Mechanic David
Rutgers University, Institute for Health, Health Care Policy, and Aging Research, USA.
Health Aff (Millwood). 2003 Sep-Oct;22(5):8-20. doi: 10.1377/hlthaff.22.5.8.
Mental disorders are highly prevalent, but prevalence is different from need for treatment. Some mental disorders are a major source of distress, disability, and social burden, and many people who could benefit from treatment do not receive it. Need is typically self-defined or defined by clinicians who are motivated to bring treatment to those who could benefit. Defining need appropriately requires consideration of the duration and reoccurrence of disorder, associated distress and disability, and the likelihood that treatment will be beneficial. Demand may be promoted inappropriately by clinicians and drug manufacturers who profit from expansion of demand. Future assessments of need must be based on evidence and take into account priorities for care and cost-effectiveness.
精神障碍极为普遍，但患病率与治疗需求不同。一些精神障碍是痛苦、残疾和社会负担的主要来源，许多能从治疗中获益的人却未得到治疗。需求通常由自身定义或由积极为可能受益的人提供治疗的临床医生定义。恰当地定义需求需要考虑疾病的持续时间和复发情况、相关的痛苦和残疾，以及治疗有益的可能性。临床医生和从需求扩张中获利的药品制造商可能会不适当地推动需求。未来对需求的评估必须基于证据，并考虑护理重点和成本效益。
