Eisenberg L
Harvard Medical School, Boston, MA 02115.
Bull Pan Am Health Organ. 1992;26(3):230-41.
The systematic, population-wide application of preventive measures based on what is known about the causes and outcomes of psychiatric disorders can markedly reduce morbidity from mental ill health among children in the Americas. The actions proposed here rely partly upon increasing access for all women and their children to thoroughly tested obstetric and pediatric care; in part they depend on improving nutrition and opportunities for cognitive stimulation; and in part they call for enhancing the mental health skills of primary care practitioners by appropriate in-service training. There are limits to our knowledge and to the effectiveness of some of our interventions; nonetheless, the greatest barrier to better child mental health is failure to muster the political will to apply what is known to the care of mothers and children in all sectors of society.
基于对精神疾病病因和后果的了解,在全人群中系统地应用预防措施,可显著降低美洲儿童心理健康问题导致的发病率。这里提出的行动部分依赖于增加所有妇女及其子女获得经过充分检验的产科和儿科护理的机会;部分依赖于改善营养和认知刺激机会;部分还要求通过适当的在职培训提高初级保健从业者的心理健康技能。我们的知识以及某些干预措施的有效性存在局限性;尽管如此,改善儿童心理健康的最大障碍在于未能鼓起政治意愿,将已知的知识应用于社会各部门对母亲和儿童的照料中。