Reed B G, Mowbray C T
School of Social Work, University of Michigan, Ann Arbor, USA.
J Am Med Womens Assoc (1972). 1999 Spring;54(2):71-8.
Individuals with serious mental illness (SMI) and/or alcohol and other drug (AOD) problems often have physical health concerns that are not appropriately treated and that interfere with effective management of SMI and/or AOD problems and contribute to the overall costs to society of these disorders. Although the literature has limitations, available evidence suggests that women with SMI and/or AOD problems have more numerous and severe health concerns than comparable men and that they receive less appropriate health care than men do. These greater problems relate directly to SMI or AOD use, or involve difficulties in complying with medical regimens, side effects of medications, or interactions of AOD use and SMI with other health conditions. Individuals' life situations can also increase their vulnerabilities and health risks. Health problems frequently are not detected by specialty or general practice health professionals, and thus get worse. Women with SMI and AOD disorders have less access to appropriate physical health care services--both within the AOD and SMI treatment systems and within health care settings. Recommendations for improved health care for highly stigmatized groups of women with multiple needs include stronger linkages between systems, increased training of health providers, and policy and program changes.
患有严重精神疾病（SMI）和/或酒精及其他药物（AOD）问题的个体通常存在身体健康问题，这些问题未得到适当治疗，干扰了对SMI和/或AOD问题的有效管理，并增加了这些疾病给社会带来的总体成本。尽管相关文献存在局限性，但现有证据表明，患有SMI和/或AOD问题的女性比同龄男性有更多、更严重的健康问题，且她们获得的医疗保健不如男性合适。这些更严重的问题直接与SMI或AOD使用相关，或涉及在遵守医疗方案方面的困难、药物副作用，或AOD使用及SMI与其他健康状况的相互作用。个体的生活状况也会增加其脆弱性和健康风险。健康问题常常未被专科或全科医疗专业人员察觉，因而愈发严重。患有SMI和AOD疾病的女性获得适当身体健康护理服务的机会较少——无论是在AOD和SMI治疗系统内还是在医疗保健机构中。针对有多种需求、备受污名化的女性群体改善医疗保健的建议包括加强系统间的联系、增加对医疗服务提供者的培训，以及政策和项目变革。
