Thacker W, Tremaine L
Office of Substance Abuse Services, Richmond, Virginia.
Hosp Community Psychiatry. 1989 Oct;40(10):1046-9. doi: 10.1176/ps.40.10.1046.
State service delivery systems have had limited success in meeting the needs of persons with major mental illness and substance abuse problems. Systems issues that create barriers to effective services include rigid program boundaries, inadequate assessment and diagnosis, lack of trained staff, the limited array of special services, and inflexible funding patterns. The state of Virginia, which administers mental health and substance abuse services through a single agency, has addressed these issues by clearly communicating that services for mentally ill substance abusers should be given high priority, by instituting a collaborative working relationship between mental health and substance abuse services, and by providing funding incentives. Additional efforts to develop advocacy organizations for mentally ill substance abusers, to train mental health professionals to serve this population, and to improve program evaluation and assessment are needed.
在满足患有严重精神疾病和药物滥用问题者的需求方面，州服务提供系统成效有限。造成有效服务障碍的系统问题包括僵化的项目界限、评估和诊断不足、缺乏训练有素的工作人员、特殊服务种类有限以及资金模式缺乏灵活性。弗吉尼亚州通过一个单一机构管理心理健康和药物滥用服务，该州通过明确表示应高度优先为患有精神疾病的药物滥用者提供服务、在心理健康和药物滥用服务之间建立协作工作关系以及提供资金激励措施来解决这些问题。还需要做出更多努力，为患有精神疾病的药物滥用者建立倡导组织、培训心理健康专业人员为这一人群服务，并改善项目评估。
