精神健康和非传染性疾病

N. Gray, J. Klein
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引用次数: 0

摘要

儿童和青少年需要能够预防精神卫生和发育障碍问题的环境和系统,需要能够及早对其需求作出反应的综合初级保健,需要在其他干预措施失败时采取富有同情心的精神卫生保健方法。本文概述了儿童和青少年心理健康实践的历史,以及将心理健康与更广泛的非传染性疾病(NCD)预防和治疗领域联系起来的流行主题。将精神卫生作为世界卫生组织非传染性疾病议程的一部分,提高了全球对精神卫生问题的认识,包括继续消除污名化、临床医生培训和获得基本药物的必要性。精神卫生的政策领域是复杂的,我们反思了错过的将精神卫生有意义地纳入以生命历程为导向的整体卫生保健提供系统的机会。我们探索身体和心理健康之间的双向联系,以及社会决定因素和儿童早期经历对发病率和死亡率的影响。我们研究了心理健康问题的预防,注意到与其他非传染性疾病共有的风险因素,并反思了心理健康治疗(有和没有使用药物),强调了全民健康覆盖(UHC)对儿童和青少年心理健康和福祉的重要性。需要做大量工作,以更好地将精神卫生和其他非传染性疾病相关护理纳入一线初级卫生保健服务,并在儿童和青年的非传染性疾病预防和治疗中纳入真正的生命全过程方法。
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Mental health and non-communicable diseases
Children and adolescents need environments and systems that prevent mental health and developmental disorder problems, comprehensive primary care that is able to respond early to their needs, and methods of compassionate mental health care when other interventions fail. This paper provides an overview of the history of child and adolescent mental health practices and prevailing themes that connect mental health with the wider field of non-communicable disease (NCD) prevention and treatment. Inclusion of mental health as part of the World Health Organization NCD agenda has raised global awareness of mental health issues, including the need for continued de-stigmatization, clinician training, and access to essential medicines. The policy arena for mental health is complex, and we reflect on missed opportunities for meaningful integration of mental health within holistic life-course oriented healthcare delivery systems. We explore bidirectional links between physical and mental health, and the impact of social determinants and early childhood experiences on morbidity and mortality. We examine the prevention of mental health problems, noting risk factors shared with other NCDs, and reflect on mental health treatment—with and without the use of medicines—underlining the importance of universal health coverage (UHC) for children and adolescents’ mental health and wellbeing. Considerable work is needed to better integrate mental health and other NCD related care into front-line primary health care delivery, and to include a true life-course approach to NCD prevention and treatment for children and youth.
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