López Alvarez Marcelino, Laviana Cuetos Margarita
Programas, evaluación e investigación Fundación Pública Andaluza, Integración Social de Personas con Enfermedad Mental, FAISEM, Sevilla, España.
Servicio Andaluz de Salud, Comunidades Terapéuticas de la Unidad de Gestión Clínica de Salud Mental, Hospital Virgen del Rocío, Sevilla, España.
Enferm Clin. 2016 Jan-Feb;26(1):61-7. doi: 10.1016/j.enfcli.2015.08.006. Epub 2015 Nov 11.
Coordination between health and social services is a key point in caring for an increasing number of people affected by different types of health problems. The change in demographic and epidemiological patterns in our societies evidences the need of this coordination, usually not covered by our care systems. A sector in which the coordination is particularly important is the care of people with disabilities related to the suffering from severe mental disorders. This is a field that has been too long on the sidelines of the general health and social care systems as a result of the social stigma and traditional psychiatric institutions, setting in motion a vicious circle that must be broken in order to identify and to respond to the needs of such persons. In fact, the processes of change towards community care, with targets for recovery and not mere palliative or marginalizing care, necessarily incorporate this coordination as a cornerstone strategy for social inclusion and citizenship. Although there are still significant gaps in this regard, especially in Spain. However, there are experiences of change, such as that of Andalusia, which set the tone for the development of a strategy for integrated care, whose foundations and main elements we try to summarize in the present article.
卫生与社会服务之间的协调是照料越来越多受不同类型健康问题影响的人群的关键所在。我们社会中人口结构和流行病学模式的变化证明了这种协调的必要性,而我们的照料体系通常并未涵盖这一点。协调尤为重要的一个领域是对与严重精神障碍相关的残疾人的照料。由于社会污名和传统精神病院的存在,这个领域长期处于一般卫生和社会照料体系的边缘,从而形成了一个恶性循环,必须打破这个循环,以便识别并满足这类人群的需求。事实上,向社区照料转变的过程,其目标是康复而非仅仅是姑息性或边缘化照料,必然将这种协调作为社会包容和公民身份的基石战略。尽管在这方面仍存在重大差距,尤其是在西班牙。然而,也有一些变革的经验,比如安达卢西亚的经验,它为综合照料战略的发展奠定了基调,我们试图在本文中总结该战略的基础和主要要素。