Hoffmann P, Tiggemann H G
Akademie für öffentliches Gesundheitswesen Düsseldorf.
Offentl Gesundheitswes. 1991 Dec;53 Suppl 3:254-9.
Psychiatric care has gradually been shifting in Germany from its original inpatient basis to outpatient and complementary treatment. This shift of emphasis resulted in a transfer of psychiatry-political responsibility to communal bodies and hence also to communal public health services. Sociopsychiatric service ranks high in communal psychiatric care setups, since it promotes cooperation and helps to coordinate efforts in individual cases in respect of focal points on which such care is centered. For the future, an expert commission has suggested that the various institutions actively engaged in community psychiatric care should team up in each region. This applies in particular to mobile services visiting the patients in their homes, and to the offices providing contracts to sociopsychiatric services of public health offices. Despite positive outlooks there are also quite a few negative aspects of present-day practice. One of them is poor definition of tasks and functions of communal sociopsychiatric services, whereas another one are the unsatisfactory quantitative and qualitative means at their disposal. It is also too often overlooked that psychiatric patients and disabled persons are entitled to compensation insurance payments to promote their rehabilitation, as provided for by individual legislation in the various German laender. To tap these sources sufficiently well, sociopsychiatric services must be better equipped in every respect. The professional competence of social workers and physicians, as well as of the relevant staff, must be safeguarded by continuing education and specialist training measures.
在德国,精神科护理已逐渐从最初的住院治疗模式转向门诊治疗和辅助治疗。这种重点的转变导致精神科的政治责任转移到社区机构,进而也转移到社区公共卫生服务部门。社会精神病学服务在社区精神科护理体系中占据重要地位,因为它促进合作,并有助于就此类护理的重点在个别案例中协调各方努力。未来,一个专家委员会建议,各地区积极参与社区精神科护理的各类机构应携手合作。这尤其适用于上门探访患者的流动服务机构,以及为公共卫生办公室的社会精神病学服务提供合同的办事处。尽管前景乐观,但当前的实践也存在不少负面问题。其中之一是社区社会精神病学服务的任务和职能界定不清,另一个问题是其可支配的数量和质量手段不尽人意。人们还常常忽视,根据德国各州的个别立法,精神病患者和残疾人有权获得赔偿保险金以促进康复。为了充分利用这些资源,社会精神病学服务必须在各方面得到更好的配备。社会工作者、医生以及相关工作人员的专业能力必须通过继续教育和专业培训措施加以保障。