Shinfuku N
International Center for Medical Research, Kobe University School of Medicine, Japan.
Psychiatry Clin Neurosci. 1998 Jun;52(3):269-74. doi: 10.1046/j.1440-1819.1998.00400.x.
In contrast to European countries and the United States of America, there has been a steady increase in the psychiatric inpatient population in Japan between 1960 and 1993. Japan has the biggest number of psychiatric beds in the world, both in absolute and relative numbers per population. However, Japan now focuses on community based services and the human rights of patients. In other Asian countries, the number of psychiatric beds is relatively small; however, the numbers are increasing each year in China, the Republic of Korea, Philippines, Indonesia and in many other countries in Asia. These countries are still facing the challenge of increasing psychiatric services and to improve the quality of care with scarce mental health resources. Should Asian countries take the similar path to European countries and develop mental health services? This review provides an overview of Asian mental health services and discussing the following issues: how many psychiatric beds do we need in Asia?; public vs private psychiatric services?; financing scheme to promote community based care in Asia; mental health services in primary health care; family education and user involvement in Asia; and the challenge for psychiatrists in Asia.
与欧洲国家和美利坚合众国不同,1960年至1993年间,日本的精神科住院人数一直在稳步增加。日本的精神病床数量无论是绝对数量还是按人口计算的相对数量,均位居世界首位。然而,日本目前注重基于社区的服务以及患者的人权。在其他亚洲国家,精神病床数量相对较少;不过,中国、韩国、菲律宾、印度尼西亚以及亚洲其他许多国家的精神病床数量每年都在增加。这些国家仍面临着增加精神科服务以及利用稀缺的心理健康资源提高护理质量的挑战。亚洲国家是否应走与欧洲国家类似的道路来发展心理健康服务?本综述概述了亚洲的心理健康服务并讨论以下问题:亚洲需要多少张精神病床?;公立与私立精神科服务?;促进亚洲社区护理的融资方案;初级卫生保健中的心理健康服务;亚洲的家庭教育和用户参与;以及亚洲精神科医生面临的挑战。