Saxena Shekhar, Jané-Llopis Eva, Hosman Clemens
Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland.
World Psychiatry. 2006 Feb;5(1):5-14.
There is sufficient evidence indicating the efficacy of interventions in reducing risk factors, increasing protective factors, preventing psychiatric symptoms and new cases of mental disorders. Macro-policy interventions to improve nutrition, housing and education or to reduce economic insecurity have proven to reduce mental health problems. Specific interventions to increase resilience in children and adolescents through parenting and early interventions, and programmes for children at risk for mental disorders such as those who have a mentally ill parent or have suffered parental loss or family disruption, have also shown to increase mental well-being and decrease depressive symptoms and the onset of depressive disorders. Interventions for the adult population, from macro-policy strategies, such as taxation of alcohol products or workplace legislation, to individual support for those with signs of a mental disorder, can reduce mental health problems and associated social and economic burdens. Exercise, social support or community participation have also shown to improve mental health of older populations. Public mental health will benefit from continuing building the evidence base through combining different evaluation methods across low, middle and high income countries. The translation of evidence into policy and practice calls for action at the international, national and local level, including building capacity, advocacy, mainstreaming mental health into public health and other policies and securing infrastructures and sustainability. Mental health professionals have an important role to play in improving the evidence on prevention and promotion in mental health, in engaging relevant stakeholders for developing programmes, and as professional care providers in their practice.
有充分证据表明干预措施在降低风险因素、增加保护因素、预防精神症状和精神障碍新病例方面的有效性。改善营养、住房和教育或减少经济不安全状况的宏观政策干预已证明可减少心理健康问题。通过育儿和早期干预增强儿童和青少年复原力的具体干预措施，以及针对有精神障碍风险儿童的项目，如那些有精神疾病父母或经历过父母丧亡或家庭破裂的儿童，也显示出可增进心理健康、减轻抑郁症状并减少抑郁症的发作。针对成年人群的干预措施，从宏观政策策略，如酒类产品征税或工作场所立法，到对有精神障碍迹象者的个人支持，都可减少心理健康问题及相关的社会和经济负担。锻炼、社会支持或社区参与也已证明可改善老年人群的心理健康。通过在低收入、中等收入和高收入国家结合不同评估方法持续建立证据基础，公共心理健康将从中受益。将证据转化为政策和实践需要在国际、国家和地方层面采取行动，包括建设能力、开展宣传、将心理健康纳入公共卫生和其他政策的主流以及确保基础设施和可持续性。心理健康专业人员在改善心理健康预防和促进方面的证据、促使相关利益攸关方参与制定项目以及作为专业护理提供者开展实践方面可发挥重要作用。
