Lehtinen V, Taipale V
National Research and Development Centre for Welfare and Health, STAKES.
Int J Integr Care. 2001;1:e26. doi: 10.5334/ijic.30.
The aim of this paper is to give a short description of the most important developments of mental health services in Finland during the 1990s, examine their influences on the organisation and provision of services, and describe shortly some national efforts to handle the new situation. The Finnish mental health service system experienced profound changes in the beginning of the 1990s. These included the integration of mental health services, being earlier under own separate administration, with other specialised health services, decentralisation of the financing of health services, and de-institutionalisation of the services. The same time Finland underwent the deepest economic recession in Western Europe, which resulted in cut-offs especially in the mental health budgets. Conducting extensive national research and development programmes in the field of mental health has been one typically Finnish way of supporting the mental health service development. The first of these national programmes was the Schizophrenia Project 1981-97, whose main aims were to decrease the incidence of new long-term patients and the prevalence of old long-stay patients by developing an integrated treatment model. The Suicide Prevention Project 1986-96 aimed at raising awareness of this special problem and decreasing by 20% the proportionally high suicide rate in Finland. The National Depression Programme 1994-98 focused at this clearly increasing public health concern by several research and development project targeted both to the general population and specifically to children, primary care and specialised services. The latest, still on-going Meaningful Life Programme 1998-2003 which main aim is, by multi-sectoral co-operation, to improve the quality of life for people suffering from or living with the threat of mental disorders. Furthermore, the government launched in 1999 a new Goal and Action Programme for Social Welfare and Health Care 2000-2003, in which mental health has been chosen as one of the eight priority areas.
本文旨在简要描述芬兰20世纪90年代心理健康服务的最重要发展，审视其对服务组织和提供的影响，并简要介绍一些应对新情况的国家举措。芬兰的心理健康服务体系在20世纪90年代初经历了深刻变革。这些变革包括将此前单独管理的心理健康服务与其他专科医疗服务整合，医疗服务融资的分散化，以及服务的去机构化。与此同时，芬兰经历了西欧最严重的经济衰退，这导致心理健康预算尤其被削减。开展心理健康领域广泛的国家研发项目一直是芬兰支持心理健康服务发展的典型方式。这些国家项目中的第一个是1981 - 1997年的精神分裂症项目，其主要目标是通过开发综合治疗模式来降低新的长期患者的发病率和老的长期住院患者的患病率。1986 - 1996年的自杀预防项目旨在提高对这一特殊问题的认识，并将芬兰相对较高的自杀率降低20%。1994 - 1998年的国家抑郁症项目通过针对普通人群以及特别是儿童、初级保健和专科服务的多个研发项目，关注这一明显日益受到公共卫生关注的问题。最新的、仍在进行的1998 - 2003年有意义生活项目，其主要目标是通过多部门合作，改善患有精神障碍或面临精神障碍威胁的人群的生活质量。此外，政府在1999年启动了一项新的2000 - 2003年社会福利和医疗保健目标与行动计划，其中心理健康被选为八个优先领域之一。
