Goldberg D
Department of Research and Development, Institute of Psychiatry, King's College, London, UK.
Acta Psychiatr Scand Suppl. 2000;399:57-60. doi: 10.1111/j.0902-4441.2000.007s020[dash]14.x.
The King's Fund published its second London Commission in July 1997, and had produced a report 'London's Mental Health' in preparation for this, consisting of the most complete account ever published of the present state of the mental health services. They are found to be in a state of crisis, unable to cope with the very high levels of demand seen in the deprived inner city areas. There are now too few beds in the National Health Service to deal with the number of patients who need to be admitted, and too few residential places in the community to take those ready for discharge. The report considers the reasons for the high demand, and finds London to contain the six most socially deprived districts in the country, the highest unemployment rates, and double the number of persons living in single person accommodation. Emergency care is from the Accident and Emergency Departments, and the complete range of community care is not available anywhere. Remedies for these problems include adjustments to the resource allocation formulae, removal of the difficulties preventing new capital building in the public sector, and removing the divide between health and social services.
国王基金于1997年7月发布了其第二项伦敦委员会报告，并在此之前撰写了一份《伦敦的心理健康》报告，其中包含了有史以来对心理健康服务现状最完整的描述。人们发现这些服务处于危机状态，无法应对贫困市中心地区极高的需求水平。目前国民保健制度中床位太少，无法收治需要住院的患者数量，社区中的住宿场所也太少，无法接收那些准备出院的患者。该报告考虑了高需求的原因，发现伦敦包含了全国六个社会最贫困的地区、最高的失业率，以及居住在单人住所的人数是其他地区的两倍。急诊由事故与急救部门负责，社区护理的全方位服务在任何地方都无法提供。解决这些问题的措施包括调整资源分配公式、消除阻碍公共部门新建资金投入的困难，以及消除卫生与社会服务之间的隔阂。
