【摘要】 目的:对中国1949-2009年精神卫生服务提供模式和相关政策进行了系统回顾,分析不同发展阶段的特征,为我国精神卫生改革提供借鉴。方法:通过检索电子期刊数据库和我国卫生部官方网站等数据库并配合相应的手工检索,纳入收集整理与精神疾病流行病学、精神卫生服务提供、精神卫生服务利用、精神卫生政策和规划高度相关的资料。访谈国内外从事精神卫生服务工作的多名知名专家和主管领导,对其访谈内容记录、录音,进行归纳、分析、总结。结果:共纳入216篇文献,213人参与访谈。研究显示,60年来中国精神卫生资源和服务模式的演变经历了快速发展、稳步发展和改革等三个阶段;中国精神卫生服务体系在60年间发生了巨变化,但仍存在资源短缺、精神病治疗率较低、普通人群和医务人员精神卫生知识匮乏、社会对精神病人的偏见严重等现状;60年间,中国精神卫生服务政策也经历了巨大的变化,正向着建立以社区精神卫生服务为主的综合服务网络方向前进。结论:我国应继续强化社区卫生服务,提高精神卫生服务的公平性和可及性。更多还原

【Abstract】 Objective: To explore the development of mental health services in China from 1949 to 2009,analyze the characteristics of different development stages,and to provide a reference for mental health reform.Methods: By searching the CBM,CNKI,Pubmed,Ministry of Health of China,and corresponding with the manual search,collected information about the epidemiology of mental illness,mental health service offer,mental health service use,and the mental health policy and scheme.Meanwhile,carried out the informant interviews between a number of experts in mental health services and the competent leadership at home and abroad,and then analyzed the interview content.Results: Totally 216 articles met the inclusion criteria,and 213 persons participated in the interviews.The evolution of mental health resources and service model in the 60 years experienced three phases,i.e.,rapid growth,steady development,and the reform period.The situation,such as the shortage of resource,lower rate of psychiatric treatment,lack of the knowledge of mental health,social prejudices of serious mental illness,still existed.The mental health service policy had also undergone dramatic changes,and moving toward the establishment of the integrated service network-based community mental health services of the mental health services.But there still were some problems,such as shortage of resource,lower rate of psychiatric treatment,lack of the knowledge of mental health,social prejudices of serious mental illness,and so on.Conclusion: The community health service should be strengthening,and the fairness and accessibility of mental health service should be improving in the long run.更多还原