Department of Health Policy and Management in the UCLA Fielding School of Public Health, 650 Charles Young Dr. S., 31-269 CHS Box 951772, Los Angeles, CA 90095-1772, USA.
Department of Psychology, Department of Health Policy and Management in the UCLA Fielding School of Public Health, and UCLA BRITE Center for Science, Research and Policy, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA.
Health Policy Plan. 2018 Jan 1;33(1):107-122. doi: 10.1093/heapol/czx137.
Eager to build an integrated community-based mental health system, in 2004 China started the '686 Programme', whose purpose was to integrate hospital and community services for patients with serious mental illness. In 2015, the National Mental Health Working Plan (2015-2020) proposed an ambitious strategy for implementing this project. The goal of this review is to assess potential opportunities for and barriers to successful implementation of a community-based mental health system that integrates hospital and community mental health services into the general healthcare system. We examine 7066 sources in both English and Chinese: the academic peer-reviewed literature, the grey literature on mental health policies, and documents from government and policymaking agencies. Although China has proposed a number of innovative programmes to address its mental health burden, several of these proposals have yet to be fully activated, particularly those that focus on integrated care. Integrating mental health services into China's general healthcare system holds great promise for increased access to and quality improvement in mental health services, as well as decreased stigma and more effective management of physical and mental health comorbidities. This article examines the challenges to integrating mental health services into China's general healthcare system, especially in the primary care sphere, including: accurately estimating mental health needs, integrating mental and physical healthcare, increasing workforce development and training, resolving interprofessional issues, financing and funding, developing an affordable and sustainable mental health system, and delivering care to specific subpopulations to meet the needs of China's diverse populace. As China's political commitment to expanding its mental health system is rapidly evolving, we offer suggestions for future directions in addressing China's mental health needs.
中国渴望建立一个综合性的社区精神卫生系统，因此于 2004 年启动了“686 项目”，旨在整合严重精神疾病患者的医院和社区服务。2015 年，《全国精神卫生工作规划（2015-2020 年）》提出了一项雄心勃勃的实施该项目的战略。本综述旨在评估将医院和社区精神卫生服务整合到一般医疗保健系统中建立社区为基础的精神卫生系统的潜在机会和障碍。我们检查了中英文的 7066 个来源：学术同行评议文献、精神卫生政策灰色文献以及政府和决策机构的文件。尽管中国提出了许多创新方案来解决其精神卫生负担问题，但其中一些方案尚未得到充分实施，特别是那些关注综合护理的方案。将精神卫生服务整合到中国的一般医疗保健系统中，有望增加获得精神卫生服务的机会，提高服务质量，减少污名化，并更有效地管理身心共病。本文探讨了将精神卫生服务整合到中国的一般医疗保健系统中所面临的挑战，特别是在初级保健领域，包括：准确估计精神卫生需求、整合精神和身体健康护理、增加劳动力发展和培训、解决跨专业问题、融资和资金、开发负担得起和可持续的精神卫生系统以及为满足中国多样化人口的需求而向特定亚人群提供护理。随着中国扩大精神卫生系统的政治承诺迅速发展，我们为解决中国的精神卫生需求提供了未来方向的建议。
