Allen Caitlin G, Sugarman Michael A, Wennerstrom Ashley
Department of Medicine, Boston University, 72 E. Concord Street, Boston, MA, 02118, USA.
Department of Psychology, Wayne State University, 5057 Woodward Ave, Detroit, MI, 48202, USA.
J Behav Health Serv Res. 2017 Apr;44(2):341-346. doi: 10.1007/s11414-016-9515-x.
Community health workers (CHWs) are frontline public health workers who are becoming increasingly integrated into medical settings for the prevention, treatment, and control of chronic disease. In particular, they have demonstrated the ability to improve medication adherence in underserved populations. One overlooked population that could benefit from CHW intervention is individuals with severe mental illnesses such as schizophrenia and bipolar disorder. These conditions are disproportionally weighted to economically disadvantaged communities and people of color, and are typically treated using antipsychotic medications. A number of factors, including social disadvantage, contribute to antipsychotic non-adherence, which is highly prevalent and drastically increases the burden of illness and economic impact of these conditions. This commentary examines the ways in which CHWs may be able to best serve individuals with severe mental illness, and proposes methods for facilitating this expanded scope of work.
社区卫生工作者（CHWs）是一线公共卫生工作者，他们越来越多地融入医疗环境，以预防、治疗和控制慢性病。特别是，他们已证明有能力提高服务不足人群的药物依从性。一个可能从社区卫生工作者干预中受益但被忽视的人群是患有精神分裂症和双相情感障碍等严重精神疾病的个体。这些疾病在经济上处于不利地位的社区和有色人种中比例过高，通常使用抗精神病药物进行治疗。包括社会不利因素在内的一些因素导致抗精神病药物治疗不依从，这种情况非常普遍，极大地增加了这些疾病的疾病负担和经济影响。本评论探讨了社区卫生工作者能够以最佳方式为严重精神疾病患者服务的途径，并提出了促进这一扩大工作范围的方法。
