Saxena Shekhar, Lora Antonio, van Ommeren Mark, Barrett Thomas, Morris Jodi, Saraceno Benedetto
Department of Mental Health and Substance Abuse, World Health Organization, 20 Ave. Appia, Geneva 1211, Switzerland.
Psychiatr Serv. 2007 Jun;58(6):816-21. doi: 10.1176/ps.2007.58.6.816.
Information about mental health systems is essential for mental health planning to reduce the burden of neuropsychiatric disorders. Unfortunately, many low- and middle-income countries lack systematic information on their mental health systems. The objectives, scope, structure, and contents of mental health assessment and monitoring instruments commonly used in high-income countries may not be appropriate for use in middle- and low-income countries. The World Health Organization (WHO) has recently developed the WHO Assessment Instrument for Mental Health Systems (WHO-AIMS), a comprehensive assessment tool for mental health systems designed for middle- and low-income countries. WHO-AIMS was developed through an iterative process that included input from in-country and international experts on the clarity, content, validity, and feasibility of the instrument, as well as a pilot trial. The resulting instrument, WHO-AIMS 2.2, consists of six domains: policy and legislative framework, mental health services, mental health in primary care, human resources, public information and links with other sectors, and monitoring and research. These domains address the ten recommendations of the World Health Report 2001 through 28 facets and 155 items. All six domains need to be assessed to form a basic, yet broad, picture of a mental health system, with a focus on health sector activities. WHO-AIMS provides essential information for mental health policy and service delivery. Countries will be able to develop information-based mental health policy and plans with clear baseline information and targets. Moreover, they will be able to monitor progress in implementing reform policies, providing community services, and involving consumers, families, and other stakeholders in mental health promotion, prevention, care and rehabilitation. This article provides an overview of the rationale, development process, and potential uses and benefits of WHO-AIMS.
有关精神卫生系统的信息对于精神卫生规划以减轻神经精神障碍负担至关重要。不幸的是,许多低收入和中等收入国家缺乏关于其精神卫生系统的系统性信息。高收入国家常用的精神卫生评估和监测工具的目标、范围、结构和内容可能不适用于低收入和中等收入国家。世界卫生组织(WHO)最近开发了世界卫生组织精神卫生系统评估工具(WHO-AIMS),这是一种为低收入和中等收入国家设计的精神卫生系统综合评估工具。WHO-AIMS是通过一个迭代过程开发的,该过程包括国内和国际专家对该工具的清晰度、内容、有效性和可行性的意见,以及一次试点试验。最终形成的工具WHO-AIMS 2.2由六个领域组成:政策和立法框架、精神卫生服务、初级保健中的精神卫生、人力资源、公共信息以及与其他部门的联系,以及监测和研究。这些领域通过28个方面和155个项目落实了《2001年世界卫生报告》的十项建议。所有六个领域都需要进行评估,以形成一个关于精神卫生系统的基本但全面的情况,重点是卫生部门的活动。WHO-AIMS为精神卫生政策和服务提供提供了重要信息。各国将能够利用明确的基线信息和目标制定基于信息的精神卫生政策和计划。此外,它们将能够监测改革政策实施、提供社区服务以及让消费者、家庭和其他利益攸关方参与精神卫生促进、预防、护理和康复方面取得的进展。本文概述了WHO-AIMS的基本原理、开发过程以及潜在用途和益处。