Glasson J
Br J Nurs. 1996;5(10):615-7. doi: 10.12968/bjon.1996.5.10.615.
Transferring the care of mentally ill patients to the community is not a new initiative. The first comprehensive Hospital Plan by the Department of Health and Social Security (DHSS, 1962) recognized and recommended that areas of health care which did not need to take place in hospital should be carried out in the community. Some 30 years later, this transition is taking place. This transition has not been a smooth process and in certain cases it has failed. The public image of mental illness has played a significant role in delaying the transfer of care to the community, although this is not the sole hindering factor. Poor liaison between health and social services, closure of hospitals before development of community facilities, inadequate community support and resources, and sensationalized media coverage have all been cited. Community care of mentally ill patients is a reality and it has been demonstrated that it can be well planned and properly funded (Faugier, 1993). Rather than dwelling on the shortcomings surrounding the implementation of community care, the way forward is to learn from mistakes and to identify means of increasing public acceptance of people suffering from mental illness.
将精神病患者的护理工作转移至社区并非一项新举措。卫生与社会保障部(DHSS,1962年)制定的首个综合医院计划就认识到并建议,无需在医院进行的医疗保健领域应在社区开展。大约30年后,这一转变正在发生。但这一转变并非一帆风顺,在某些情况下甚至失败了。尽管这并非唯一的阻碍因素,但精神疾病的公众形象在延迟护理向社区转移方面起到了重要作用。卫生与社会服务之间的联络不畅、在社区设施发展之前关闭医院、社区支持和资源不足以及媒体的耸人听闻的报道都被提及。对精神病患者的社区护理已成为现实,并且已经证明它可以得到精心规划和适当资助(福吉尔,1993年)。与其纠结于社区护理实施过程中的缺点,不如从错误中吸取教训,找出提高公众对精神病患者接受度的方法。