中国精神卫生法中的康复问题(英文)

Mental health laws and acts usually have a long history behind them when they are eventually adopted. In most jurisdictions the time spent between initial discussions and drafts and the formal adoption of     

中国的精神卫生法(草案)是保护患者公民权利的里程碑(英文)

The draft National Mental Health Law of China was released for public consultations on June 10,2011 [1].Following wide-ranging public consultations,the draft was further amended by the Standing Committee of the National People’s Congress on October 24,2011 [2,3].Although the penultimate draft has been finalized,there are continuous debates and concerns about its potential negative effects on mental health services in China.The article in this issue of the Shanghai Archives of Psychiatry by Professor Xie [4] argues that the proposed law over-emphasizes patient’s self-sufficiency and,thus,neglects traditional Chinese culture,accepted     

神经系统疾病肠内营养支持操作规范共识(2011版)

一、营养风险筛查背景与证据:神经系统疾病伴吞咽障碍患者进食减少或不能进食,危重神经疾病患者分解代谢大于合成代谢,部分神经疾病患者病前就已经存在营养不足或营养风险.因此有必要进行营养风险筛查(nutrition risk screening,NRS,表1),以确定进一步的营养评估和营养支持方案.2003年Kondrup等[2]对128个有关营养支持的随机对照研究进行了系统分析,经NRS2002筛查的8944例患者中,总分≥3分并予以营养支持的,良好结局比例明显增高(P =0.000,Ⅰ a级证据).2003年欧洲肠外肠内营养学会(European Society for Parenteral and Enteral Nutrition,ESPEN)、2006年中华医学会肠外肠内营养学分会(Chinese Society of Parenteral and Enteral Nutrition,CSPEN)和2011年美国肠外肠内营养学会(American Society for Parenteral and Enteral Nutrition,ASPEN)均推荐住院患者使用营养风险筛查工具[3-5].由于NRS2002简便易用,又有循证医学支持证据,2005年至2006年北京3家三级甲等医院神经内科对住院患者应用NRS2002进行了营养风险筛查,在753例住院患者中,461例(61.2％)完成了筛查,营养不足和营养风险的发生率分别为4.2％和21.2％,有营养风险的患者仅14.4％接受营养支持[6](Ⅲb级证据).由此说明,即便大城市的大医院也存在营养风险率较高和营养支持率较低的现状.因此,有必要将营养风险筛查纳入神经系统疾病营养支持操作规范,以加强住院患者营养支持管理.     

精神卫生立法需要着眼于未来(英文)

The forum article by Professor Xie [1] raises the broad issue of whether mental health legislation in China needs to respond to the existing realities of the community mental health services system.Given the lack of community mental health resources in China,the burden of caring for persons with mental illnesses has traditionally been borne by families and by psychiatric hospitals.As China introduces its first national mental health legislation the concern is that     

精神卫生法时代的司法精神病学(一)

司法精神病学发展的历史,长期以来一直是研究和应对精神病人各种危害行为的历史.尽管民事司法鉴定领域业务量不断增大,但精神疾病司法鉴定理论和实践在我国仍主要围绕刑事责任能力、受审能力、服刑能力等展开.当精神卫生服务及其法制化进入到精神卫生专门立法时代后,这种情形可能会出现较大转变,带来司法精神病学领域诸多新的挑战.     

精神卫生法时代的司法精神病学(二)

除了对患者的危险性和住院等行使同意的"决策能力"评估外,精神卫生法对未来司法精神病学领域的重要影响还包括对医疗决定争议的鉴定,以及监狱精神卫生服务.我们以目前全国人大审议中的《精神卫生法(草案)》(以下简称《草案》)[1]相关规定为例加以梳理.     

神经系统疾病肠内营养支持操作规范共识

[编者按] 本刊本卷第9期刊登了神经系统疾病肠内营养支持适应证共识,在此刊登操作规范共识,希望能够对广大神经科医务工作者有所帮助,也希望得到大家的反馈,使共识不断修订和完善     

《中华人民共和国精神卫生法(草案)》相关问题之我见

精神卫生既是全球性的重大公共卫生问题,也是较为严重的社会问题.为了保护和改善公众健康,预防精神障碍发生,规范精神卫生服务,保护精神障碍患者的合法权益,精神卫生的立法进程在加速推进.《中华人民共和国精神卫生法(草案)》(以下简称《精神卫生法》)即将出台,这是精神障碍者的福音,是全民的福音,是精神卫生行业从业者的福音,也是文明的进步,法治的进步.     

精神卫生法对精神卫生服务的影响

精神卫生法的实施,对中国精神卫生服务体系将带来重大的机遇和挑战。一些痼疾将得到改善,也有些新的问题需要破解。现结合相关规定及其背景,概括梳理实施该法律给精神卫生服务可能带来的正反两方面影响。     

中国的精神卫生法曙光初现

中国的精神卫生法在1985年卫生部指定四川省卫生厅协同湖南省卫生厅起草精神卫生法草案以来,经历了20余年的漫长岁月终于快要走到立法的尽头,这一次的公开征求意见稿由国务院法制办公室修改后[1],将送到人大常委会审议、再修改,然后通过,并颁布、实施。从1985年到1999年     

The psychiatric hospital and therapeutic jurisprudence: applying the law to promote mental health

If the law provided for accessible and efficient means to facilitate mental health treatment, the law itself could be a component of the comprehensive care system.     

Military mental health professionals on operational deployment: an exploratory study

This exploratory study aimed to develop greater insight into the occupational and personal nature of the practice of mental healthcare on operational deployments. Twenty-eight British military mental health professionals were identified as having recently returned from deployment, with 35% agreeing to participate in semi-structured qualitative interviews. Results suggest that whilst this population have a range of stressors, their main concern is to work towards the success of the overall mission objectives, mainly through achieving their clinical goals. Such work is impacted by challenges such as ethical difficulties, professional obstacles, bonding with colleagues and personal issues. They do however rely upon a range of intra and inter-personal strategies to overcome these hurdles successfully. A number of suggestions for improved mental healthcare on deployment are also identified. A review of the implications of the findings is offered and recommendations for improved training and support for mental healthcare professionals are explored. Finally, potential avenues for future research are considered.     

How community mental health centers are coping

Many community mental health centers have had to operate with less funding in the past several years, especially since the advent of block grant funding. Evidence is now accumulating that some centers have had to decrease their overall level of services and staffing. Others have attempted to adjust by increasing their clinician caseloads, closing their satellite facilities, and de-emphasizing services that fail to generate adequate fees and third-party reimbursements, such as consultation and education, partial hospitalization, and programs for children and the elderly. In contrast, and partly as a result of the increased authority of the states over the community mental health centers program, services for the severely and chronically mentally ill appear to be receiving higher priority. This development will require that centers improve their access to the general health care sector, maintain and improve their relationships with academic institutions, and increase the number, responsibilities, and rewards of the psychiatrists they employ.