Ng Chee Hong, Than Phong Thai, La Cuong Duc, Van Than Quang, Van Dieu Chu
International Unit, Department of Psychiatry, University of Melbourne and St Vincent's Mental Health, Melbourne, VIC, Australia.
Australas Psychiatry. 2011 Apr;19(2):143-50. doi: 10.3109/10398562.2011.563308.
The aim of this paper is to review the national community mental health care (CMHC) project in Vietnam and recommend improvements to the model based on findings reported at a national workshop of major service providers, and supplemented by information gathered from site visits and discussions with mental health leaders, professionals and stakeholders in the hospital and community mental health services.
Since 2000, the CMHC project has been carried out in all 63 provinces with an overall national district coverage of around 64% and a total registry of 145 160 patients. It demonstrates a commitment by the government to integrate mental health into primary health care, in line with the World Health Organization recommendations, and set up a national community mental health network. Free treatment is provided for patients, mostly with schizophrenia (62.83%) and epilepsy (34.78%), at the local community level, and a national monitoring system is well established. However, the limitations include the lack of project funds, human resources and facilities, treatment scope, and linkages with families and community. A revised model of CMHC that builds on the strengths of existing services is proposed. While progress in community mental health care in Vietnam has been significant, many challenges facing the CMHC project need addressing.
本文旨在回顾越南的国家社区精神卫生保健（CMHC）项目，并根据主要服务提供者在全国研讨会上报告的结果，以及通过实地考察和与医院及社区精神卫生服务领域的精神卫生领导者、专业人员和利益相关者的讨论所收集的信息，对该模式提出改进建议。
自2000年以来，CMHC项目已在越南所有63个省份开展，全国总体县区覆盖率约为64%，患者总登记人数为145160人。这表明政府致力于按照世界卫生组织的建议，将精神卫生纳入初级卫生保健，并建立了全国社区精神卫生网络。在地方社区层面为患者提供免费治疗，这些患者大多患有精神分裂症（62.83%）和癫痫（34.78%），并且建立了完善的国家监测系统。然而，其局限性包括缺乏项目资金、人力资源和设施、治疗范围，以及与家庭和社区的联系。本文提出了一种基于现有服务优势的CMHC修订模式。虽然越南社区精神卫生保健取得了显著进展，但CMHC项目面临的许多挑战仍需解决。
