Bigelow D A, Sladen-Dew N, Russell J S
Alcohol and Drug Programs, British Columbia Ministry of Health.
New Dir Ment Health Serv. 1994 Spring(61):53-62. doi: 10.1002/yd.23319946108.
Over the past twenty years, GVMHS has been the single organization taking ultimate responsibility for the seriously mentally ill throughout the city. It uses central coordination coupled with community-based teams and partnership programs with other agencies to strike a useful balance between integration and flexibility. GVMHS's mission throughout that time has been to provide everyday community support, networking, case management, rehabilitation, and counseling services to as many seriously mentally ill persons with concomitant disabilities as possible. To carry out that mission, GVMHS has developed some innovative solutions for the problems of community support--problems such as psychiatric emergencies, crises, community demands for service outside the mandate, and workload management. GVMHS has also developed dual-diagnosis, multicultural, multiagency case coordination for the multiproblem client (Buckley and Bigelow, 1992), specialized family and child programs, and specialized geriatric programs. This has all been possible only because financial support is available on an ongoing basis at a level adequate to provide good, dependable services. GVMHS has been proven an effective service in a number of studies (Bigelow and Beiser, 1978; Beiser, Shore, Peters, and Tatum, 1985). It has also demonstrated good cost-efficiency (Bigelow and McFarland, 1989) and abundant innovation and adaptation to emerging challenges (Bigelow, McFarland, Russell, and Sladen-Dew, 1990). It has proven that dedicated, well-trained professionals working at the community level will work hard and smart and that an agency and its staff will stick to the mandate of serving people with serious mental illnesses and disabilities even under pressure to do otherwise. The intriguing thing is that this productivity is not driven by competition, incentives, or threat: none of these factors presses upon the Greater Vancouver Mental Health Services Society from without and none is built in. The excellent performance of GVMHS seems to derive from the professional dedication and motivation of the clinical staff and its administration.
在过去二十年里，大温哥华心理健康服务协会（GVMHS）一直是本市唯一对严重精神疾病患者承担最终责任的机构。它采用中央协调机制，结合社区团队以及与其他机构的合作项目，在整合与灵活性之间取得了有益的平衡。在此期间，GVMHS的使命一直是为尽可能多的伴有残疾的严重精神疾病患者提供日常社区支持、建立网络、病例管理、康复和咨询服务。为了履行这一使命，GVMHS针对社区支持问题开发了一些创新解决方案，比如精神科紧急情况、危机、社区对超出任务范围服务的需求以及工作量管理等问题。GVMHS还为多问题客户开发了双重诊断、多元文化、多机构病例协调服务（巴克利和比奇洛，1992年），以及专门的家庭和儿童项目，还有专门的老年项目。这一切之所以成为可能，仅仅是因为有持续的资金支持，且资金水平足以提供优质、可靠的服务。在多项研究中（比奇洛和贝泽，1978年；贝泽、肖尔、彼得斯和塔图姆，1985年），GVMHS已被证明是一项有效的服务。它还展现出良好的成本效益（比奇洛和麦克法兰，1989年），以及对新出现挑战的丰富创新和适应能力（比奇洛、麦克法兰、拉塞尔和斯拉登 - 迪尤，1990年）。它证明了在社区层面工作的敬业且训练有素的专业人员会努力且明智地工作，以及一个机构及其工作人员即使在面临其他压力的情况下也会坚持为严重精神疾病和残疾患者服务的使命。有趣的是，这种高效并非由竞争、激励或威胁驱动：这些因素都没有从外部施加于大温哥华心理健康服务协会，内部也没有设置这些因素。GVMHS的卓越表现似乎源于临床工作人员及其管理层的专业奉献精神和积极性。
