Segal Steven P, Riley Sharon
Mental Health and Social Welfare Research Group, University of California, Berkeley, School of Social Welfare, 120 Haviland Hall, Berkeley, CA 94720.
Soc Work Ment Health. 2003;1(3):1-17. doi: 10.1300/j200v01n03_01.
This article places evidenced-based knowledge of practice within the social context of care and proposes five policy objectives and specific policy and program changes to address care needs of people with serious mental illness. In spite of demonstration programs that provide the basis for proposed policy initiatives throughout the United States, treatment provision for this population remains inadequate and their safety and well-being continues to be at risk. The authors suggest that treatment initiatives need to be tied to stable policies protecting the mentally ill from adverse social context changes. The authors conclude that policies are needed that will enhance housing assistance, independent social functioning, personal empowerment, and treatment engagement. In addition, efforts are needed to make better use of inpatient hospital care, to better understand the role of assisted treatment, and to better develop consistent long-term fiscal support for the seriously mentally ill. They offer specific policy recommendations for changes in HUD programs, Medicaid and Medicare funding, and treatment programming that address these needs.
本文将基于证据的实践知识置于护理的社会背景中,并提出了五项政策目标以及具体的政策和项目变革,以满足严重精神疾病患者的护理需求。尽管示范项目为美国各地拟议的政策举措提供了依据,但针对这一人群的治疗服务仍然不足,他们的安全和福祉仍面临风险。作者认为,治疗举措需要与保护精神病患者免受不利社会环境变化影响的稳定政策挂钩。作者得出结论,需要制定政策来加强住房援助、促进独立的社会功能、增强个人权能以及提高治疗参与度。此外,还需要努力更好地利用住院医院护理,更好地理解辅助治疗的作用,并更好地为严重精神疾病患者制定持续的长期财政支持。他们针对住房和城市发展部(HUD)项目、医疗补助和医疗保险资金以及治疗项目的变革提出了具体的政策建议,以满足这些需求。