Institute of Psychiatry, King's College London, P.O. 35, David Goldberg Building, De Crespigny Park, London SE5 8AF, United Kingdom.
Psychiatr Serv. 2010 Mar;61(3):229-34. doi: 10.1176/ps.2010.61.3.229.
This article synthesizes the views of participants in two roundtables that were convened in Nairobi (March 2007) and London (July 2008) to identify key challenges to the prioritization of mental health in Africa and possible solutions. Participants included leading development experts and policy makers from head and country offices of international donors, national directors of mental health for several African countries, key mental health and public health professionals, epidemiologists, and an international nongovernmental organization. The challenges they identified to mainstreaming mental health include lack of understanding of the contribution of mental disorders to morbidity and mortality, competition for limited resources within health reform efforts, poor distribution of interventions and lack of inclusion of mental health among core generic health indicators, lack of economic research evidence, lack of a strategic approach to human resources planning, lack of partnerships with the social development sector, and mental health professionals' need for public health skills to effectively conduct national advocacy. Potential solutions include further investment in economic research, better strategic identification of the levers and entry points for integrating mental health into health sector reform plans, more vigorous engagement of mental health professionals in general health sector reforms, strengthening the linkage between mental health and social development, and intensive resource mobilization. In summary, partnerships, underpinned by collaborative training, research, and mutual dialogue with other health and nonhealth sectors, are needed.
本文综合了两次在内罗毕（2007 年 3 月）和伦敦（2008 年 7 月）举行的圆桌会议与会者的观点，这些会议旨在确定在非洲优先重视精神卫生方面的主要挑战和可能的解决办法。与会者包括来自国际捐助方总部和国家办事处的主要发展专家和政策制定者、一些非洲国家的精神卫生国家主任、主要精神卫生和公共卫生专业人员、流行病学家以及一个国际非政府组织。他们确定的将精神卫生纳入主流所面临的挑战包括：对精神障碍对发病率和死亡率的影响认识不足、卫生改革努力中有限资源的竞争、干预措施分布不均以及缺乏将精神卫生纳入核心通用卫生指标、经济研究证据不足、人力资源规划缺乏战略方法、与社会发展部门缺乏伙伴关系以及精神卫生专业人员需要公共卫生技能以有效开展国家宣传。潜在的解决办法包括进一步投资于经济研究，更好地确定将精神卫生纳入卫生部门改革计划的杠杆和切入点，更积极地让精神卫生专业人员参与一般卫生部门改革，加强精神卫生与社会发展之间的联系，以及大力调集资源。总之，需要建立伙伴关系，这种伙伴关系的基础是与其他卫生和非卫生部门开展协作培训、研究和相互对话。
