London School of Hygiene and Tropical Medicine, London, UK.
World Psychiatry. 2010 Oct;9(3):169-76. doi: 10.1002/j.2051-5545.2010.tb00305.x.
The treatment gap for people with mental disorders exceeds 50% in all countries of the world, approaching astonishingly high rates of 90% in the least resourced countries. We report the findings of the first systematic survey of leaders of psychiatry in nearly 60 countries on the strategies for reducing the treatment gap. We sought to elicit the views of these representatives on the roles of different human resources and health care settings in delivering care and on the importance of a range of strategies to increase the coverage of evidence-based treatments for priority mental disorders for each demographic stage (childhood, adolescence, adulthood and old age). Our findings clearly indicate three strategies for reducing the treatment gap: increasing the numbers of psychiatrists and other mental health professionals; increasing the involvement of a range of appropriately trained non-specialist providers; and the active involvement of people affected by mental disorders. This is true for both high income and low/middle income countries, though relatively of more importance in the latter. We view this survey as a critically important first step in ascertaining the position of psychiatrists, one of the most influential stakeholder communities in global mental health, in addressing the global challenge of scaling up mental health services to reduce the treatment gap.
在世界上所有国家，精神障碍患者的治疗缺口超过 50%，在资源最少的国家，这一比例惊人地接近 90%。我们报告了对近 60 个国家的精神病学领导人进行的首次系统调查，以了解他们在减少治疗缺口方面的策略。我们试图从这些代表那里了解不同人力资源和医疗保健环境在提供护理方面的作用，以及一系列增加针对每个人口阶段（儿童、青少年、成年和老年）优先精神障碍的基于证据的治疗方法覆盖范围的策略的重要性。我们的调查结果清楚地表明了三种减少治疗缺口的策略：增加精神科医生和其他心理健康专业人员的数量；增加一系列经过适当培训的非专业提供者的参与；以及让受精神障碍影响的人积极参与。这对于高收入和中低收入国家都是如此，尽管后者相对更为重要。我们认为，这项调查是确定精神科医生立场的一个至关重要的第一步，精神科医生是全球精神卫生领域最有影响力的利益相关者群体之一，他们正在努力应对扩大精神卫生服务规模以减少治疗缺口的全球挑战。
