Burns B J, Burke J D
Public Health Rep. 1985 May-Jun;100(3):294-300.
This paper reviews restraints on the provision of mental health services in primary health care under the broad categories of physician profile, patient behavior, the nature of psychiatric illness as presented in primary care, and service system characteristics. An extensive research agenda is proposed toward improving mental health care in primary care settings. Research recommendations focus on the following types of issues: seeking a better understanding of the clinical decision making process when confronted with psychological or emotional problems, designing more focused mental health training for primary care physicians and nurses, providing patient education to encourage communication of psychosocial problems to medical providers, clarifying the nature and course of psychiatric disorder in primary care, designing innovative clinical interventions applicable to primary care, and examining organizational models for better coordination of health and mental health services.
本文从医生概况、患者行为、基层医疗中呈现的精神疾病性质以及服务系统特征等广泛类别,回顾了基层医疗中精神卫生服务提供方面的限制因素。针对改善基层医疗环境中的精神卫生保健,提出了一项广泛的研究议程。研究建议聚焦于以下几类问题:在面对心理或情感问题时,寻求对临床决策过程的更深入理解;为基层医疗医生和护士设计更具针对性的精神卫生培训;开展患者教育,鼓励将心理社会问题告知医疗服务提供者;阐明基层医疗中精神障碍的性质和病程;设计适用于基层医疗的创新性临床干预措施;以及研究能更好协调健康与精神卫生服务的组织模式。