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通过加强现有医疗保健平台缩小精神、神经和物质使用障碍的治疗差距:循证干预措施的提供与整合策略

Closing the treatment gap for mental, neurological and substance use disorders by strengthening existing health care platforms: strategies for delivery and integration of evidence-based interventions.

作者信息

Shidhaye Rahul, Lund Crick, Chisholm Dan

机构信息

Centre for Chronic Conditions and Injuries, Public Health Foundation of India, 19, Rishi Nagar, Char Imli, Bhopal, Madhya Pradesh India ; CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.

Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa ; Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

出版信息

Int J Ment Health Syst. 2015 Dec 30;9:40. doi: 10.1186/s13033-015-0031-9. eCollection 2015.

Abstract

This paper outlines the main elements and features of a mental health care delivery platform and its delivery channels. These include evidence-based interventions that can be delivered via this platform as well as broader health system strengthening strategies for more effective and efficient delivery of services. The focus is broadly on health systems perspective rather than strictly disorder-oriented intervention analysis. A set of evidence-based interventions within the WHO pyramid framework of self-care, primary care, and specialist care have been identified; the main challenge lies in the translation of that evidence into practice. The delivery of these interventions requires an approach that puts into practice key principles of public health, adopts systems thinking, promotes whole-of-government involvement and is focused on quality improvement. Key strategies for effective translation of evidence into action include collaborative stepped care, strengthening human resources, and integrating mental health into general health care. In order to pursue these principles and strategies using a platform-wide approach, policy makers need to engage with a wide range of stakeholders and make use of the best available evidence in a transparent manner.

摘要

本文概述了一个精神卫生保健服务平台及其服务渠道的主要要素和特征。这些要素和特征包括可通过该平台提供的循证干预措施,以及为更有效和高效地提供服务而采取的更广泛的卫生系统加强战略。重点主要从卫生系统角度出发,而非严格进行以疾病为导向的干预分析。在世卫组织自我保健、初级保健和专科护理的金字塔框架内,已确定了一系列循证干预措施;主要挑战在于将这些证据转化为实践。提供这些干预措施需要一种将公共卫生的关键原则付诸实践、采用系统思维、促进政府全面参与并注重质量改进的方法。将证据有效转化为行动的关键战略包括协作式逐步护理、加强人力资源以及将精神卫生纳入一般卫生保健。为了采用全平台方法推行这些原则和战略,政策制定者需要与广泛的利益相关者进行接触,并以透明的方式利用现有最佳证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7d6a/4696279/1dc616000ffd/13033_2015_31_Fig1_HTML.jpg

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