中国精神卫生政策研究资源中心

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《中国卫生评论》(China Health Review)是中国卫生政策与管理协会(海外)的电子季刊,提供对一个对中国卫生政策研究有兴趣的学者评论和交流的平台。中国卫生政策与管理学会(CHPAMS)是在美国中华医学基金会(CMB)的大力支持下,美国几所著名公共卫生学院和研究机构的一群中国青年学者于2008年冬在波士顿发起的一个独立的非营利性组织。学会希望通过推动中国公共卫生尤其是卫生政策和管理领域的研究与实践来提高中国人民的健康;目标包括促进国内外学术机构和学者的交流,帮助国内外学者建立合作,共同研究中国面临的最紧迫的公共卫生问题,并为卫生政策制定者与卫生机构管理者搭建一个与海外学界沟通的桥梁。

China Health Review is the electronic magazine published quarterly by the CHPAMS. Initiated by some young scholars in a few renowned public health schools and research institutes in the United States, the China Health Policy and Management society aims to improve the health of Chinese people by advancing public health research, practice and education, particularly in the health policy and management arena.The goal of CHPAMS is to foster scholarly exchanges among its members, to promote such exchanges between overseas academic community with Chinese public health community, and to help solve the most pressing public health issues China is now facing. With the support from China Medical Board (CMB).

[Volume 1 Issue 1] [Volume 1 Issue 2]

[Volume 2 Issue 1] [Volume 2 Issue 2] [Volume 2 Issue 3] [Volume 2 Issue 4]

[Volume 3 Issue 1] [Volume 3 Issue 2] [Volume 3 Issue 3] [Volume 3 Issue 4]

[Volume 4 Issue 1] [Volume 4 Issue 2] [Volume 4 Issue 3] [Volume 4 Issue 4]

[Volume 5 Issue 1] [Volume 5 Issue 2]

 

译者:陈晗晖、费立鹏、程辉、陈琼琼、陈晓东、朱子龙、张银娥、黄佳、毕曼丽

原文"中华人民共和国精神卫生法(英文)"发表于上海精神医学,2012年第6期。

Chen HH, Phillips MR, Cheng H, Chen QQ, Chen XD, Fralick D, Zhang YE, Liu M, Huang J, Bueber M. Mental health law of the People's Republic of China (English translation with annotations). Shanghai Archives of Psychiatry 2012; 24(6): 305-321. doi: 10.3969/j.issn.1002-0829.2012.06.001

世界精神卫生地图2011

 Mental Health Atlas 2011 was released in middle October 2011. Project Atlas was launched by the WHO in 2000 in an attempt to map mental health resources in the world. The primary objective of the project is to collect, compile, analyze, and disseminate basic information on mental health resources from WHO Member States. The data analysis in latest version covers 6 domains: governance, financing, mental health care delivery, human resources, medicines for mental and behavioral disorders, and information systems.

2011年10月中旬,第三版《世界精神卫生地图》出炉。该项目由世界卫牛组织(WHO)于2000年启动,最初的目标是收集、编辑、分析并传播WHO成员国精神卫生资源的基本信息。新版精神卫生地图的数据分析分为6项主题:管理、财务、精神卫生服务、人员、药品和信息收集系统。

英文全文下载 Full text download

 

文章对所有世界卫生组织成员国可利用的精神卫生资源信息进行了介绍。

The country profiles include available information on mental health resources for all WHO Member States.

《世界卫生组织精神卫生、人权与立法资源手册:停止排斥,勇于关爱》

WHO Resource Book on Mental Health, Human Rights and Legislation: Stop exclusion, dare to care

好的立法是改善精神障碍者的生活的一种重要方式。本资源手册目的在于帮助那些正在起草、实施和修改这类立法的国家。它并非要为这些国家指定某种特定的立法模式,而是对需要纳入法律之中的主要内容和原则加以归纳。

本手册中概要说明了有效的立法的三个关键性基础:背景、内容和过程;换句话说,即是精神卫生立法的"原因"、"内容"和"方式"。此外,附件1提供一个精神卫生立法清单,它可与本资源手册联合使用。此清单是用来帮助各国评估是否已经把关键的内容包括进了其精神卫生法之中,以及用以保证资源手册中所提出的广泛的建议得到仔细的检查和考虑。

Good legislation is one important way to improve the lives of people with mental disorders. Resource Book aims to assist countries in drafting, adopting and implementing such legislation.It does not prescribe a particular legislative model for countries, but rather highlights the key issues and principles to be incorporated into legislation.

Three key elements of effective legislation are outlined: context, content and process; in other words, the "why", "what" and "how" of mental health legislation. In addition, Annex 1 contains a Checklist on Mental Health Legislation, which can be used in conjunction with the Resource Book. The checklist is designed to assist countries in assessing whether key components are included in their mental health law, and in ensuring that the broad recommendations contained in the Resource Book are carefully examined and considered..

Mental health services in China:A review of delivery and policy issues in 1949 - 2009

【摘要】目的: 对中国1949 - 2009 年精神卫生服务提供模式和相关政策进行了系统回顾,分析不同发展阶段的特征,为我国精神卫生改革提供借鉴。方法: 通过检索电子期刊数据库和我国卫生部官方网站等数据库并配合相应的手工检索,纳入收集整理与精神疾病流行病学、精神卫生服务提供、精神卫生服务利用、精神卫生政策和规划高度相关的资料。访谈国内外从事精神卫生服务工作的多名知名专家和主管领导,对其访谈内容记录、录音,进行归纳、分析、总结。结果: 共纳入216 篇文献,213 人参与访谈。研究显示,60 年来中国精神卫生资源和服务模式的演变经历了快速发展、稳步发展和改革等三个阶段; 中国精神卫生服务体系在60 年间发生了巨变化,但仍存在资源短缺、精神病治疗率较低、普通人群和医务人员精神卫生知识匮乏、社会对精神病人的偏见严重等现状; 60 年间,中国精神卫生服务政策也经历了巨大的变化,正向着建立以社区精神卫生服务为主的综合服务网络方向前进。结论: 我国应继续强化社区卫生服务,提高精神卫生服务的公平性和可及性。

【Abstract】Objective: To explore the development of mental health services in China from 1949 to 2009,analyze the characteristics of different development stages,and to provide a reference for mental health reform. Methods: By searching the CBM,CNKI,Pubmed,Ministry of Health of China, and corresponding with the manual search,collected information about the epidemiology of mental illness,mental health service offer,mental health service use,and the mental health policy and scheme. Meanwhile,carried out the informant interviews between a number of experts in mental health services and the competent leadership at home and abroad,and then analyzed the interview content. Results: Totally 216 articles met the inclusion criteria,and 213 persons participated in the interviews.The evolution of mental health resources and service model in the 60 years experienced three phases,i.e.,rapid growth,steady development,and the reform period. The situation,such as the shortage of resource,lower rate of psychiatric treatment,lack of the knowledge of mental health,social prejudices of serious mental illness,still existed. The mental health service policy had also undergone dramatic changes,and moving toward the establishment of the integrated service network-based community mental health services of the mental health services. But there still were some problems,such as shortage of resource,lower rate of psychiatric treatment,lack of the knowledge of mental health,social prejudices of serious mental illness,and so on. Conclusion: The community health service should be strengthening, and fairness and accessibility of mental health service should be improving in the long run. 

 

The World Health Report 2001: Mental Health: New Understanding, New Hope provides scientific evidence on the huge burden of disease associated with mental illness. This report also outlines the need and rationale for building community-based mental health systems and services. The report's 10 recommendations address key components of mental health system development:

1. Provide treatment for mental disorders in primary care; 2. Ensure wider accessibility to essential psychotropic drugs; 3. Provide care in the community; 4. Educate the public; 5. Involve communities, families and consumers; 6. Establish national policies, programmes and legislation on mental health; 7. Develop human resources; 8. Link with other sectors; 9. Monitor community mental health; 10. Support relevant research.

世界卫生组织2001年报告《精神卫生:新理解,新希望》提供了精神障碍导致巨大疾病负担的科学证据。  该报告还阐述了建立以社区为基础的精神卫生系统和服务的需要和根据。 该报告提出了10项建议,以解决精神卫生系统发展的关键问题:

1、为精神障碍患者提供初级保健中的治疗; 2、确保基本精神药物有更广泛的可及性; 3、提供社区服务; 4、教育公众; 5、社区、家庭和服务对象共同参与; 6、制定精神卫生国家政策、项目和法规; 7、开发人力资源; 8、与其他部门合作; 9、社区精神卫生的监测; 10、支持相关研究。

[编者按] 世界卫生组织(WHO)的2001年报告“精神卫生:新认识,新希望”最近公布。WHO总干事Gro Harlem Brundtland为此写了序言。该报告的主要内容包括精神卫生的公共卫生观点、精神与行为障碍的负担、解决精神卫生问题、精神卫生政策与服务提供、未来方向以及一些最新的统计数据附录。在前言和第五章“未来方向”中,WHO提出了10点建议,希望各国根据自己的需求和资源情况遵照执行,以改善全球的精神卫生工作。现将这10点建议译出,供同道们参考。

Editor’s Notes: World Health Organization (WHO) has recently released its World Health Report 2001 “Mental Health: New Understanding,New Hope”, for which Dr Gro Harlem Brundtland, the Director General of WHO, wrote a preface. The report consists of the following chapters: a public health approach to mental health, burden on mental and behavioral disorders, solving mental health problems, mental health policy and service provision, the way forward and statistical annex. In the preface and the fifth chapter of “the way forward”, WHO proposes 10 recommendations and calls for actions of each country depending on their needs and resources available, in an attempt to improve the global mental health. Now the 10 recommendations have been translated for your reference.

Assessment of contents of local mental health laws in Mainland China

【摘要】目的: 了解我国大陆地区地方性精神卫生条例在内容上的不足,为精神卫生立法提供建议. 方法: 采用专题讨论的方法,对我国大陆地区六部地方精神卫生条例按照爯世界卫生组织有关精神卫生立法的检查清单爲进行评价. 结果: 按照世界卫生组织立法检查清单,六部地方性精神卫生条例彼此之间相差不大,六部地方性精神卫生条例在自愿入院、自愿治疗、非自愿入院、非自愿治疗、社区中的非自愿治疗、特殊治疗、监督调查机制、犯罪的精神障碍患者的处理、保护弱势群体、保护精神障碍患者的就业、住房权利、社会保障等方面的具体规定较少. 结论: 我国精神卫生立法需要在对非自愿就医的标准、批准机构、复核机构、实施步骤、期限等方面做出明确的规定; 需要规定切实可行的审查、监督机制及司法救济途径; 需要对精神障碍患者的就业、住房权利和社会保障制订具体的规定或实施细则.

【Abstract】Objective: To find the defects in local mental health regulations announced in recent years in Mainland China and provide recommendations for mental health legislation. Methods: Using a five-point scale for each dimension,the contents of the six local mental health regulations were assessed based on the World Health Organization on Mental Health Legislation Checklist by a group of researchers collectively. Results: Within the six local mental health regulations evaluated,there were no significant differences. Compared with the World Health Organization on Mental Health Legislation Checklist,these regulations are significantly lack of emphases on voluntary admission, voluntary treatment,involuntary hospitalization,involuntary treatment,involuntary treatment in the community, special treatment,mechanisms to supervise the investigation of criminal treatment of mental disorders,protection of vulnerable groups,protection of mental disorders in employment,housing,and social security,etc. Conclusion: China' s mental health legislation need to clearly define the procedures and time limitation for involuntary admission and treatments,clearly define feasible mechanism and routines of review,supervision and judicial remedies, and clearly define provisions or implementation details on employment and social security,housing rights of people with mental disorders.

Selection of assessment indicators for mental health service

ABSTRACT Assessment of mental health service refers to the process of using the indicator system and methods to reflect the quality or performance of mental health. Mental health evaluation can effectively promote the development of mental health system and service quality. Scientific and comprehensive indicator system is key to assessment. After long-term practice and exploration, there have been many successful assessment schemes in foreign countries, which may be used in establishing the assessment system and screening indicators in China.

[ 摘要] 精神卫生服务评估是指建立并运用评估指标体系和方法,量化表达精神卫生工作质量或绩效的过程。精神卫生评估能有效地促进精神卫生系统的发展和精神卫生服务质量的改善。科学全面的评估指标体系是评估工作开展的基础。国外精神卫生服务评估经过长期的实践与探索,形成了许多成功的评估方案。这些方案在指标体系的构建与指标的筛选方面值得国内借鉴。

Allocation of mental health facilities and psychiatric beds in China in 2010

[摘要]目的:了解中国精神卫生机构和床位资源分布情况,为制定全国性精神卫生服务资源配置规划提供参考。方法:数据来源于卫生部“2010年全国卫生资源与医疗服务调查”和国家精神卫生项目办公室“2010年精神卫生专业机构调查”,对其中的精神卫生机构主办单位管理归属床位资源等相关数据进行描述性分析。结果:2010年全国共有1650家精神卫生机构,精神科开放床位数228100张。精神科床位主要分布在精神病专科医院中,占总床位数的86.4%; 主办单位包括政府部门、企业、个人、事业单位、社会团体等,以政府部门主办为主,占总床位数的88.4%。精神科床位密度全国平均为1.71张/万人,上海和北京最高,西藏自治区精神科床位数为0。全国精神病专科医院床位使用率为92.4%,平均住院日中位数为45d。结论:全国精神卫生机构主办部门众多,精神卫生床位资源数量不足,地域分布不合理。

[Abstract] Objective: To analyze the allocation of mental health facilities and psychiatric beds in China,in order to provide a reference for developing the national plan for resource allocation for mental health services. Methods: Data were collected from two surveys. In 2010-2011,one,funded by the Ministry of Health,surveyed national health resources and medical services. The other,conducted by the National Mental Health Program Office,surveyed mental health facilities. Descriptive methods were used. Results :At the end of 2010,there were 1650 facilities which provided mental health services in China,comprising 874 psychiatric hospitals,604 psychiatric or psychological departments in general hospitals,95 psychiatric or psychological clinics,and 77 rehabilitation facilities. Mental health facilities were funded by government departments,enterprises,private individuals,institutions and social organizations; most (69.5%) of the mental health facilities were funded by government departments. At the end of 2010,there were228,100 psychiatric beds,mainly (86.4%) located in psychiatric hospitals. Most (88.4%) of the psychiatric beds were funded by government departments. The national mean number of psychiatric beds per10,000 population was1.71,with Shanghai and Beijing having the highest numbers,i.e.,5.55 and 4.88 beds per 10,000 population respectively. There were no psychiatric beds in Tibet,and Qinghai was the province with lowest number of psychiatric beds per 10,000 population (0.28). The median bed utilization ratio was 92.4% and the median length of stay in psychiatric hospitals was 45days.  Conclusion: The number of psychiatric beds per 10,000 population in China is well below the mean for countries of a similar economic level,and the beds allocation is very unequal. Funding for mental health facilities and psychiatric beds nationwide comes from many different sources,which may promote in efficiency and poor coordination of mental health resources.

【摘要】 目的:在考虑精神障碍住院治疗"急慢分治"需求的前提下,提出适合我国国情的精神科床位配置方案,为制定全国性精神卫生服务资源配置规划提供参考。方法:通过文献复习、专家咨询,获得目前使用住院服务的主要精神障碍(精神病性障碍、双相情感障碍、重性抑郁障碍和老年期痴呆)的患病率和急慢性住院治疗的比例、平均住院日的数据,根据世界卫生组织推荐的精神科床位配置计算公式,计算精神科床位配置方案。结果:全国精神科床位的最低配置(满足可能有危害社会行为的精神病性障碍和双相情感障碍患者的急、慢性住院治疗需要)为262562张(床位密度1.97张/万人口),其中急性床位112206张,慢性床位150356张;中等配置(在最低配置基础上,进一步满足有严重自杀倾向重性抑郁障碍患者和有明显精神行为症状老年期痴呆患者的急性住院治疗需要)需618461张(4.64张/万人),其中急性468105张,慢性150356张;较高配置(在中等配置基础上,进一步满足可能致残的精神病性障碍和双相情感障碍患者的急、慢性住院治疗需要)需1141340张(8.56张/万人),其中急性692517张,慢性448823张。结论:精神科床位资源配置应分阶段进行,首先满足最低配置,逐步加强床位建设。在各档配置中首先应满足急性住院的需要,在此基础上,进一步增加慢性治疗床位建设。

Abstract Objective:Based on the principle of meeting different hospitalization needs of acute and chronic patients with mental disorder,an allocation plan of psychiatric beds in China was proposed to provide a reference for developing the national plan for resource allocation for mental health services.Methods:Data were obtained by literature review, including the prevalence rates of the psychotic disorders,bipolar disorder,major depressive disorder and dementia,which were the disorders principally utilized inpatient services. Data were also collected by Delphi study ,including the proportion of patients with above disorders requiring inpatient treatment and their average hospitalization days. Then how many psychiatric beds were required in China with the computing formula recommended by World Health Organization were calculated.Results:A three-level allocation plan was proposed. The low level was to meet the hospitalization need for the patients with psychotic disorder or bipolar disorder who had high risk violence behavior,and 262,562 psychiatric beds ( 1. 97 per 10,000 population) were needed,comprising 112,206 beds for acute admission and 150,356 beds for chronic hospitalization. The middle level,based on the low level,was to further meet the acute hospitalization needs for major depressive disorder patients with serious suicide risk,and dementia patients with obvious behavioral and psychological symptoms,and 618,461 beds ( 4. 64 per 10,000 population) were required,in which the beds for acute hospitalization went up to 468,105. The high level,based on the middle level,was to further meet the hospitalization need for patients with psychotic disorder or bipolar disorder who had high risk of disability,and 1141340 beds ( 8. 56 per 10,000 population) in total should be allocated,comprising 692,517 beds for acute admission and 448,823 beds for chronic hospitalization.Conclusions:It suggests that psychiatric beds allocation should be carried out step by step,with the first step to meet the need of low level,then to increase beds number to further meet the higher level needs. For each level,the acute hospitalization need should be met first,then to develop the chronic hospitalization beds.

 [摘要] 精神卫生监测指系统地、连续地收集和分析人群精神健康、影响精神健康的因素和相关的精神卫生服务信息的活动。虽然国际上开展精神卫生监测的时间并不长,但目前监测内容已发展得较为丰富,涵盖了精神健康问题、危险因素、精神卫生服务以及精神病人的权利保障等方面。负责或资助监测的主体包括国际组织、政府部门和非政府机构三类。目前,监测资料主要用于学术研究和政府决策。

[关键词] 精神卫生监测;监测内容;监测组织;监测利用

[Abstract] Mental health surveillance is the systematic and ongoing collection and analysis of data on population mental health, factors affecting mental health and relevant information of mental health services. Although mental health surveillance in the world has only a short history, it has developed rich content, covering mental health problems, risk factors, mental health services and rights protection for the patients. Organizations responsible for or sponsoring surveillance include international organizations, government departments and non-governmental organizations. The surveillance data are often used for academic research and government decision-making.

[Key words] mental health surveillance; surveillance content; surveillance organizations; utilization of surveillance

Integration not Isolation:Paradigm Transformation of Modern Mental Health Policy in UK

【摘要】长期以来,精神疾病是困扰人类社会的重要难题。在英国,政府借助于公共政策,介入于精神卫生问题的历史由来已久。纵观英国精神卫生政策的发展历程,"融入"而非"隔离"的理念逐渐成为该领域的主导哲学,并由此引发传统的精神卫生政策向现代精神卫生政策的范式转换。

Abstract Mental disease is one of major problems puzzling human society for a long time.There is along history for the UK government to conduct intervention into the field of mental health by public policies.In the history of UK's mental health policies, the theme of integration overwhelms isolation.and becomes the initiation of paradigm transformation from traditional mental health policy to modern mental health policy.

欧洲精神卫生政策与实践: 迎接挑战

This WHO report, co-funded by the European Commission, gives an overview of policies and practices for mental health in 42 Member States in the WHO European Region. Nearly all countries have made significant progress over the past few years, and several are among the leaders in the world in such areas as mental health promotion, mental disorder prevention, service reform and human rights. Nevertheless, this report also identifies weaknesses in Europe: some systematic, such as the lack of consensus on definitions and the absence of compatible data collection, and others that show great variation across countries, such as the stage of community services development and the level of investment in various areas. It also identifies gaps in information in areas of strategic importance for the development of mental health policies. This report is a baseline against which progress can be measured towards the vision and the milestones of the Mental Health Declaration for Europe.

该报告由世界卫生组织和欧洲委员会共同资助完成。该报告简要介绍了世界卫生组织欧洲地区的42个会员国的精神卫生政策与实践。几乎所有国家在过去的几年里都取得了显著的进步,还有几个国家在如精神健康促进、精神障碍预防、服务改革与人权等领域处于世界领先地位。然而,这份报告也指出了欧洲国家精神卫生工作的缺陷:一些系统性的缺陷,如缺乏界定的共识和兼容的数据收集;此外,还有一些缺陷在各国表现程度非常不同,如社区服务发展的阶段、在不同领域的投资水平。该报告还指出,对精神卫生政策发展有战略重要性的领域存在信息缺失。本报告为基线研究,能衡量已有进展与《欧洲精神卫生宣言》里的远景和里程碑间存在的差距。

2001-2005年在中国四省精神障碍的患病率、治疗和相关残疾的流行病学调查

We used multistage stratified random sampling methods to identify 96 urban and 267 rural primary sampling sites in four provinces of China; the sampling frame of 113 million individuals aged 18 years or older included 12% of the adult population in China. 63 004 individuals, identified with simple random selection methods at the sampling sites, were screened with an expanded version of the General Health Questionnaire and 16 577 were administered a Chinese version of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV axis I disorders by a psychiatrist.

Substantial differences between our results and prevalence, disability, and treatment rate estimates used in the analysis of global burden of disease for China draw attention to the need for low-income and middle-income countries to do detailed, country-specific situation analyses before they scale up mental health services.

作者采用多阶段分层随机抽样方法,以确定在中国的四个省份的96个城市和267个农村初级抽样点;抽样框为 18岁以上的113万人口,涵盖了全国成年人口的12%。对在抽样点简单随机抽样选出的63004个体使用了一般健康问卷扩展版进行筛查,精神科医生对16577个体进行了 中国版的精神障碍诊断与统计手册IV轴I的定式临床检查。

本研究的结果和用于中国全球疾病负担分析的患病率、残疾和治疗率的估计值存在极大差异,差异提请中低收入国家注意,在扩大其精神卫生前,需要进行具体的、针对本国的现状分析。

中国精神卫生及精神卫生相关政策的评判性综述: 需要更多行动

In China, there are over 170 million people suffering from mental illness. However, there is a lack of a critical review of the policies governing the provision of mental health services.Drawing on the framework of mental health policy developed by the WHO, this article critically examines mental health policies regarding legislation, financing, model of care and delivery, as well as manpower and the training of mental health professionals in China. This analysis raises a number of policy-related questions concerning the lack of communitybased psychiatric services, inadequate coverage of mental health services in the rural areas, poor standard of education and an insufficient number of trained mental health professionals, and insufficient protection of the human rights of people with mental illness. The article ends by urging the various levels of governments to make a firm commitment to improve mental health care for people with mental illness in China.

精神卫生行动:国际政策回顾

This study provides a review of mental health policy in fourteen developed countries and investigates the interventions proposed in policy to address the problem.

本研究回顾了14个发达国家的精神卫生政策,并且审查了政策中提出的解决精神卫生问题的干预措施。

An important pathway of mental health service reform in China: introduction of 686 Program

【摘要】本文全面介绍了"中央补助地方重性精神疾病管理治疗项目"实施7 年来的主要内容和效果。该项目以崭新的"医院社区一体化"服务模式覆盖了全国160个市( 州) 的680个区县,实际覆盖人口3.3亿。共登记建档了28万例重性精神病患者,随访20万例次,提供免费药物治疗累计9.4万例次,免费收治患者1. 24 万人次。2006 年1 月至2011 年4 月的统计显示,随访患者病情维持稳定的比例从基线的67.0%增加到第5 年的90.7%; 所管患者的肇事率从基线的4.8% 下降到0.5%; 肇祸率从基线时的1.5%下降到0。同时将精神卫生服务半径从医院外展至平均74 公里,培训多功能服务团队人员38.2万人、52.5万人次。其中专科医生1万人,占我国精神科医师的50%; 约7万人参与686,其中精神专科医护人员与其他参与人员之比为1∶7. 25,7年来间接地将精神卫生服务队伍扩大了7倍。

【Abstract】This paper comprehensively describes the main contents and outcomes of National Continuing Management and Intervention Program for Psychoses (686 Program) which has been developed for seven years. With a new hospital-community integrated service model,this program has actually covered 0.33 billion general population in 680 districts /counties,160 cities. Above 280000 patients suffering from psychoses were registered,200000 person-times received regular follow-up,94000 person-times received free medication,and 12400 person-times were given a subsidy for hospitalization. The statistic results of five consecutive years ( From January 2006 to April 2011) showed that the proportion of followed up patients in stable condition increased from a baseline of 67.0% to 90.7% in the fifth year; the rate of violating social security regulations declined from 4.8% to 0.5%,while that committing crimes reduced from 1.5% to 0. Meanwhile,the radius of mental health care outreached to an average of 74 kilometers from the hospitals. About 382000 persons and 525000 person times were trained as members of multi-functional team,in which 10000 were psychiatrists that accounting for half of all psychiatrists in China. Currently,above 70000 persons are participating in 686 Program,including psychiatric personnel and other medical personnel in the ratio of 1: 7. 25,which means mental health service team nationwide has been enlarged to 7 times during the past seven years.

 

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