Wasylenki D, Goering P, Macnaughton E
Continuing Care Division, Clarke Institute of Psychiatry, Toronto, Ontario.
Can J Psychiatry. 1992 Apr;37(3):199-206. doi: 10.1177/070674379203700311.
Planning mental health services is a complex task requiring an understanding of background developments and key issues related to mental health services. In Canada, the deinstitutionalization of patients attempted to shift the locus of care from provincial psychiatric hospitals to general hospital psychiatric units. This resulted in the isolation of provincial psychiatric hospitals, general hospital psychiatric units and community mental health programs, with little overall accountability for the services provided--three solitudes. To move toward the creation of responsible, integrated systems a number of issues must be addressed: target population(s); the roles of provincial psychiatric and general hospitals; community support services; continuity of care; co-morbidity; consumerism; and methods of integration. In the development of a comprehensive mental health plan, each issue should be recognized and decisions made which are in keeping with current knowledge. A companion report will survey Canadian initiatives in mental health planning and discuss approaches to many of the issues identified.
规划心理健康服务是一项复杂的任务，需要了解与心理健康服务相关的背景发展和关键问题。在加拿大，患者的非机构化试图将护理地点从省级精神病医院转移到综合医院的精神科病房。这导致了省级精神病医院、综合医院精神科病房和社区心理健康项目的孤立，对所提供的服务几乎没有总体问责制——三个孤立的部分。为了朝着建立负责的、综合的系统迈进，必须解决一些问题：目标人群；省级精神病医院和综合医院的作用；社区支持服务；护理的连续性；共病；消费主义；以及整合方法。在制定全面的心理健康计划时，应认识到每个问题，并根据当前知识做出决策。一份配套报告将调查加拿大在心理健康规划方面的举措，并讨论对许多已确定问题的处理方法。
