Climent C E, De Arango M V
Acta Psiquiatr Psicol Am Lat. 1980 Mar;26(1):48-53.
Mental Disorders constitute a severe Public Health problem in developing countries due to inadequate resources specially in terms of trained personnel; furthermore, Mental Health care is given out only in specialized Institutions where it has not been possible to provide coverage for more than a small part of the population. In this context the Collaborative Study on Strategies for the Extension of Mental Health Care has been planned, using as its guiding principle the recommendations of the WHO Expert Committee on Organization of Mental Health Services in Developing Countries (W.H.O. 1975). The objectives of the study are to determine the feasibility of introducing Mental Health Care directed toward defined priority conditions into general health services, to develop methods of selection for interventions in Mental Health Care as well as methods for task oriented training for health workers, to evaluate effectiveness of alternative low cost methods and to develop and evaluate ways of simulating community response to problems related to mental disorders. The areas selected are representative of the range of environments in developing countries in terms of overall socioeconomic and health status. In each area, actions will be directed towards making baseline observations and towards provision of care (planning, training, supervision and provision of referral channels). Specific interventions in the Cali area are described in regard to the training of the Health Center personnel in Mental Health, the provision of psychotropic drugs at the peri-urban level and provision of Mental Health Care by Primary Health Workers under the supervision of Health Center physicians and nurses.
由于资源不足,特别是缺乏训练有素的人员,精神障碍在发展中国家构成了严重的公共卫生问题;此外,精神卫生保健仅在专门机构提供,而这些机构无法为超过一小部分人口提供服务。在此背景下,计划开展精神卫生保健扩展策略合作研究,以世界卫生组织发展中国家精神卫生服务组织专家委员会的建议(世界卫生组织,1975年)为指导原则。该研究的目标是确定将针对特定优先病症的精神卫生保健引入一般卫生服务的可行性,制定精神卫生保健干预措施的选择方法以及卫生工作者任务导向培训方法,评估替代低成本方法的有效性,并制定和评估模拟社区对精神障碍相关问题反应的方法。所选地区在总体社会经济和健康状况方面代表了发展中国家的各种环境。在每个地区,行动将针对进行基线观察和提供护理(规划、培训、监督和提供转诊渠道)。关于卡利地区的具体干预措施,描述了对卫生中心人员进行精神卫生培训、在城郊地区提供精神药物以及由初级卫生工作者在卫生中心医生和护士监督下提供精神卫生保健的情况。