Druss Benjamin G
Yale University School of Medicine, West Haven, CT 06516, USA.
Gen Hosp Psychiatry. 2002 Jul-Aug;24(4):197-202. doi: 10.1016/s0163-8343(02)00170-6.
This paper, the first in a series commissioned by NIMH for the "Challenges for the 21st Century: Mental Health Services Research Conference," seeks to provide a broad perspective on the primary care/mental health interface in the United States. The manuscript examines both the care of mental disorders in medical settings, and also the medical care of the seriously medically ill. The first section provides a historical overview of the cycling patterns of growth and retrenchment of primary care medicine during the 20th century, and the how those changes have paralleled the care of mental disorders and the mentally ill. The second section examines the four core features of primary care -first contact, longitudinality, comprehensiveness and coordination -and their implications for these issues. An historical and system-level perspective can provide a crucial step towards improving care on the mental health/primary care interface.
本文是美国国立精神卫生研究所（NIMH）委托撰写的系列文章中的第一篇，旨在为“21世纪的挑战：精神卫生服务研究会议”提供关于美国初级保健与精神卫生衔接的广泛视角。该手稿既探讨了在医疗环境中对精神障碍的护理，也探讨了重症患者的医疗护理。第一部分对20世纪初级保健医学的增长与缩减循环模式进行了历史概述，以及这些变化如何与精神障碍和精神疾病患者的护理并行。第二部分审视了初级保健的四个核心特征——首次接触、纵向性、全面性和协调性——及其对这些问题的影响。历史和系统层面的视角可为改善精神卫生/初级保健衔接方面的护理提供关键的一步。
