Geller J L, Brown J M, Fisher W H, Grudzinskas A J, Manning T D
University of Massachusetts Medical Center, Worcester 01655, USA.
Psychiatr Serv. 1998 Apr;49(4):498-503. doi: 10.1176/ps.49.4.498.
A national survey was conducted to determine the extent of consumer empowerment in the public mental health system.
A questionnaire was sent to mental health authorities in all U.S. states and territories asking whether consumer empowerment or responsibility was defined in statutes, regulations, or policies and whether consumers or family members were employed in central or field offices of the authority. A rating scale measured the extent of consumer empowerment, and correlations were examined between this rating and other variables.
The survey achieved a 100 percent response rate. Twenty-two states (39 percent) addressed consumer empowerment and 16 (28 percent) consumer responsibility in a statute, regulation, or policy. Twenty-seven states (48 percent) had paid positions for consumers in central offices, and three (5 percent) had such positions for family members. Half the states had paid positions for consumers in field offices, and 12 states (24 percent) had such positions for family members. The extent of a state's consumer empowerment had no relationship to region of the country or the state's mental health budget. A significant positive relationship was found between extent of empowerment and the size of the state's population and the quality of its mental health services.
State mental health authorities vary widely in their direct involvement with consumer empowerment. Results indicate that mental health authorities need to make a greater commitment to the achievement of such empowerment if it is to become a meaningful part of government involvement with mental health services.
开展一项全国性调查,以确定公共精神卫生系统中消费者赋权的程度。
向美国所有州和领地的精神卫生当局发送一份调查问卷,询问在法规、条例或政策中是否对消费者赋权或责任进行了界定,以及当局的中央或地区办公室是否聘用了消费者或家庭成员。用一个评分量表来衡量消费者赋权的程度,并检验该评分与其他变量之间的相关性。
调查的回复率达到了100%。22个州(39%)在法规、条例或政策中涉及了消费者赋权,16个州(28%)涉及了消费者责任。27个州(48%)在中央办公室为消费者设有带薪职位,3个州(5%)为家庭成员设有此类职位。一半的州在地区办公室为消费者设有带薪职位,12个州(24%)为家庭成员设有此类职位。一个州的消费者赋权程度与该国的地区或该州的精神卫生预算无关。在赋权程度与该州人口规模及其精神卫生服务质量之间发现了显著的正相关关系。
各州精神卫生当局在直接参与消费者赋权方面差异很大。结果表明,如果消费者赋权要成为政府参与精神卫生服务的一个有意义的部分,精神卫生当局需要在实现这种赋权方面做出更大的承诺。