Mental Health, Drugs & Alcohol Service, Barwon Health, Geelong, Australia.
Department of Psychiatry, The University of Melbourne, Parkville, Australia.
Asia Pac Psychiatry. 2019 Jun;11(2):e12349. doi: 10.1111/appy.12349. Epub 2019 Feb 8.
Psychiatric rehabilitation can provide and support recovery-oriented care by assisting individuals living with severe mental illness to lead full lives. Despite a well-established evidence-base, implementation and access to these interventions in clinical practice for people with severe mental illness in the Asia-Pacific region is low. We therefore aimed to evaluate prominent themes impacting on clinical practice, policy, and the implementation of psychiatric rehabilitation across the Asia-Pacific region.
A comprehensive review of relevant literature on psychiatric rehabilitation of three regions within the Asia-Pacific was conducted using a structured search of PubMed and other databases. Eligible articles were selected which focussed on how psychiatric rehabilitation is defined and implemented across the Asia-Pacific region, as well as the associated successes and challenges. Common themes were generated.
Six themes emerged: the impact of policy, legislation, and human rights; access difficulties; the important role of family; the significance of culture, religion, and spiritual beliefs; the widespread impact of stigma; and the indigenous models of excellence being developed.
Consideration of the six themes and their implications should help raise awareness of the issues involved in the provision of psychiatric rehabilitation in the Asia-Pacific region and may improve outcomes for people living with severe mental illness. Suggested strategies include: developing a shared understanding of psychiatric rehabilitation; establishing quality legislation that's well implemented; adapting evidence-based models to develop culturally appropriate services; implementing stigma reduction and empowerment-based interventions; and, ensuring coordinated action among all stakeholders, combined with effective leadership.
精神康复可以提供和支持以康复为导向的护理，通过帮助患有严重精神疾病的个体过上充实的生活。尽管有成熟的证据基础，但在亚太地区的临床实践中，严重精神疾病患者获得和实施这些干预措施的情况很少。因此，我们旨在评估影响亚太地区临床实践、政策和精神康复实施的突出主题。
使用 PubMed 和其他数据库的结构化搜索，对亚太地区三个地区的精神康复相关文献进行全面综述。选择了重点关注精神康复在亚太地区的定义和实施方式，以及相关成功和挑战的文章。生成了常见的主题。
出现了六个主题：政策、立法和人权的影响；获得困难；家庭的重要作用；文化、宗教和精神信仰的重要性；广泛存在的污名化影响；以及正在开发的本土卓越模式。
考虑这六个主题及其影响应该有助于提高对亚太地区提供精神康复服务所涉及问题的认识，并可能改善严重精神疾病患者的预后。建议的策略包括：发展对精神康复的共同理解；制定得到有效实施的高质量立法；改编基于证据的模式，以开发文化上适当的服务；实施减少污名化和赋权干预措施；并确保所有利益相关者之间的协调行动，以及有效的领导。
