Lamb H R, Talbott J A
JAMA. 1986 Jul 25;256(4):498-501. doi: 10.1001/jama.256.4.498.
The homeless mentally ill have become one of the greatest problems of present-day society. The American Psychiatric Association's Task Force on the Homeless Mentally Ill concluded that this is not the result of deinstitutionalization per se but of the way it has been carried out; homelessness among the chronically and severely mentally ill is symptomatic of the grave problems facing them generally in this country. Thus, the problem will not be solved until the basic underlying problems are addressed and a comprehensive and integrated system of care for the chronically mentally ill is established. Specific recommendations of the Task Force include an ample range of graded, supervised community housing; comprehensive and accessible psychiatric care and rehabilitation; the availability of general medical assessment and care, crisis services, and a dependable source of income; a system of case management in which one mental health worker is responsible for each patient; changes in commitment laws to make them more responsive to clinical needs; coordination between the various community resources; and ongoing asylum and sanctuary for that small proportion who require it.
无家可归的精神病患者已成为当今社会最严重的问题之一。美国精神病学协会无家可归精神病患者特别工作组得出结论，这并非非机构化本身的结果，而是其实施方式的结果；长期和严重精神病患者中的无家可归现象是他们在这个国家普遍面临的严重问题的症状。因此，在解决基本的潜在问题并建立一个全面综合的慢性精神病患者护理系统之前，这个问题无法得到解决。特别工作组的具体建议包括一系列充足的分级、受监督的社区住房；全面且可及的精神病护理和康复；提供一般医疗评估和护理、危机服务以及可靠的收入来源；建立一个病例管理系统，其中一名心理健康工作者负责每位患者；修改收容法律，使其更能响应临床需求；协调各种社区资源；以及为那一小部分有需要的人提供持续的庇护所。
