Centre for Global Health & School of Psychology, Trinity College Dublin, Dublin, Ireland, and Centre for Rehabilitation Studies, Stellenbosch University, Stellenbosch, South Africa.
Int J Ment Health Syst. 2013 Feb 13;7(1):7. doi: 10.1186/1752-4458-7-7.
One of the most crucial steps towards delivering judicious and comprehensive mental health care is the formulation of a policy and plan that will navigate mental health systems. For policy-makers, the challenges of a high-quality mental health system are considerable: the provision of mental health services to all who need them, in an equitable way, in a mode that promotes human rights and health outcomes.
EquiFrame, a novel policy analysis framework, was used to evaluate the mental health policies of Malawi, Namibia, and Sudan. The health policies were assessed in terms of their coverage of 21 predefined Core Concepts of human rights (Core Concept Coverage), their stated quality of commitment to said Core Concepts (Core Concept Quality), and their inclusion of 12 Vulnerable Groups (Vulnerable Group Coverage). In relation to these summary indices, each policy was also assigned an Overall Summary Ranking, in terms of it being of High, Moderate, or Low quality.
Substantial variability was identified across EquiFrame's summary indices for the mental health policies of Malawi, Namibia, and Sudan. However, all three mental health policies scored high on Core Concept Coverage. Particularly noteworthy was the Sudanese policy, which scored 86% on Core Concept Coverage, and 92% on Vulnerable Group Coverage. Particular deficits were evident in the Malawian mental health policy, which scored 33% on Vulnerable Group Coverage and 47% on Core Concept Quality, and was assigned an Overall Summary Ranking of Low accordingly. The Overall Summary Ranking for the Namibian Mental Health Policy was High; for the Sudanese Mental Health Policy was Moderate; and for the Malawian Mental Health Policy was Low.
If human rights and equity underpin policy formation, it is more likely that they will be inculcated in health service delivery. EquiFrame may provide a novel and valuable tool for mental health policy analysis in relation to core concepts of human rights and inclusion of vulnerable groups, a key practical step in the successful realization of the Millennium Development Goals.
提供明智和全面的精神卫生保健服务最重要的步骤之一是制定政策和计划，以引导精神卫生系统。对于决策者来说，建立高质量的精神卫生系统面临着巨大的挑战：以促进人权和健康结果的方式，以公平的方式，为所有需要的人提供精神卫生服务。
采用新的政策分析框架 EquiFrame 来评估马拉维、纳米比亚和苏丹的精神卫生政策。从以下三个方面评估卫生政策：21 个预先确定的人权核心概念的涵盖范围（核心概念涵盖范围）、对这些核心概念的承诺质量（核心概念质量）以及包括 12 个弱势群体（弱势群体涵盖范围）。根据这些总结指标，还为每个政策分配了总体总结排名，分为高质量、中等质量和低质量。
马拉维、纳米比亚和苏丹的精神卫生政策在 EquiFrame 的总结指标方面存在很大差异。然而，这三个精神卫生政策在核心概念涵盖范围方面得分都很高。值得特别注意的是苏丹的政策，在核心概念涵盖范围方面得分为 86%，在弱势群体涵盖范围方面得分为 92%。马拉维的精神卫生政策在弱势群体涵盖范围方面得分仅为 33%，在核心概念质量方面得分仅为 47%，因此总体总结排名为低。纳米比亚精神卫生政策的总体总结排名为高；苏丹精神卫生政策的总体总结排名为中；马拉维精神卫生政策的总体总结排名为低。
如果人权和公平是政策制定的基础，那么它们更有可能被纳入卫生服务提供。EquiFrame 可能为精神卫生政策分析提供一个新颖而有价值的工具，涉及人权的核心概念和弱势群体的包容，这是成功实现千年发展目标的关键实际步骤。
