去机构化的制度化：精神卫生系统改革的跨国分析。
Institutionalization of deinstitutionalization: a cross-national analysis of mental health system reform.
机构信息
School of Public Health, Yale University, 60 College Street, P.O. Box 208034, New Haven, CT 06520 USA.
School of Public Health, University of California at Berkeley, 235 University Hall, Berkeley, CA 94720 USA.
出版信息
Int J Ment Health Syst. 2014 Nov 22;8(1):47. doi: 10.1186/1752-4458-8-47. eCollection 2014.
BACKGROUND
Policies generate accountability in that they offer a standard against which government performance can be assessed. A central question of this study is whether ideological imprint left by policy is realized in the time following its adoption. National mental health policy expressly promotes the notion of deinstitutionalization, which mandates that individuals be cared for in the community rather than in institutional environments.
METHODS
We investigate whether mental health policy adoption induced a transformation in the structure of mental health systems, namely psychiatric beds, using panel data on 193 countries between 2001 and 2011.
RESULTS
Our striking regression results demonstrate that late-adopters of mental health policy are more likely to reduce psychiatric beds in mental hospitals and other biomedical settings than innovators, whereas they are less likely than non-adopters to reduce psychiatric beds in general hospitals.
CONCLUSIONS
It can be inferred late adopters are motivated to implement deinstitutionalization for technical efficiency rather than social legitimacy reasons.
背景
政策具有问责制，因为它们提供了一个可以评估政府绩效的标准。本研究的一个核心问题是，政策留下的意识形态印记是否会在其通过后的时间里得到实现。国家心理健康政策明确提倡去机构化的理念，要求将个人在社区中而不是在机构环境中得到照顾。
方法
我们使用 2001 年至 2011 年间 193 个国家的面板数据，调查心理健康政策的采用是否导致了心理健康系统结构的转变，即精神病床位。
结果
我们引人注目的回归结果表明，心理健康政策的后期采用者比创新者更有可能减少精神病院和其他生物医学环境中的精神病床位，而比非采用者更不可能减少综合医院中的精神病床位。
结论
可以推断出，后期采用者出于技术效率而不是社会合法性的原因而积极推动去机构化。
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