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推进法医服务公平、多样性和包容性的综合框架。

A Comprehensive Framework to Advance Equity, Diversity, and Inclusion in a Forensic Service.

作者信息

Chatterjee Sumeeta, Simpson Alexander I F, Wilkie Treena

机构信息

Dr. Chatterjee is Person in Charge, Forensic Service, Centre for Addiction and Mental Health, Toronto, Canada, and Director, Forensic Psychiatry Subspecialty Program and Assistant Professor, University of Toronto. Dr. Simpson is Chair in Forensic Psychiatry, The Centre for Addiction and Mental Health and University of Toronto, and Professor, Department of Psychiatry, University of Toronto. Dr. Wilkie is Deputy Physician in Chief, Medical Affairs and Practice, and Chief, Division of Forensic Psychiatry, The Centre for Addiction and Mental Health; and Associate Professor, University of Toronto.

出版信息

J Am Acad Psychiatry Law. 2023 Dec 8;51(4):486-493. doi: 10.29158/JAAPL.230027-23.

Abstract

Minority and Indigenous populations have disproportionate representation within forensic mental health services. Social determinants of health and systemic discrimination have contributed to the difficulties these populations have in accessing care, as well as significant differences in care trajectories. In addition, staffing and structural equity, diversity, and inclusion (EDI) challenges permeate forensic systems as in other health care settings. There is little literature to guide forensic mental health services in how best to provide equitable, diverse, and inclusive practices for patients, families, and staff. The forensic service at a major urban center in the Canadian province of Ontario has adapted an EDI framework to describe the processes employed to organize and integrate EDI principles and initiatives within a culture of learning and continuous improvement. This Forensic EDI Framework is composed of six domains: Organizational Commitment, Staff/Workforce Competencies, Service Access and Delivery, Promoting Responsiveness, Community Outreach, and Data Collection. Initiatives within each of these domains form the foundation of a sustainable platform for forensic service EDI practices that will promote lasting change.

摘要

少数族裔和原住民在法医精神卫生服务中的代表性过高。健康的社会决定因素和系统性歧视导致这些人群在获得护理方面存在困难,以及护理轨迹存在显著差异。此外,与其他医疗环境一样,人员配备和结构公平、多样性和包容性(EDI)挑战也渗透到法医系统中。几乎没有文献指导法医精神卫生服务如何为患者、家庭和工作人员提供最佳的公平、多样和包容的实践。加拿大安大略省一个主要城市中心的法医服务部门采用了一个EDI框架,以描述在学习和持续改进的文化中组织和整合EDI原则及举措所采用的过程。这个法医EDI框架由六个领域组成:组织承诺、员工/劳动力能力、服务获取与提供、促进响应能力、社区外展和数据收集。这些领域中的每一个领域的举措构成了法医服务EDI实践可持续平台的基础,将促进持久的变革。

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