Swenson John Robert, Bradwejn Jacques
Can J Psychiatry. 2002 Sep;47(7):644-51. doi: 10.1177/070674370204700706.
To discuss developments in Ontario mental health reform, describe general psychiatric services in contrast to tertiary services, describe guidelines for the training of general psychiatrists, and suggest what changes may be required to develop an integrated mental health system (IMHS).
We review the Ontario government's recent blueprint for mental health reform and the Canadian federal government's document on best practices in psychiatry, in the context of defining general psychiatric services and their relation to tertiary services. From this, we consider the education of general psychiatrists and make suggestions for their training.
General psychiatric services correspond to first-line and intensive psychiatric services delivered by community mental health agencies, community psychiatrists, and general hospitals for patients with moderate or serious mental illness. Many suggest that psychiatrists are not being trained to meet the needs of a reformed mental health system. An education program for general psychiatrists should include training in a wide range of community and general hospital settings, work within a multidisciplinary mental health team, and experience working in a shared care model with family physicians.
Along with training general psychiatrists better, we must also develop recruitment and payment incentives, which would allow general psychiatrists who are based in the community and general hospitals to work within an IMHS.
探讨安大略省心理健康改革的进展，对比普通精神科服务与三级服务，描述普通精神科医生的培训指南，并提出建立综合心理健康系统（IMHS）可能需要哪些变革。
在界定普通精神科服务及其与三级服务的关系的背景下，我们回顾了安大略省政府近期的心理健康改革蓝图以及加拿大联邦政府关于精神病学最佳实践的文件。据此，我们考虑普通精神科医生的教育问题，并对其培训提出建议。
普通精神科服务对应于社区心理健康机构、社区精神科医生和综合医院为中度或重度精神疾病患者提供的一线和强化精神科服务。许多人认为，精神科医生的培训无法满足改革后的心理健康系统的需求。普通精神科医生的教育计划应包括在广泛的社区和综合医院环境中进行培训，在多学科心理健康团队中工作，以及体验与家庭医生合作的共享护理模式。
除了更好地培训普通精神科医生外，我们还必须制定招聘和薪酬激励措施，使社区和综合医院的普通精神科医生能够在综合心理健康系统中工作。
