Campion Jonathan
FRCPsych, Visiting Professor of Population Mental Health, University College London; Director for Public Mental Health and Consultant Psychiatrist, South London & Maudsley National Health Service Foundation Trust, London, UK; email
BJPsych Int. 2018 Aug;15(3):51-54. doi: 10.1192/bji.2017.11.
Public mental health involves a population approach to mental health, and includes treatment of mental disorder, prevention of associated impacts, prevention of mental disorder and promotion of mental well-being, including for those people recovering from mental disorder. Such interventions can result in a broad range of impacts and associated economic savings even in the short term. However, even in high-income countries only a minority of people with mental disorder receive any treatment, while provision is far less in low- and middle-income countries. Coverage of interventions to prevent mental disorder and promote mental well-being is far less even in high-income countries, despite such interventions being required for sustainable reduction in the burden of mental disorder. This implementation gap results in a broad set of impacts and associated economic costs. Mental health needs assessments represent an important framework and mechanism to address this implementation gap - in low- and middle-income as well as high-income countries. Training and support to perform mental health needs assessments is important, as is the use of information derived from such assessments to more effectively advocate for the required level of resources to address the implementation gap. Such a public health approach to mental health represents an opportunity for psychiatrists to advocate more effectively for resources at both the local and national level. This can improve the coverage and outcomes of a range of public mental health interventions that result in broad impacts and associated economic savings, which can be estimated.
公共心理健康涉及以人群为导向的心理健康方法，包括精神障碍的治疗、相关影响的预防、精神障碍的预防以及促进心理健康，包括对那些正在从精神障碍中康复的人。即使在短期内，此类干预措施也能产生广泛的影响并带来相关的经济节约。然而，即使在高收入国家，也只有少数精神障碍患者接受任何治疗，而在低收入和中等收入国家，治疗服务则少得多。即使在高收入国家，预防精神障碍和促进心理健康的干预措施的覆盖范围也小得多，尽管要持续减轻精神障碍负担需要此类干预措施。这种实施差距导致了一系列广泛的影响和相关的经济成本。心理健康需求评估是解决这一实施差距的重要框架和机制，在低收入、中等收入以及高收入国家均是如此。开展心理健康需求评估的培训和支持很重要，利用此类评估得出的信息来更有效地争取所需资源水平以弥补实施差距也很重要。这种公共卫生的心理健康方法为精神科医生提供了一个机会，使其能够在地方和国家层面更有效地争取资源。这可以提高一系列公共心理健康干预措施的覆盖范围和效果，这些干预措施会产生广泛影响并带来可估算的相关经济节约。
