Davidson Larry, O'Connell Maria, Tondora Janis, Styron Thomas, Kangas Karen
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06513, USA.
Psychiatr Serv. 2006 May;57(5):640-5. doi: 10.1176/ps.2006.57.5.640.
The notion of "recovery" has recently taken center stage in guiding mental health policy and practice. However, it is not yet clear what the term means and what is to be entailed in transforming the nation's mental health system to promote it. The authors discuss the various meanings of recovery as applied to mental illness and list the top ten concerns encountered in efforts to articulate and implement recovery-oriented care. These concerns include the following: recovery is old news, recovery-oriented care adds to the burden of already stretched providers, recovery involves cure, recovery happens to very few people, recovery represents an irresponsible fad, recovery happens only after and as a result of active treatment, recovery-oriented care is implemented only through the addition of new resources, recovery-oriented care is neither reimbursable nor evidence based, recovery-oriented care devalues the role of professional intervention, and recovery-oriented care increases providers' exposure to risk and liability. These concerns are addressed through discussion of the two over-arching challenges that they pose, namely the issues of resources and risk.
“康复”这一概念最近在指导心理健康政策与实践方面占据了核心地位。然而，该术语的含义以及为促进康复而转变国家心理健康系统需要涉及哪些方面尚不明晰。作者们探讨了应用于精神疾病的康复的各种含义，并列出了在阐明和实施以康复为导向的护理过程中遇到的十大关切问题。这些关切包括：康复是老生常谈，以康复为导向的护理增加了本就不堪重负的提供者的负担，康复意味着治愈，只有极少数人能康复，康复是一种不负责任的时尚，康复仅在积极治疗之后且作为其结果才会发生，以康复为导向的护理仅通过增加新资源来实施，以康复为导向的护理既不可报销也无循证依据，以康复为导向的护理贬低了专业干预的作用，以及以康复为导向的护理增加了提供者面临的风险和责任。通过讨论这些关切所带来的两个首要挑战，即资源和风险问题，对上述关切进行了回应。
