体资源,还是精神卫生服务的均等化;无论是省市级精神疾病专科医院建设与发展,还是社区和农村精神卫生工作;无论是精神医学的学科发展水平,还是精神卫生服务质量方面,还存在发展不平衡的现状,尤其是西部偏远地区与国内先进省市还有较大差距。这种差距已成为影响群众健康水平提高和社会和谐稳定的一个因素。     

发达国家社区精神卫生服务有效模式的特征及其启示

社区精神卫生服务是当前世界精神卫生服务的重要趋势。在一些发达国家社区精神卫生服务已经有半个多世纪的发展历史。因此,在分析现有的相对成熟精神卫生服务模式的基础上,归纳其有效模式的特征,并进一步提出对我国精神卫生事业的启示。     

社区妇女精神卫生服务需求的调查分析

目的:了解武汉市社区妇女精神卫生服务需求的特点,为社区精神卫生服务的管理提供科学依据。方法:采用自编社区精神卫生服务需求调查问卷对武汉市某社区妇女300人进行调查。结果:社区妇女由于文化程度不同、年龄不同、婚姻状况不同对精神卫生服务内容及服务方式的选择存在差异,不能主动寻求精神卫生服务原因以及了解精神卫生服务途径也不一致。结论:在社区卫生服务中心应积极开展精神卫生服务,满足不同文化程度、不同婚姻状态、不同年龄社区妇女的精神卫生服务需求。     

开展社区妇幼保健卫生服务 发展妇幼保健事业

《中共中央、国务院关于卫生改革与发展的决定》要求卫生工作以预防为主,以初级卫生保健为基础,以提高社区人民群众健康水平和生活质量为目标,面向社区、面向家庭,为居民提供优质、高效、便捷的基本卫生服务。发展妇幼保健事业也应以此为指导思想,走出医院大门,进入社区,积极开展妇幼保健卫生服务。本文就如何开展社区妇幼保健卫生服务进行了探讨。     

不同收入社区居民精神卫生服务需求的调查分析

目的：了解武汉市不同收入社区居民对精神卫生服务需求的特点，为社区精神卫生服务的管理提供科学依据。方法：采用自编社区精神卫生服务需求调查问卷对武汉市社区居民570人进行调查。结果：不同收入组社区居民精神卫生服务收费承受能力不同，对精神卫生服务内容的选择存在差异，不愿主动寻求精神卫生服务的原因也不一致。结论：社区卫生服务中心应积极开展精神卫生服务活动，针对不同经济收入人群开展不同内容的服务，满足不同收入社区居民的精神卫生服务需求。     

我国社区精神卫生服务的发展概况、存在问题及对策

随着我国社区卫生服务的不断发展,社区精神卫生服务工作也逐步完善.结合在精神卫生领域长期工作的经验,以及参与社区精神卫生科建设的实践,概述我国社区精神卫生服务的发展情况,明确现阶段社区精神卫生服务发展存在的主要问题,并提出政策建议.     

广东省居民对社区心理健康服务需求的调查

目的了解广东省居民对社区心理健康服务的需求情况,为社区心理健康服务的开展和完善提供参考。方法于2017年8月12日-9月4日和2018年1月23日-2月8日,采用分层随机抽样方法,选取广东省7个城市108个社区的1 250名居民作为调查对象,使用自编社区心理健康服务需求调查问卷,进行社区心理健康服务需求调查。采用SPSS21. 0软件对数据进行描述性分析和相关分析,多组间比较采用Kruskal-Wallis检验,以P <0. 05为差异有统计学意义。结果广东省社区居民的主观心理健康状况普遍良好,655名(57. 4%)调查对象认为自己的心理健康状况经常处于良好或较好状态,不同年龄、不同区域间居民的主观心理健康状况差异无统计学意义(P> 0. 05)。238名(20. 8%)居民表示其所在的社区有专门部门负责社区心理健康服务,不同区域间的社区心理健康服务开展情况差异无统计学意义(P>0. 05)。762名(66. 7%)社区居民认为有必要面向全社区开展心理健康教育,809名(70. 8%)居民认为社区心理健康服务对工作、生活有帮助,659名(57. 7%)居民表示经常或有时需要社区心理健康服务。结论广东省居民对社区心理健康服务需求强烈,当前的社区心理健康服务开展不足,应综合考虑社区心理健康服务的服务内容、服务对象、服务方式,加强制度保障,探索具有区域特色的社区心理健康服务模式。     

Health, mental health, substance use, and service utilization among rural and urban incarcerated women.

Incarcerated women commonly report health, mental health, and substance use problems, yet there is limited research on service utilization before incarceration, particularly among women from urban and rural areas. This study includes a stratified random sample of 100 rural and urban incarcerated women to profile the health, mental health, substance use, and service utilization; examine the relationship between the number of self-reported problems and service utilization; and examine self-reported health and mental health problems in prison as associated with preincarceration health-related problems and community service utilization. Study findings suggest that health and mental health problems and substance use do not differ significantly among rural and urban women prisoners. However, there are differences in service utilization -- particularly behavioral health services including mental health and substance abuse services; urban women report more service utilization. In addition, rural women who reported using needed community services before prison also reported fewer health problems in prison. Implications for correctional and community treatment opportunities in rural and urban areas are discussed.     

Evidence-Based Practices in Community Mental Health: Outcome Evaluation

In 2003, questions were being raised relating to the lack of evidence-based treatments available in public mental health and whether the use of treatments found effective in research settings would be equally effective in real world situations. In response, one state passed a bill mandating a disease management model of service delivery and the use of evidence-based practices designed to obtain better clinical and functional outcomes, and to maximize the possibility for recovery for adults experiencing a serious mental illness. The purpose of this article is to provide an overview of the re-engineered public mental health system and report on findings of a longitudinal time-series study of the redesigned community mental health system. Findings of the study suggest using evidence-based practices and following a disease management model of mental health service delivery can be effective in real world settings for adults experiencing serious mental health symptoms and functional impairment.     

Creating Culturally Competent and Responsive Mental Health Services: A Case Study Among the Amish Population of Geauga County,Ohio

Providing effective mental health services requires knowledge about and cultural competence across a wide array of beliefs and practices. This study provides an example of a successful project to improve public mental health service delivery in an Amish community. County boards of mental health in a rural area of Northeast Ohio contacted researchers in 1998 to provide assistance in reaching the Amish community because of a concern that mental health services were not being utilized by the Amish population. Following meetings with community leaders, changes were made to improve the relationships of service providers and public funding agencies with the local Amish community, disseminate information about mental health concerns and services, and improve accessibility to mental health services. In 2013, a follow-up analysis of records found a 320% increase in public mental health service utilization by the Amish community within the first five years after these changes were made.     

Mental health. Doing the hurdles

A survey of senior mental health managers in London found that less than half thought they would stay in their job more than a year. The resulting turnover could create significant instability. Respondents considered the development of community mental health teams as the top priority for implementation. Financial restrictions were seen as the major obstacle to service development. Most respondents welcomed the national service framework for mental health.     

A task shifting approach to primary mental health care for adults in South Africa: human resource requirements and costs for rural settings

BACKGROUND A recent situational analysis suggests that post-apartheid South Africa has made some gains with respect to the decentralization and integration of mental health into primary health care. However, service gaps within and between provinces remain, with rural areas particularly underserved. Aim This study aims to calculate and cost a hypothetical human resource mix required to populate a framework for district adult mental health services. This framework embraces the concept of task shifting, where dedicated low cost mental health workers at the community and clinic levels supplement integrated care. METHOD The expected number and cost of human resources was based on: (a) assumptions of service provision derived from existing services in a sub-district demonstration site and a literature review of evidence-based packages of care in low- and middle-income countries; and (b) assumptions of service needs derived from other studies. RESULTS For a nominal population of 100?000, minimal service coverage estimates of 50% for schizophrenia, bipolar affective disorder, major depressive disorder and 30% for post-traumatic stress disorder and maternal depression would require that the primary health care staffing package include one post for a mental health counsellor or equivalent and 7.2 community mental health worker posts. The cost of these personnel amounts to ￡28?457 per 100?000 population. This cost can be offset by a reduction in the number of other specialist and non-specialist health personnel required to close service gaps at primary care level. CONCLUSION The adoption of the concept of task shifting can substantially reduce the expected number of health care providers otherwise needed to close mental health service gaps at primary health care level in South Africa at minimal cost and may serve as a model for other middle-income countries.     

Mental health. Nought for their comfort

The development of resource centres works against mental health users being seen in GPs' surgeries. The community mental health team needs to be linked to inpatient services. Measuring activity is not a valid way of assessing service quality. Mental health inquiries are useless as learning exercises. The money and time they absorb would be better spent on remedying well-known problems in mental health services.     

深圳市宝安区社区全科医生精神卫生知识调查

目的调查深圳市宝安区社区全科医生对精神卫生知识的掌握情况。方法通过分层抽样,在宝安区的社区健康服务中心选取全科医生作为调查对象,以典型的焦虑症、抑郁症和精神分裂症个案作为案例描述,调查其对常见精神障碍的认识和相关知识的掌握情况。结果共回收有效问卷134份,深圳市宝安区社区全科医生对焦虑症、抑郁症、精神分裂症三种精神障碍的平均正确识别率为74.6%。对于非重性精神疾病中焦虑症和抑郁症,分别有85.1%和54.5%的全科医生建议咨询心理医生;而对于精神分裂症,79.1%全科医生建议看精神科医生。工作中遇到精神障碍患者,绝大多数(95.6%)会选择转诊转介专科机构,但其中只有71.4%人明确知道市级或区级精神卫生机构。结论有必要在社区全科医生中加大关于精神卫生知识的培训和宣传,提升其对常见精神障碍的识别、转诊、转介能力。     

10/ Peer Supervision in the Community Mental Health Center:

This chapter is divided into three major sections. The first pan delineates six models of supervision that are frequently used in a community mental health setting. The second section spells out some of the possible administrative considerations and concerns regarding supervision in family service agencies, mental health centers, social service organizations, and similar counseling environments. The last segment of this chapter describes a novel supervision model which I have called "peer supervision carried to the extreme". This model has been used in a community mental health center in the Rocky Mountain region. This model is analyzed and its advantages and disadvantages are explicated. It is the conclusion of this author that the "peer supervision carried to extreme" format is viable, but only under certain specific conditions which in the short run may make the model less attractive to community mental health centers.