Centre for International Mental Health, Melbourne School of Population Health, University of Melbourne, Melbourne, VIC, Australia.
Lancet. 2011 Nov 5;378(9803):1654-63. doi: 10.1016/S0140-6736(11)61093-3. Epub 2011 Oct 16.
A challenge faced by many countries is to provide adequate human resources for delivery of essential mental health interventions. The overwhelming worldwide shortage of human resources for mental health, particularly in low-income and middle-income countries, is well established. Here, we review the current state of human resources for mental health, needs, and strategies for action. At present, human resources for mental health in countries of low and middle income show a serious shortfall that is likely to grow unless effective steps are taken. Evidence suggests that mental health care can be delivered effectively in primary health-care settings, through community-based programmes and task-shifting approaches. Non-specialist health professionals, lay workers, affected individuals, and caregivers with brief training and appropriate supervision by mental health specialists are able to detect, diagnose, treat, and monitor individuals with mental disorders and reduce caregiver burden. We also discuss scale-up costs, human resources management, and leadership for mental health, particularly within the context of low-income and middle-income countries.
许多国家都面临着一个挑战,那就是提供足够的人力资源来提供基本的精神卫生干预措施。全世界精神卫生人力资源严重短缺,尤其是在低收入和中等收入国家,这一点已得到充分证实。在这里,我们回顾了精神卫生人力资源的现状、需求以及行动策略。目前,中低收入国家的精神卫生人力资源严重短缺,如果不采取有效措施,这种短缺情况可能会进一步加剧。有证据表明,通过初级卫生保健机构、社区方案和任务转移方法,可以有效地提供精神卫生保健。非专业卫生专业人员、基层工作人员、受影响的个人以及经过简短培训并由精神卫生专家提供适当监督的照顾者,能够发现、诊断、治疗和监测患有精神障碍的个人,并减轻照顾者的负担。我们还讨论了扩大规模的成本、精神卫生人力资源管理和领导力,特别是在低收入和中等收入国家的背景下。