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从评估视角看社区心理健康中心项目概述。

Overview of the Community Mental Health Centers Program from an evaluation perspective.

作者信息

Dowell D A, Ciarlo J A

出版信息

Community Ment Health J. 1983 Summer;19(2):95-128. doi: 10.1007/BF00877603.

Abstract

The 18-year Community Mental Health Center (CMHC) Program of the National Institute of Mental Health (NIMH) was a complex and ambitious social experiment. This review identifies nine of the major goals of the program and examines available evaluative information on how well each was achieved. The most significant achievements of the program include increasing the quantity and range of public mental health services. Equality of access to services was also improved but all inequities were not removed. Problems continue to exist in funding services on the basis of need, in providing services to chronic clients, and in coordinating services. Prevention efforts suffered from uncertainties and perhaps overly optimistic expectations. The achievements of the program are currently threatened by third-party reimbursement mechanisms, the loss of federal leadership and oversight, and the loss of a community orientation in public mental health services. A great deal can be learned from the achievements and the shortfalls of the CMHC program that may be useful in state and federal mental health planning.

摘要

美国国立精神卫生研究所(NIMH)开展的为期18年的社区精神卫生中心(CMHC)项目是一项复杂且雄心勃勃的社会实验。本综述确定了该项目的九个主要目标,并审视了现有的评估信息,以考察每个目标的达成情况。该项目最显著的成就包括增加了公共精神卫生服务的数量和范围。服务获取的平等性也有所改善,但并未消除所有不平等现象。在根据需求提供资金服务、为慢性患者提供服务以及协调服务方面,问题依然存在。预防工作存在不确定性,且预期可能过于乐观。该项目的成就目前正受到第三方报销机制、联邦领导力和监督的缺失以及公共精神卫生服务中社区导向的丧失的威胁。从CMHC项目的成就和不足中可以学到很多东西,这可能对州和联邦的精神卫生规划有用。

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