不让一个人掉队:反思国家层面预防精神障碍的政策与实践

Davide Papola , Corrado Barbui , Vikram Patel
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引用次数: 0

摘要

随着传染性疾病向慢性非传染性疾病的转变,精神障碍给全球造成的负担日益加重。精神障碍影响到个人的功能,不仅造成巨大的精神痛苦和生活质量下降,还造成耻辱和歧视。这种负担延伸到社区和社会,造成深远的经济和社会后果。即使在最佳条件下,单靠治疗也不足以减轻全球精神障碍的负担,因此应在中央层面通过立法、政策制定和资源分配等形式,推动将重点从精神障碍的治疗转向预防。全民预防计划和选择性预防计划应在全国范围内得到优先考虑,因为它们分别旨在改变整个人口的风险状况和专门针对精神障碍高危人群。在本文中,我们将回顾精神障碍的主要风险因素,以及在国家层面可以采取的预防措施,并充分考虑到预防工作可能因其面向的受众、提供的强度水平和针对的人生阶段而有所不同。通过采用人权视角并将健康的社会决定因素置于我们叙述的中心,我们坚持认为,仅靠加强医疗服务是无法改善心理健康的。政府各部门之间需要协调,在广泛的环境、项目和政策中实施多层次的公共卫生干预措施。关注儿童心理健康,解决贫困、性别不平等和社会歧视问题,应该成为国家心理健康政策和计划的绝对优先事项。
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Leave no one behind: Rethinking policy and practice at the national level to prevent mental disorders

The global burden of mental disorders is increasing, in line with the shift from communicable to chronic non-communicable diseases. Mental disorders affect the functioning of individuals, resulting not only in enormous emotional suffering and diminished quality of life, but also in stigma and discrimination. This burden extends to the community and society, with far-reaching economic and social consequences. Even under optimal conditions, treatment alone will never be sufficient to reduce the global burden of mental disorders, so a shift in focus from treatment to prevention of mental disorders should be promoted at the central level in the form of legislation, policy formulation and resource allocation. Universal and selective prevention programs should be prioritized nationally, as they aim to change the risk profile of the entire population and specifically target populations at risk for mental disorders, respectively. In this article, we review the key risk factors for mental disorders and the measures that can be taken at the national level to prevent them, taking into due consideration that prevention efforts can vary based on the audience they are addressing, level of intensity they are providing, and the life phase they target. By adopting a human rights perspective and placing the social determinants of health at the center of our narrative, we maintain that improving mental health cannot be achieved by strengthening health services alone. Coordination across government departments is needed to implement multi-level public health interventions across a wide range of settings, programs, and policies. Focusing on children's mental health and addressing poverty, gender inequality and social discrimination should be absolute priorities for national mental health policies and plans.

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来源期刊
Mental Health and Prevention
Mental Health and Prevention Medicine-Psychiatry and Mental Health
CiteScore
2.10
自引率
0.00%
发文量
22
审稿时长
24 days
期刊最新文献
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