From the Center for Health Services and Society (Drs. Chung, Bromley, Kataoka, Young, Miranda, and Wells), Center for Social Medicine and Humanities (Drs. Braslow and Castillo), Division of Child and Adolescent Psychiatry (Dr. Kataoka), Department of Psychiatry and Biobehavioral Sciences (Dr. Greenberg), David Geffen School of Medicine, and School of Public Health (Drs. Miranda and Wells), University of California, Los Angeles; Los Angeles County Department of Mental Health (Dr. Castillo); RAND Corporation (Drs. Chung and Wells); Los Angeles Biomedical Research Institute (Dr. Chung); Healthy African American Families II (Dr. Chung); Health Services Research & Development Center of Innovation (Dr. Young), Desert Pacific MIRECC Health Services Unit (Drs. Bromley and Greenberg), VA Greater Los Angeles Healthcare System; Division of Behavioral Health Services and Policy Research, Department of Psychiatry, Columbia University College of Physicians and Surgeons (Drs. Essock and Dixon); New York State Psychiatric Institute (Drs. Essock and Dixon).
Harv Rev Psychiatry. 2018 Mar/Apr;26(2):70-81. doi: 10.1097/HRP.0000000000000178.
This commentary examines the roles that communities and public policies play in the definition and processes of recovery for adults with mental illness. Policy, clinical, and consumer definitions of recovery are reviewed, which highlight the importance of communities and policies for recovery. This commentary then presents a framework for the relationships between community-level factors, policies, and downstream mental health outcomes, focusing on macroeconomic, housing, and health care policies; adverse exposures such as crime victimization; and neighborhood characteristics such as social capital. Initiatives that address community contexts to improve mental health outcomes are currently under way. Common characteristics of such initiatives and select examples are discussed. This commentary concludes with a discussion of providers', consumers', and other stakeholders' roles in shaping policy reform and community change to facilitate recovery.
本评论探讨了社区和公共政策在定义和促进成年人精神疾病康复过程中的作用。评论回顾了政策、临床和消费者对康复的定义,强调了社区和政策对康复的重要性。然后,本评论提出了一个社区层面因素、政策和下游心理健康结果之间关系的框架,重点关注宏观经济、住房和医疗保健政策;犯罪受害等不利暴露;以及社会资本等邻里特征。目前正在开展解决社区环境以改善心理健康结果的倡议。讨论了这些倡议的共同特征和一些例子。本评论最后讨论了提供者、消费者和其他利益相关者在塑造政策改革和社区变革以促进康复方面的作用。