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精神科医疗全面照护至关重要,床位只是起点。

The Vital Role of a Full Continuum of Psychiatric Care Beyond Beds.

机构信息

Program in Psychiatry, Law and Ethics, University of Michigan, Ann Arbor (Pinals); Mental Illness Research Associates, Arlington, Virginia (Fuller).

出版信息

Psychiatr Serv. 2020 Jul 1;71(7):713-721. doi: 10.1176/appi.ps.201900516. Epub 2020 Apr 23.

Abstract

The authors make the case for expanding the national discussion of inpatient psychiatric beds to recognize and incorporate other vital components of the continuum of care in order to improve outcomes for individuals with serious mental illness. They review the varied terminology applied to psychiatric beds and describe how the location of these beds has changed from primarily state hospitals to the criminal justice system, emergency departments, inpatient units, and the community. The authors propose 10 recommendations related to beds or to contextual issues regarding them. The recommendations address issues of mental illness terminology, criminal and juvenile justice diversion, the Emergency Medical Treatment and Labor Act, mental health technology, and the mental health workforce, among others. Each recommendation is based on findings from publicly available data and clinical observation and is intended to reduce the human and economic costs associated with severe mental illness by promoting a robust, interconnected, and evidence-based system of care that goes beyond beds.

摘要

作者主张扩大全国范围内对住院精神病床位的讨论,以认识和纳入连续护理的其他重要组成部分,从而改善严重精神疾病患者的治疗效果。他们回顾了应用于精神病床位的各种术语,并描述了这些床位的位置如何从主要的州立医院转变为刑事司法系统、急诊部门、住院病房和社区。作者提出了 10 项与床位或与之相关的背景问题有关的建议。这些建议涉及精神疾病术语、刑事和少年司法分流、《紧急医疗救治和劳动法》、精神卫生技术以及精神卫生劳动力等问题。每项建议都是基于公开数据和临床观察的结果提出的,旨在通过促进一个强大、相互关联和基于证据的护理系统来减少与严重精神疾病相关的人力和经济成本,而不仅仅是床位。

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