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在临床实践中解决精神障碍患者的健康社会决定因素:综述与建议

Addressing social determinants of health in individuals with mental disorders in clinical practice: review and recommendations.

作者信息

Jeste Dilip V, Smith Jeffery, Lewis-Fernández Roberto, Saks Elyn R, Na Peter J, Pietrzak Robert H, Quinn McKenzie, Kessler Ronald C

机构信息

Global Research Network on Social Determinants of Mental Health and Exposomics, La Jolla, CA, USA.

Department of Psychiatry, New York Medical College, New York, NY, USA.

出版信息

Transl Psychiatry. 2025 Apr 3;15(1):120. doi: 10.1038/s41398-025-03332-4.

Abstract

Social determinants of health have been shown to have a greater impact on overall health than traditionally considered medical risk factors, especially in people with mental disorders. It is the primary responsibility of healthcare providers to ensure that persons with psychiatric disorders are actively helped in reducing the adverse effects of SDoMH on their health and healthcare. Yet, the current clinical psychiatric practice in the U.S. does not have any standardized guidelines for evaluating or addressing these critical factors even among individuals who are receiving psychiatric and other medical treatment. Although there are several barriers to implementing such interventions, there are also practical approaches to address selected social determinants of mental health and improve the well-being of our patients. In this article, we review the literature on the assessment of relevant social factors and pragmatic psychosocial strategies at the individual, family, and community levels to help reduce their adverse impact. We offer guidelines for psychiatric clinicians and case managers to improve the health and quality of life of persons with mental disorders, using sustained inter-professional collaborative efforts.

摘要

健康的社会决定因素已被证明对整体健康的影响比传统上认为的医学风险因素更大,尤其是在患有精神障碍的人群中。医疗保健提供者的首要责任是确保积极帮助患有精神疾病的人减少健康的社会决定因素对其健康和医疗保健的不利影响。然而,即使在美国接受精神病治疗和其他医疗治疗的个体中,目前的临床精神病学实践也没有任何评估或解决这些关键因素的标准化指南。尽管实施此类干预存在若干障碍,但也有切实可行的方法来解决特定的心理健康社会决定因素并改善我们患者的福祉。在本文中,我们回顾了有关在个体、家庭和社区层面评估相关社会因素及实用心理社会策略的文献,以帮助减少其不利影响。我们为精神科临床医生和病例管理人员提供指导方针,通过持续的跨专业协作努力,改善患有精神障碍者的健康和生活质量。

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