■西班牙的医疗系统是分散的,由十七个自治区监督医疗保健。然而,监狱医疗保健在全国范围内管理,除了加泰罗尼亚,巴斯克地区,还有纳瓦拉.这些变化影响了患有严重精神疾病(SMI)的囚犯的精神保健服务。
■为了描述地区之间在为SMI患者提供精神卫生保健方面的差异,可用资源,以及在西班牙监狱环境中工作的医疗保健专业人员的观点。
■采用解释性顺序混合方法,这项研究进行了广泛的文献综述,通过结构化问卷收集定量数据,并通过焦点小组和四次深度访谈收集定性数据。分析涉及计算定量数据的百分比和比率,以及用于定性数据解释的主题分析,以全面了解精神医疗服务。
■2021年12月,西班牙约4%的囚犯患有SMI。西班牙监狱系统中有三种不同的精神保健模式。传统的监狱模式,占被监禁人口的83%,在国家一级的监狱机构总秘书处下独立运作。该模型依赖于每1000名囚犯平均5.2名监狱全科医生(pGP)用于精神病和普通医疗保健。外部精神科医生从事兼职精神病评估。急性精神病住院发生在监狱中心的一般护理模块或参考医院的限制进入单元(RAU)中。两家监狱精神病医院为来自西班牙各地的不可推卸的SMI囚犯提供护理。创新的监狱模式,占监狱人口的17%,将监狱医疗保健纳入区域公共卫生系统。巴斯克地区设有一个精神健康部门,在监狱中心内设有专职护理团队。加泰罗尼亚强调社区护理,在监狱内外提供全职的专门精神服务,确保社区的持续护理。两种模式都优先考虑接受类似于非监狱医疗机构的专门心理健康培训和补偿的人员。
■西班牙监狱精神保健模式的地区差异导致资源不平等,影响SMI囚犯的专业护理和医疗保健专业人员的机会。巴斯克地区和加泰罗尼亚的模型为监狱医疗保健提供了宝贵的经验。
UNASSIGNED: Spain healthcare system is decentralized, with seventeen autonomous regions overseeing healthcare. However, penitentiary healthcare is managed nationally, except in Catalonia, the Basque Country, and Navarra. These variations impact mental health care provision for inmates with serious mental illness (SMI).
UNASSIGNED: To delineate differences between regions in terms of mental health care provision for individuals with SMI, available resources, and the perspectives of healthcare professionals operating in the Spanish prison environment.
UNASSIGNED: Employing an explanatory sequential mixed-method approach, the study conducted an extensive literature review, quantitative data collection through structured questionnaires, and qualitative data collection via focus groups and four in-depth interviews. Analysis involved calculating percentages and ratios for quantitative data and thematic analysis for qualitative data interpretation to comprehensively understand mental healthcare provision.
UNASSIGNED: In December 2021, about 4% of inmates in Spain had SMI. There are three distinct models of mental healthcare within the Spanish prison system. The traditional penitentiary model, representing 83% of the incarcerated population, operates independently under the General Secretariat of Penitentiary Institutions at a national level. This model relies on an average of 5.2 penitentiary General Practitioners (pGP) per 1,000 inmates for psychiatric and general healthcare. External psychiatrists are engaged for part-time psychiatric assessment. Acute psychiatric hospitalization occurs in general nursing modules within penitentiary centers or in Restricted Access Units (RAUs) in reference hospitals. Two penitentiary psychiatric hospitals provide care to unimputable SMI inmates from all over Spain. Innovative penitentiary models, constituting 17% of the prison population, integrate penitentiary healthcare within regional public health systems. The Basque Country features a Mental Health Unit with full-time care teams within the penitentiary center. Catalonia emphasizes community care, providing full-time dedicated psychiatric services within and outside prisons, ensuring continued care in the community. Both models prioritize personnel with specialized mental health training and compensation akin to non-prison healthcare settings.
UNASSIGNED: Regional disparities in penitentiary mental healthcare models in Spain result in resource inequalities, impacting specialized care for inmates with SMI and opportunities for healthcare professionals. The models in the Basque Country and Catalonia offer valuable experiences for penitentiary healthcare.