探索印度果阿邦精神科医生在从1987年《精神健康法》过渡到2017年《精神卫生保健法》期间的经历。
Exploring Psychiatrists' Experiences During Transition from Mental Health Act, 1987 to Mental Healthcare Act, 2017 in Goa, India.
作者信息
Vanagundi Rohan, Pokle Sneha, Walwaikar Rohit, Waikar Shilpa
机构信息
Dept. of Psychiatry, Institute of Psychiatry and Human Behavior, Goa, India.
出版信息
Indian J Psychol Med. 2024 Jan;46(1):32-38. doi: 10.1177/02537176231198404. Epub 2023 Sep 28.
BACKGROUND
Mental Healthcare Act 2017 (MHCA) came into force on 29 May 2018. Goa State Mental Health Authority (GSMHA) notified the Mental Health Review Board on 8 February 2022, completing the important process of implementation of the act. The transition comes with challenges.
METHODS
A qualitative study was conducted with 18 practicing psychiatrists who had worked under Mental Health Act 1987 as well as MHCA 2017 through purposive sampling across Goa. Data was collected through individual interviews; analysis was done by Braune and Clarke's framework of Thematic Analysis.
RESULTS
Eighteen psychiatrists participated: 4 private, 3 secondary and 11 from tertiary levels. The themes extracted were work during MHA 1987, transition, and after the implementation of MHCA 2017. Some participants reported difficulties, felt an increase in workload, and had negative emotions, while a few were neutral, indicating mixed perceptions.
CONCLUSION
This study highlights the administrative struggles and moral dilemmas faced by psychiatrists in handling the new legislation. It's imperative that the implementation of new act should be carried out with sufficient resource allocation and monitoring mechanisms.
背景
《2017年精神卫生保健法》（MHCA）于2018年5月29日生效。果阿邦精神卫生管理局（GSMHA）于2022年2月8日公布了精神健康审查委员会，完成了该法案实施的重要进程。这一转变带来了挑战。
方法
通过在果阿邦进行目的抽样，对18名曾依据1987年《精神卫生法》以及《2017年精神卫生保健法》执业的精神科医生开展了一项定性研究。通过个人访谈收集数据；采用布劳恩和克拉克的主题分析框架进行分析。
结果
18名精神科医生参与其中：4名来自私立机构，3名来自二级机构，11名来自三级机构。提取的主题为1987年《精神卫生法》实施期间的工作、转变以及《2017年精神卫生保健法》实施之后的情况。一些参与者报告了困难，感到工作量增加且有负面情绪，而少数人持中立态度，表明看法不一。
结论
本研究突出了精神科医生在应对新立法时面临的行政困难和道德困境。新法案的实施必须要有充足的资源配置和监督机制。
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