Neal David
Clinical School, University of Cambridge, Cambridge, UK,
Psychiatr Danub. 2015 Sep;27 Suppl 1:S84-91.
In May 2015 the UK elected a new government. In election campaigns, health is one of the most important areas of debate and over the preceding 12 months, the state of child and adolescent mental health services (CAMHS) had held a particularly high profile in the media and in political debate. Many had suggested that the rate of mental illness starting in adolescence is increasing and that service provision is not of sufficient quality or scale to meet this need. A brief review of the sources for these statistics reveals that whilst this may be true, there is a dearth of accurate and up to date data on the scale of the need for CAMHS or the extent to which it is being met. Nonetheless, members of all parties claimed to support improvements in mental health service provision for children and adolescents through increases in funding. A key question for policy makers has therefore become, from where any additional funding might be derived. One suggestion has been that funding be transferred from spending on adult mental health services. The exact practical nature of such a policy is yet to be explored in detail by government or stakeholders. The primary purpose of the present discussion is therefore to consider the possible ethical implications of such a policy in principle. The discussion forms part of a wider and evolving political and professional discourse on society's and government's attitude towards mental illness, towards the balance of individual and societal needs and towards the balance between preventative and supportive interventions to improve health.
2015年5月，英国选举产生了新政府。在竞选活动中，医疗保健是最重要的辩论领域之一，在过去的12个月里，儿童和青少年心理健康服务（CAMHS）的状况在媒体和政治辩论中备受关注。许多人认为，始于青春期的精神疾病发病率正在上升，而服务的质量和规模不足以满足这一需求。对这些统计数据来源的简要回顾表明，虽然这可能是事实，但关于儿童和青少年心理健康服务需求规模或满足程度的准确和最新数据却很匮乏。尽管如此，所有政党的成员都声称支持通过增加资金来改善儿童和青少年的心理健康服务。因此，政策制定者面临的一个关键问题是，额外的资金可能从何而来。一种建议是，将资金从成人心理健康服务支出中转移。政府或利益相关者尚未详细探讨这一政策的确切实际性质。因此，本次讨论的主要目的是原则上考虑这一政策可能产生的伦理影响。该讨论是关于社会和政府对精神疾病的态度、个人和社会需求平衡以及改善健康的预防和支持性干预措施平衡的更广泛且不断演变的政治和专业论述的一部分。
