精神保健システムを世界的に変革する:原則と政策勧告
Vikram Patel1, Shekhar Saxena2, Crick Lund3
1Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA.
Lancet (London, England)
|August 19, 2023
まとめ
診断カテゴリーを超えた パラダイムシフトが必要です 権利に基づくアプローチで コミュニティと多様な提供者を力づけることで 既存のリソースを利用して 介護を変革できます
科学分野:
- 世界保健
- メンタルヘルスサービス研究
- 公共衛生政策
背景:
- 国家の資源にかかわらず 深刻な世界的な精神衛生危機が 拡大しています
- 診断カテゴリーに焦点を当てた現在のアプローチは 専門家の介入を制限し コミュニティベースの促進と予防戦略を無視しています
研究 の 目的:
- 世界的な精神衛生危機に対応する 変革の枠組みを提案する
- 精神保健医療の提供を改善するための実行可能な原則と政策勧告を特定する.
主な方法:
- 実践変革の鍵となる原則を特定するための証拠を集約する.
- メンタルヘルスケアにおける制度的変化のための政策勧告を策定する.
主要な成果:
- 精神保健の実践を変えるための5つの基本原則は 社会的決定因子に対処し 病気の段階と照合し 医療提供者の多様性を強化し 権利に基づくアプローチを採用し 生きた経験を中心にすることです
- 4つの政策行動:社会全体のアプローチ,ケアアーキテクチャの再設計,証拠に基づいた介入への投資,モニタリングによる説明責任
結論:
- 精神保健の変革は 既存の地域社会や国家資源を活用することで 実現可能なのです
- メンタルヘルスの危機を効果的に対処するには "いつものようにビジネス"から統合された,コミュニティを中心とした,権利に基づいたアプローチへの移行が不可欠です.
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