Community mental health

社区心理健康
  • 文章类型: Journal Article
    目的:精神卫生已成为影响经济和社会发展的重大公共卫生问题,严重精神障碍(SMD)是重中之重。近年来,北京,中国,已经出台了几项政策来减轻精神健康障碍患者的经济负担。这项研究的目的是调查在引入多种医疗政策后患者医疗费用的现状和构成。探索可能影响医疗服务利用的因素,为后续政策改进提供参考和依据。
    方法:多阶段抽样用于选择代表性研究人群。采用回顾性调查方法收集2019年患者信息和医疗费用数据。
    方法:采用描述性统计方法分析患者医疗费用的现状,并使用两部分模型来检查影响医疗保健利用率的因素并对预测费用进行建模。
    结果:在4940名参与者中,发生医疗费用的SMD患者的平均门诊费用为8373.61元,平均住院费用为81,594.05元。自付费用占门诊费用的29.22%,占住院费用的8.13%。年龄等因素,家庭地位,经济地位,婚姻状况,参与社区免费药物服务(CFMS)和诊断的疾病类型影响了医疗费用和服务利用率的差异。
    结论:北京SMD患者的医疗费用较高,但是一些出台的政策有效地降低了患者的这些成本。未来的研究应关注年龄等因素的影响,经济地位,参与CFMS和医疗费用诊断的疾病类型。
    OBJECTIVE: Mental health has become a significant public health problem that impacts both economic and social development, with severe mental disorders (SMDs) being the top priority. Over recent years, Beijing, China, has introduced several policies to reduce the economic burden on patients with mental health disorders. The aim of this study was to investigate the current status and composition of patients\' medical expenses following the introduction of multiple medical policies, explore the factors that may impact the utilisation of medical services and provide a reference and basis for subsequent policy improvements.
    METHODS: Multistage sampling was used to select a representative study population. A retrospective survey was used to collect patient information and data on medical expenses in 2019.
    METHODS: Descriptive statistics were applied to analyse the current status of patients\' medical expenses, and a two-part model was used to examine the factors influencing healthcare utilisation and to model predicted expenses.
    RESULTS: Among 4940 participants, the average outpatient expenses of patients with SMD who incurred medical expenses were 8373.61 Yuan, and the average hospitalisation expenses were 81,594.05 Yuan. The out-of-pocket expenses were 29.22% of outpatient expenses and 8.13% of inpatient expenses. Factors such as age, household status, economic status, marital status, participation in the Community Free-Medication Service (CFMS) and the type of disease diagnosed influenced the differences in medical expenses and utilisation of services.
    CONCLUSIONS: The medical expenses of patients with SMD in Beijing are high, but a number of introduced policies have effectively reduced these costs for patients. Future studies should focus on the impact of factors such as age, economic status, participation in the CFMS and the type of disease diagnosed on medical expenses.
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  • 文章类型: Journal Article
    本研究在理论层面上界定了社区的代际融合,并验证了一系列措施是否可以促进社区居民与其他利益相关者之间的谈判和沟通,以产生积极健康的社区环境并逐步改善群体间关系。具体来说,我们运用社区心理学,利用上海虹桥新村,中国,作为探索公共社区空间代际冲突的研究场所。研究分为两个阶段:输入阶段和输出阶段。在输入阶段,通过参与式研究和茶会深入探讨居民的公共空间需求。在输出阶段,我们通过使用代际态度量表来调查代际关系是否因共同创造干预而改变,从而检验了该理论的有效性.结果表明,干预措施降低了使用广场的居民之间的冲突发生率,并导致一些儿童加入了年龄较大的群体。因此,我们提出了一个包含整合要素的代际整合策略的理论体系模型,分歧,以及代际互动中的协同作用。总的来说,本文为构建支持心理健康、改善代际关系和社会福祉的社区环境提供了新思路。
    This study defined intergenerational integration in communities at a theoretical level and verified whether a series of measures could facilitate negotiation and communication between community residents and other stakeholders to generate a positive and healthy community environment and gradually improve intergroup relations. Specifically, we applied community psychology and used Hongqiao New Village in Shanghai, China, as a research site to explore intergenerational conflict in public community spaces. The research was divided into two stages: an input stage and an output stage. In the input stage, participatory research and tea parties were used to deeply explore residents\' public space requirements. In the output stage, we tested the validity of the theory by using the Intergenerational Attitude Scale to investigate whether the intergenerational relationships were changed by the co-creation intervention. The results showed that the intervention caused a decrease in the incidence of conflict between residents using the square and caused some children to join the older groups in their activities. We thus propose a theoretical system model of intergenerational integration strategies that incorporates elements of integration, disagreement, and synergy in intergenerational interactions. Overall, this paper provides new ideas for building a community environment that supports mental health and improves intergenerational relationships and social well-being.
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  • 文章类型: Letter
    人们越来越关注与心理健康有关的污名和歧视对生活质量以及获得医疗保健的机会和质量的影响。存在减少污名的有效策略,但大多数证据来自高收入环境。最近对污名研究的评论发现了该领域的差距,包括干预措施的有限文化和背景适应,缺乏关于评估工具的上下文心理测量信息,and,最值得注意的是,缺乏减少污名的多层次策略。靛蓝伙伴关系研究方案将通过多国,在低收入和中等收入国家(LMICs)开展反污名干预措施的多地点合作(中国,埃塞俄比亚,印度,尼泊尔,和突尼斯)。Indigo伙伴关系旨在:(1)开展研究,以加强对污名化过程机制的理解,并减少对中低收入国家精神健康状况人群的污名化和歧视;(2)通过开展该计划建立一个强大的合作研究联盟。具体来说,靛蓝伙伴关系涉及在社区开发和试点测试反污名干预措施,初级保健,和心理健康专家护理水平,用系统的方法来适应整个网站的文化和语境。这项工作还涉及跨文化翻译以及污名和歧视测量工具的适应。Indigo伙伴关系的主要原则是与有精神健康状况经验的人合作,以制定和实施试点干预措施,以及能力建设和跨现场学习,以积极发展更具全球代表性和公平的心理健康研究社区。这项工作预计会产生长期的影响,在向参与机构和研究人员提供的能力建设方面,以及它为未来的研究提供的基础,以扩展什么可以减少并最终消除心理健康中的污名和歧视的证据基础。
    There is increasing attention to the impacts of stigma and discrimination related to mental health on quality of life and access to and quality of healthcare. Effective strategies for stigma reduction exist, but most evidence comes from high-income settings. Recent reviews of stigma research have identified gaps in the field, including limited cultural and contextual adaptation of interventions, a lack of contextual psychometric information on evaluation tools, and, most notably, a lack of multi-level strategies for stigma reduction. The Indigo Partnership research programme will address these knowledge gaps through a multi-country, multi-site collaboration for anti-stigma interventions in low- and middle-income countries (LMICs) (China, Ethiopia, India, Nepal, and Tunisia). The Indigo Partnership aims to: (1) carry out research to strengthen the understanding of mechanisms of stigma processes and reduce stigma and discrimination against people with mental health conditions in LMICs; and (2) establish a strong collaborative research consortium through the conduct of this programme. Specifically, the Indigo Partnership involves developing and pilot testing anti-stigma interventions at the community, primary care, and mental health specialist care levels, with a systematic approach to cultural and contextual adaptation across the sites. This work also involves transcultural translation and adaptation of stigma and discrimination measurement tools. The Indigo Partnership operates with the key principle of partnering with people with lived experience of mental health conditions for the development and implementation of the pilot interventions, as well as capacity building and cross-site learning to actively develop a more globally representative and equitable mental health research community. This work is envisioned to have a long-lasting impact, both in terms of the capacity building provided to participating institutions and researchers, and the foundation it provides for future research to extend the evidence base of what works to reduce and ultimately end stigma and discrimination in mental health.
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  • 文章类型: Journal Article
    随着COVID-19大流行席卷全球,人们越来越关注代际关系,社区心理健康问题,和社区环境中的福祉。本文从理论层面评估了代际融合的共同创造方法的有效性。该研究在社区设计过程中采用了协作共创设计方法,以探讨各个年龄段的社区居民参与解决社区问题是否促进了交流并缓解了各代人之间的刻板印象。本研究在上海虹桥新村广场进行,在那里,我们进行了参与式研究和共同创造研讨会,以响应使用公共空间作为社会互动场所的需求。结果表明,通过协同设计对社区创作进行干预,有利于促进不同年龄段之间的友好关系,形成社会安全感,从而增进社会福祉。最后,本文结合实践案例和理论模型研究了协同合作创意设计方法促进社区代际融合,并从投入和产出部分以及协同合作创意的影响因素和制约因素进行了总结。此外,它为未来如何改善代际关系和形成积极和可持续的社区心理健康环境提供了新的思路。
    With the COVID-19 pandemic sweeping the world, there is an increased focus on intergenerational relationships, community mental health issues, and well-being in community contexts. This paper assesses the effectiveness of a co-creation approach for intergenerational integration at the theoretical level. The study used a collaborative co-creation design method in the community design process to explore whether the participation of community residents of all ages in addressing community issues promoted communication and alleviated stereotyping between the various generations. This study was conducted in Shanghai\'s Hongqiao New Village square, where we conducted participatory research and co-creation workshops in response to the demand for the use of the public space as a location for social interactions. The results showed that intervention in community creation through collaborative design is conducive to promoting friendly relations among different age groups, forming a sense of social security and thus enhancing social well-being. Finally, this paper combines practical cases and theoretical models of collaborative co-creative design approaches to promote the intergenerational integration of communities and is summarized from the input and output parts as well as the influencing factors and constraints of the collaborative co-creative. In addition, it provides new ideas on how to improve intergenerational relationships and form a positive and sustainable community mental health environment in the future.
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  • 文章类型: Journal Article
    The Violence Risk Screening-10 is one of the few instruments available for evaluating violence risk in mental health clients during and after hospitalization. This prospective study examined the applicability of this brief instrument with a sample of 289 clients in the 6 months after discharge from a general psychiatric hospital in Beijing. During the research period, 24 of the 289 clients demonstrated aggression. The receiver-operator characteristic curve yielded an area under the curve of 0.62. At the cut-off point of 4.5, its sensitivity/specificity was 79.2%/33.3%, and the corresponding positive/negative predictive value was 9.9%/94.5%. The predictive accuracy of this instrument was lower compared with the results of the original study, and was also less accurate than when it was administered while the clients were in the hospital. While promising in its utility for use beyond the hospital, it deserves further modification prior to its wide use across culturally-diverse China.
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