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中国精神卫生: 到2020年,能实现什么?

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Lancet, Vol 385, No.9987, p2548, 27 June 2015)

本月中国某农村的四个年龄在513岁的兄妹因服用农药而自杀死亡。这起悲剧事情暴露出中国几项主要的健康问题:外来务工员留守子女的心理健康;自杀的有效控制和高昂损失;社会变化过程中广泛精神卫生问题。据估计,目前中国有1.73亿人患有精神健康问题,其中登记在册患有重性精神疾病的430万。认识到挑战的严重性,中国于618日发布了《全国精神卫生工作规划(2015-2020年)》。

这项计划代表着全体相关政府部门做出的共同努力。预防和治疗抑郁症、孤独症和痴呆被认为是关键目标。计划设定未来五年内取得的具体目标包括:超过80%登记在册的重性精神病患者得到管理,至少80%的精神分裂症患者得到治疗。对于生活存在经济困难符合标准的严重患者将获得财政支持。此外,到2020年注册精神科医生的数量将增加一倍至40 000人,以提供更多的合格的和可及的精神卫生服务。然而,计划中没有明确的财政预算分配,因此这些目标能否实现仍然是一个疑问。重要的是,计划提出要加强信息系统的建立,用于收集证据、促进更多精神卫生研究的开展、创建测量未来5年进展的评估系统。令人担忧的是,政府计划中未提及如何预防自杀以及如何应对精神疾病患者遭受的羞辱和歧视。

中国精神卫生系统需要全方面融入中国的国家卫生的各个方面、社会政策、财政预算、卫生系统改革以及提供初级和二级医疗保健。精神卫生与所有人相关;好的精神卫生计划是整个中国社会更为美好未来的基础。

 


Mental health in China: what will be achieved by 2020?

This month, in a rural village in China, four siblings aged 5–13 years died by suicide after consuming pesticide. This sad case brought to light several major health concerns in China: the well-being of so-called left-behind children,whose parents are mostly migrant workers; the terrible toll, and the need for effective control, of suicide; and the broader issues of mental health in a changing society.An estimated 173 million adults in China have mental health disorders, of whom 4·3 million are registered as having severe mental health problems. Recognising the seriousness of the challenges, China released its National Mental Health Working plan (2015–20) on June 18.

This plan represents a collective effort of all relevant government bodies. Prevention and treatment of depression, autism, and dementia were defined as key targets. The plan set specific goals for the next 5 years—such as more than 80% of registered patients with severe mental illnesses in “management”, with treatment reaching at least 80% of people with schizophrenia.Eligible, severely affected patients living with economic difficulties will also receive financial support. Furthermore,the number of registered psychiatrists will be doubled to 40 000 by 2020 to provide more qualified and accessible mental health services. However, given that no explicit budget has been allocated for the plan, whether these aspirational goals are achievable remains doubtful.Importantly, the plan identifies a need to strengthen information systems, to gather evidence, to do more research in mental health, and to create an assessment system for measuring progress during the next 5 years.Worryingly, suicide prevention as well as strategies to tackle stigma and discrimination against people with mental illness were absent from the government’s plan.

China’s mental health system needs to be fully integrated into all aspects of China’s national health and social policy and budget plan, health-system reform, and delivery of primary and secondary health care. Mental health is everyone’s business; and good mental health planning is the bedrock of a better future for the whole of Chinese society.


相关链接:http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)61146-1/fulltext?elsca1=etoc&elsca2=email&elsca3=0140-6736_20150627_385_9987_&elsca4=Public%20Health%7CInfectious%20Diseases%7CHealth%20Policy%7CInternal%2FFamily%20Medicine%7CGeneral%20Surgery%7CLancet

最后更新 ( 2016-07-22 19:52 )