Fernandez Ana, Gillespie James A, Smith-Merry Jennifer, Feng Xiaoqi, Astell-Burt Thomas, Maas Cailin, Salvador-Carulla Luis
The Mental Health Policy Unit, Brain and Mind Centre, The University of Sydney, 100 Mallett Street, Camperdown, NSW 2050, Australia.
Menzies Centre for Health Policy and Sydney School of Public Health, The University of Sydney, City Road, Edward Ford Building A27, NSW 2006, Australia. Email.
Aust Health Rev. 2017 Mar;41(1):38-44. doi: 10.1071/AH15154.
Objective Australian mental health care remains hospital centric and fragmented; it is riddled with gaps and does little to promote recovery. Reform must be built on better knowledge of the shape of existing services. Mental health atlases are an essential part of this knowledge base, enabling comparison with other regions and jurisdictions, but must be based on a rigorous classification of services. The main aim of this study is to create an integrated mental health atlas of the Western Sydney LHD in order to help decision makers to better plan informed by local evidence. Methods The standard classification system, namely the Description and Evaluation of Services and Directories in Europe for Long-term Care model, was used to describe and classify adult mental health services in the Western Sydney Local Health District (LHD). This information provided the foundation for accessibility maps and the analysis of the provision of care for people with a lived experience of mental illness in Western Sydney LHD. All this data was used to create the Integrated Mental Health Atlas of Western Sydney LHD. Results The atlas identified four major gaps in mental health care in Western Sydney LHD: (1) a lack of acute and sub-acute community residential care; (2) an absence of services providing acute day care and non-acute day care; (3) low availability of specific employment services for people with a lived experience of mental ill-health; and (4) a lack of comprehensive data on the availability of supported housing. Conclusions The integrated mental health atlas of the Western Sydney LHD provides a tool for evidence-informed planning and critical analysis of the pattern of adult mental health care. What is known about the topic? Several reports have highlighted that the Australian mental health system is hospital based and fragmented. However, this knowledge has had little effect on actually changing the system. What does this paper add? This paper provides a critical analysis of the pattern of adult mental health care provided within the boundaries of the Western Sydney LHD using a standard, internationally validated tool to describe and classify the services. This provides a good picture of the availability of adult mental health care at the local level that was hitherto lacking. What are the implications for practitioners? The data presented herein provide a better understanding of the context in which mental health practitioners work. Managers and planners of services providing care for people with a lived experience of mental illness can use the information herein for better planning informed by local evidence.
目的 澳大利亚的精神卫生保健仍然以医院为中心且碎片化；存在诸多漏洞，对促进康复作用甚微。改革必须建立在对现有服务状况有更深入了解的基础上。精神卫生地图集是这一知识库的重要组成部分，有助于与其他地区和司法管辖区进行比较，但必须基于对服务的严格分类。本研究的主要目的是创建西悉尼地方卫生区的综合精神卫生地图集，以帮助决策者依据当地证据更好地进行规划。方法 采用标准分类系统，即欧洲长期护理服务描述与评估及名录模型，对西悉尼地方卫生区（LHD）的成人精神卫生服务进行描述和分类。这些信息为可达性地图以及对西悉尼LHD有精神疾病生活经历者的护理提供情况分析奠定了基础。所有这些数据都用于创建西悉尼LHD综合精神卫生地图集。结果 该地图集确定了西悉尼LHD精神卫生保健中的四个主要差距：（1）缺乏急性和亚急性社区住院护理；（2）没有提供急性日间护理和非急性日间护理的服务；（3）有精神疾病生活经历者可获得的特定就业服务较少；（4）缺乏关于支持性住房可获得情况的全面数据。结论 西悉尼LHD综合精神卫生地图集为基于证据的规划以及对成人精神卫生保健模式进行批判性分析提供了一个工具。关于该主题已知的情况是什么？ 几份报告强调澳大利亚精神卫生系统以医院为基础且碎片化。然而，这一认知对实际改变该系统几乎没有作用。本文补充了什么？ 本文使用一种经过国际验证的标准工具对服务进行描述和分类，对西悉尼LHD范围内提供的成人精神卫生保健模式进行了批判性分析。这提供了此前所缺乏的当地成人精神卫生保健可获得情况的清晰图景。对从业者有何影响？ 本文呈现的数据能让人们更好地了解精神卫生从业者的工作环境。为有精神疾病生活经历者提供护理的服务管理者和规划者可利用本文信息，依据当地证据进行更好的规划。
