Aix-Marseille University, Lest, UMR 7317, CNRS, Aix en Provence, France.
Int J Health Plann Manage. 2013 Jul-Sep;28(3):e242-55. doi: 10.1002/hpm.2158. Epub 2012 Dec 28.
The new mental health care policy, which has been set up in France, involves a change of paradigm, which has been going on since the 2000s: the emphasis is shifting from psychiatry to mental health care. This shift mainly concerns the knowledge about mental health is produced and circulates among an increasingly large number of bodies. Mainly grounded on actor interview analysis, official reports and blueprints, this study shows that the results of this process are numerous. They include the development of ambulatory care and strong moves towards decentralization. More data and knowledge are therefore to be shared in this more complex system. However, the French State, in the form of the central administration, is taking advantage of this move and is still contributing significantly to the definition and implementation of the new policy. On the other hand, the new governance dynamic is not leading to standardization of medical practices, as the mental health field remains highly heterogeneous.
法国制定的新的精神卫生保健政策涉及范式转变,这种转变自 21 世纪以来一直在进行:重点从精神病学转向精神卫生保健。这种转变主要涉及精神卫生知识的产生和在越来越多的机构中的传播。本研究主要基于对行为者的访谈分析、官方报告和蓝图,表明这一过程的结果是多方面的。其中包括门诊护理的发展和向权力下放的强烈转变。因此,在这个更加复杂的系统中需要共享更多的数据和知识。然而,法国政府以中央行政机构的形式利用了这一举措,仍然对新政策的制定和实施做出了重大贡献。另一方面,新的治理动态并没有导致医疗实践的标准化,因为精神卫生领域仍然高度多样化。