Aliev Akmal Alikhan, Salisbury Tatiana Taylor
Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Cent Asian J Glob Health. 2020 Mar 31;9(1):e513. doi: 10.5195/cajgh.2020.513. eCollection 2020.
There are large differences in the development of mental health systems of the West and the countries of the former Eastern Bloc. The latter is characterized by a more biological approach to mental health and reliance on psychiatric hospitals. In 2018, Uzbekistan authorities showed interest in reforming mental health care of the country. The policy report provides an overview of progress towards the provision of community mental health (CMH) care across Eastern Europe and recommendations for this transition within Uzbekistan.
A literature search on mental health care in Uzbekistan was conducted to understand its strengths and weaknesses. Progress towards the provision of CMH care across Eastern Europe was assessed using data on the number of psychiatric beds and availability of mental health services in community settings reported within the published literature. Countries identified as making the greatest progress towards CMH care were reviewed in detail to better understand the process of reform assets and barriers.
Mental health care in Uzbekistan is highly institutionalized, underfunded and understaffed. Social care services are poorly developed. However, current leadership has kindled the promise of mental health reform. Georgia, Lithuania and Poland have made the most progress in terms of CMH care availability. However, due to various obstacles such as dual financial burden, high stigma and lack of political will, their programs lack social integration and/or uniform availability and underfunding along with scarcity of mental health specialists are common. On the other hand, research and evaluation, involvement of service users into service planning and cooperation with donors facilitated reform implementation.
Uzbekistan may develop into a modern mental health system and avoid the setbacks encountered by other countries in the region, through careful financial planning, stigma reduction, improving mental health literacy, human resources strategic development and civil society engagement.
西方与前东欧集团国家的心理健康系统发展存在巨大差异。后者的特点是对心理健康采取更具生物医学的方法，并依赖精神病医院。2018年，乌兹别克斯坦当局对该国的心理健康护理改革表现出兴趣。该政策报告概述了东欧在提供社区心理健康（CMH）护理方面的进展情况，并为乌兹别克斯坦的这一转型提供了建议。
对乌兹别克斯坦的心理健康护理进行文献检索，以了解其优势和劣势。利用已发表文献中报告的精神病床数量和社区心理健康服务可及性的数据，评估东欧在提供CMH护理方面的进展。对被确定为在CMH护理方面取得最大进展的国家进行了详细审查，以更好地了解改革的资产和障碍过程。
乌兹别克斯坦的心理健康护理高度制度化，但资金不足且人员配备不足。社会护理服务发展不佳。然而，现任领导层点燃了心理健康改革的希望。格鲁吉亚、立陶宛和波兰在CMH护理可及性方面取得了最大进展。然而，由于双重财务负担、高度耻辱感和缺乏政治意愿等各种障碍，它们的项目缺乏社会融合和/或统一可及性，资金不足以及心理健康专家短缺的情况很常见。另一方面，研究与评估、服务使用者参与服务规划以及与捐助者的合作促进了改革的实施。
通过精心的财务规划、减少耻辱感、提高心理健康素养、人力资源战略发展和公民社会参与，乌兹别克斯坦可以发展成为一个现代化的心理健康系统，并避免该地区其他国家所遇到的挫折。
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