1Department of Psychiatry, Addis Ababa University, P.O. Box 19241, Addis Ababa, Ethiopia.
World Psychiatry. 2008 Feb;7(1):54-7. doi: 10.1002/j.2051-5545.2008.tb00153.x.
The World Health Organization (WHO) has for long proposed the development of community-based mental health services worldwide. However, the progress toward community mental health care in most African countries is still hampered by a lack of resources, with specialist psychiatric care essentially based in large, centrally located mental hospitals. It is again time to reconsider the direction of mental health care in Africa. Based on a small inquiry to a number of experienced mental health professionals in sub-Saharan Africa, we discuss what a community concept of mental health care might mean in Africa. There is a general agreement that mental health services should be integrated in primary health care. A critical issue for success of this model is perceived to be provision of appropriate supervision and continuing education for primary care workers. The importance of collaboration between modern medicine and traditional healers is stressed and the paper ends in a plea for WHO to take the initiative and develop mental health services according to the special needs and the socio-cultural conditions prevailing in sub-Saharan Africa.
世界卫生组织（WHO）长期以来一直提议在全球范围内发展基于社区的精神卫生服务。然而，大多数非洲国家在社区精神卫生保健方面的进展仍然受到资源匮乏的阻碍，专业的精神科护理基本上都集中在大型的、位于中心位置的精神病院中。现在是重新考虑非洲精神卫生保健方向的时候了。基于对撒哈拉以南非洲地区一些有经验的精神卫生专业人员的一项小型调查，我们讨论了社区精神卫生保健概念在非洲可能意味着什么。大家普遍认为，精神卫生服务应该纳入初级卫生保健。人们认为，该模式成功的关键是为初级保健工作者提供适当的监督和继续教育。文中强调了现代医学和传统治疗师之间合作的重要性，并呼吁世界卫生组织根据撒哈拉以南非洲地区的特殊需求和社会文化条件主动发展精神卫生服务。
