Bachrach L L
Hosp Community Psychiatry. 1979 Jun;30(6):387-93. doi: 10.1176/ps.30.6.387.
At the present time, deinstitutionalized services for the chronically mentally ill are less than satisfactory. If planning for the future is to reverse the trend of incomplete service delivery for this population, it must start with the recognition and application of certain fundamental concepts. Effective planning requires idealism, vision, and a sense of reality. Six separate but interrelated dimensions of reality must be taken into account: the need for mental hospital; the importance of precise planning goals; the unique service needs of the chronically mentally ill; the need for interagency planning; the importance of a functioning and sensitive patient tracking system; and appreciation of the attitudinal structure within which services are delivered. Wherever the chronically mentally ill live, whether in the hospital or in the community, their requirements must be made the primary focus in mental health planning.
目前,为慢性精神病患者提供的非机构化服务并不尽如人意。如果未来的规划要扭转针对这一人群服务提供不完整的趋势,就必须从认识和应用某些基本概念入手。有效的规划需要理想主义、远见和现实感。必须考虑六个相互独立但又相互关联的现实维度:对精神病院的需求;精确规划目标的重要性;慢性精神病患者独特的服务需求;跨机构规划的必要性;运作良好且灵敏的患者追踪系统的重要性;以及对服务提供所处态度结构的认识。无论慢性精神病患者生活在哪里,无论是在医院还是在社区,他们的需求都必须成为心理健康规划的首要关注点。