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非洲精神病学教育-肯尼亚视角。

Psychiatric education in Africa-Kenyan perspective.

机构信息

Africa Mental Health Research and Training Foundation, Nairobi, Kenya.

University of Nairobi, Nairobi, Kenya.

出版信息

Int Rev Psychiatry. 2020 Mar;32(2):157-160. doi: 10.1080/09540261.2019.1655715. Epub 2019 Sep 12.

Abstract

The existing huge global neuropsychiatry disease burden compared to the available meagre human resources underlines the need for alternative innovative approaches in psychiatry. The low middle income countries have very few psychiatry specialists who cannot meet the demand at current and even in the near future. In the Kenyan context, the prevalence of Common Mental Disorders is ∼10.8% in a country with less than 100 psychiatrists. This has a negative impact to the patients who suffer from mental disorders and also the caregivers. Undetected or undiagnosed mental disorders cause untold suffering including the socio-economic negative consequences. The lack of access to appropriate treatment is attributed to the depleted resources in terms of specialist manpower and low investment level in psychiatry infrastructure. This calls for committing substantial resources to boost mental health training and also boldly embrace alternative psychiatry remedies. Unfortunately, Psychiatry education is a discipline that has not been able to attract a significant share of medical health practitioners globally and the situation is not any different in Kenya. Therefore, the question of motivation level for students to pursue psychiatry is valid, and thinking through the strategies that can improve the intake of medical student at the post graduate psychiatry education is relevant. It is imperative to address the stigma heaped to the psychiatry discipline by other medical specialties and bring it to the limelight of medical practice. However, owing to the trend of very low psychiatrists who qualify and join the market annually, there is a need to explore alternative and innovative ways of addressing the mental health treatment gap. Involvement of primary healthcare workers and service integration should be explored as recommended by some researchers. In addition, Psychiatry should not be confined as a monopoly of western biomedical approach in an African context where traditional approaches are still in existence.

摘要

与现有的稀缺人力资源相比,全球神经精神疾病负担巨大,这突显了精神病学领域需要创新替代方法。中低收入国家只有极少数精神病学专家,即使在当前甚至不久的将来也无法满足需求。在肯尼亚,在一个只有不到 100 名精神病学家的国家,常见精神障碍的患病率约为 10.8%。这对患有精神障碍的患者及其照顾者都产生了负面影响。未被发现或未被诊断出的精神障碍会造成难以言喻的痛苦,包括社会经济方面的负面影响。无法获得适当的治疗是由于专业人力资源匮乏和精神病学基础设施投资水平低所致。这就需要投入大量资源来促进精神卫生培训,并大胆采用替代精神病学疗法。不幸的是,精神病学教育一直未能在全球范围内吸引到大量医疗保健从业者,肯尼亚的情况也没有任何不同。因此,学生选择从事精神病学的动机水平是一个合理的问题,思考可以提高研究生精神病学教育中医学生入学率的策略是相关的。必须解决其他医学专业对精神病学学科的污名化问题,并将其置于医学实践的焦点。然而,由于每年合格并进入市场的精神科医生人数很少,因此需要探索解决精神卫生治疗差距的替代和创新方法。一些研究人员建议探索初级保健工作者的参与和服务整合。此外,在非洲背景下,精神病学不应仅限于西方生物医学方法,因为传统方法仍然存在。

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