COVID-19大流行与精神卫生保健系统。

Q3 Medicine
V. Mavreas, S. Stylianidis
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The lack of accessibility to mental health services, had a greater impact on persons with social and financial problems, which deteriorated during the pandemic, leading to mental health problems.3 An additional problem is that persons suffering from severe mental disorders, such as chronic psychoses, face a greater risk of infection and death by Covid-19.7 These problems, arising during the pandemic (increased prevalence of mental disorders, increase of relapses of serious mental disorders, increased risk of infection and death by Covid-19, increased prevalence in those infected, especially those in the ICUs, problems of accessibility) underline the chronic insufficiencies of the mental health care system, which in many countries, especially in Greece, is fragmented and is not covering adequately the mental health needs of the population. 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引用次数: 1

摘要

流行病的心理影响历史上出现在人类身上,在史蒂文·泰勒(Steven Taylor)的优秀著作《流行病的心理学》(The Psychology of pandemic)中有详细描述,该书于2019年出版,就在2019冠状病毒病大流行爆发的几个月前。根据国际和希腊流行病学研究的结果,这次大流行病在精神健康问题方面与书中所述的前几次具有相似的特点。2-5这些研究的结果表明,普通精神障碍的流行率显著增加,特别是在弱势群体中,特别是在已有精神障碍的人群中。6 .实施的必要限制措施,特别是在大流行的最初阶段,对精神病患者获得精神保健服务(包括住院和门诊)产生了影响这导致门诊预约和住院人数减少,使大量这些患者无法得到必要的治疗和干预,往往导致他们的精神状态恶化或急性发作复发。缺乏获得心理健康服务的机会对有社会和经济问题的人产生了更大的影响,这种情况在大流行病期间恶化,导致心理健康问题另一个问题是,患有严重精神障碍(如慢性精神病)的人在大流行期间面临更大的感染和死亡风险(精神障碍患病率增加,严重精神障碍复发增加,Covid-19感染和死亡风险增加,感染者,特别是重症监护病房患者的患病率增加)。可获得性问题)强调了精神卫生保健系统的长期不足,在许多国家,特别是在希腊,该系统是分散的,不能充分满足人口的精神卫生需求。在著名的心理健康期刊上发表了一系列文章,指出了问题并提出了解决方案,以期通过一系列活动纠正不足,建立一个新的强大的心理健康体系。8-10这些文章强调了几十年来已知的问题,并提出了以下解决办法,以加强现有的精神卫生系统,不仅要满足大流行造成的额外需求,而且要建立一个新的精神卫生系统,充分满足人口的需求:(1)加强领导和治理,对政治家和行政人员进行干预,以便了解心理健康问题,并在包容、公平和问责制方面提供服务。(2)在财政上支持以证据为基础的服务,采取政策应对心理健康的社会决定因素以及大流行病造成的额外需求。(3)在利益攸关方的积极参与下,促进针对弱势群体的方案,特别是与社会决定因素有关的方案,重点是消除耻辱和提高心理健康素养。(4)加强三个层面的精神卫生服务,重点是社区精神卫生服务、家庭治疗、弱势群体特殊服务、Covid-19感染者和死者亲属服务、应对Covid-19的卫生服务人员服务、利用“远程医疗”服务、采用信息系统协助服务并与应对Covid-19的服务机构密切合作。(5)利用世界卫生组织(世卫组织)的卫生保健计划,对初级保健工作人员进行心理健康方面的培训,并将他们与特殊心理健康服务联系起来。(6)在利益攸关方、非政府组织和民间社会的参与下,实施促进精神健康和预防精神障碍的方案。(7)完善精神卫生信息系统,并将其与应对Covid-19的并行系统连接起来。(8)加强和资助精神卫生研究,从流行病学和服务研究到神经生物学,以及旨在为改进精神卫生服务系统和通过社交媒体提供服务和干预措施提供创新解决方案的研究。(9)利用世卫组织的WHOQualityRights等评估工具,保护精神病人的权利,旨在提供高质量的服务。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
COVID-19 pandemic and the mental health care system.
The psychological impact of pandemics, which historically appear in the human species, is described in detail in Steven Taylor's excellent book "The Psychology of Pandemics",1 which was published in 2019, a few months before the outbreak of the Covid-19 pandemic. This pandemic shows similar characteristics in terms of mental health problems to the previous ones described in the book, according to the findings of epidemiological research, both internationally and in Greece.2-5 The results of these studies show a significant increase of the prevalence of common mental disorders, especially in vulnerable groups, particularly in persons with preexisting mental disorders. The necessary restrictive measures applied, especially in the first stages of the pandemic, had an impact in the accessibility of psychiatric patients to the mental health services, both in- and outpatient ones.6 This led to decreased outpatient appointments and admissions in inpatient wards, depriving a large number of these patients from necessary treatments and interventions, often resulting in worsening their mental state or relapse of acute episodes. The lack of accessibility to mental health services, had a greater impact on persons with social and financial problems, which deteriorated during the pandemic, leading to mental health problems.3 An additional problem is that persons suffering from severe mental disorders, such as chronic psychoses, face a greater risk of infection and death by Covid-19.7 These problems, arising during the pandemic (increased prevalence of mental disorders, increase of relapses of serious mental disorders, increased risk of infection and death by Covid-19, increased prevalence in those infected, especially those in the ICUs, problems of accessibility) underline the chronic insufficiencies of the mental health care system, which in many countries, especially in Greece, is fragmented and is not covering adequately the mental health needs of the population. A series of articles in prestigious mental health journals point out the problem and propose solutions, in order to correct insufficiencies and create a new strong mental health system through a series of activities.8-10 These articles underline the problems known for decades and propose the following solutions for enhancing the existing mental health system, not only to cover additional needs created by the pandemic, but leading to a new mental health system covering adequately the needs of the population: (1) Strengthening leadership and governance, with interventions to politicians and administrators, in order to understand mental health issues, and provide services in terms of inclusivity, equity and accountability. (2) Supporting financially evidence-based services, adopting policies to counteract the social determinants of mental health, as well as the additional needs created by the pandemic. (3) Promoting programmes targeting vulnerable groups, especially those related to social determinants, with the active participation of stakeholders, with emphasis in combating stigma and enhancing mental health literacy. (4) Strengthen mental health services in all three levels, with emphasis in community mental health services, treatment at home, special services for vulnerable groups, services for the Covid-infected and the relatives of the deceased from the infection, the staff of health services dealing with Covid-19, using "telehealth" services, adopting information systems to assist services and close collaboration with the services dealing with Covid-19. (5) Training the staff of primary health care in mental health by using the mhGAP programme of the World Health Organization (WHO) and linking them to the special mental health services. (6) Implementing programmes for mental health promotion and prevention of mental disorders, with the participation of stakeholders, NGOs and the civil society. (7) Improving mental health information systems and connecting them with parallel systems dealing with Covid-19. (8) Strengthen and finance research in mental health, from epidemiology and services research, to neurobiology, as well as research aiming to provide innovative solutions for improving the system of mental health services and the provision of services and interventions through the social media. (9) Protecting rights of mental patients aiming to provide high quality services by use of evaluation instruments such as WHOQualityRights of WHO.
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来源期刊
Psychiatrike = Psychiatriki
Psychiatrike = Psychiatriki Medicine-Medicine (all)
CiteScore
2.60
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0.00%
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37
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