Docherty Mary, Thornicroft Graham
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK ; South London and Maudsley NHS Foundation Trust, London, UK.
Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF UK.
Int J Ment Health Syst. 2015 Aug 30;9:34. doi: 10.1186/s13033-015-0023-9. eCollection 2015.
Since the economic recession began in 2008 anecdotal reports suggest that mental health services in England have experienced disinvestment, but published data to test this proposition are few.
This paper presents information from a wider range of official, research and grey literature sources aiming to: (1) assess whether governmental investment in publically funded mental health services has declined since the start of the economic recession in 2008; (2) to assess whether relative changes in mental health service investment over this period were or were not similar to trends in national investment in services for people with physical disorders, and (3) to interpret these findings in terms of met and unmet population levels needs for mental health care.
The key findings are that: across England social service expenditure reductions have led to a decrease of 48 % in the number of people with mental illness who receive such care, while direct NHS expenditure was reduced in some local areas by up to 32 %.
The results of this overview suggest that there have been substantial reductions in the resources dedicated to mental health treatment and care in England since 2008, that such reductions seem not to have been applied to physical health services, and that these findings appear to run counter to the government policy of 'parity of esteem; for mental and physical healthcare.
自2008年经济衰退开始以来,有传闻称英格兰的心理健康服务遭遇了投资减少的情况,但用于验证这一说法的公开数据却很少。
本文展示了来自更广泛的官方、研究及灰色文献来源的信息,旨在:(1)评估自2008年经济衰退开始以来,政府对公共资助的心理健康服务的投资是否有所下降;(2)评估在此期间心理健康服务投资的相对变化与国家对身体疾病患者服务投资的趋势是否相似;(3)根据满足和未满足的人群心理健康护理需求来解读这些发现。
主要发现为:在英格兰,社会服务支出的减少导致接受此类护理的精神疾病患者数量减少了48%,而在一些地区,国民医疗服务体系(NHS)的直接支出减少了高达32%。
本综述结果表明,自2008年以来,英格兰用于心理健康治疗和护理的资源大幅减少,这种减少似乎并未应用于身体健康服务,而且这些发现似乎与政府关于心理健康和身体健康护理“同等重视”的政策相悖。