a London School of Hygiene & Tropical Medicine , London , UK.
b University of Zimbabwe College of Health Sciences , Harare , Zimbabwe.
Int Rev Psychiatry. 2018 Dec;30(6):170-181. doi: 10.1080/09540261.2018.1564648. Epub 2019 Mar 1.
The last decade has witnessed an exponential growth of evidence-based care packages for mental, neurological, and substance use disorders (MNS) aimed at primary care populations; however, few have been taken to scale. Several barriers to successful integration and scale-up, such as low acceptability, poor clinical engagement process, lack of targeted resources, and poor stakeholder and policy support have been cited. This review describes and highlights common features of some of the promising programmes that deliver mental health services through primary health clinics, communities, and digital platforms, with an emphasis on those that show some evidence of complete or partial scale-up. Three distinct overarching themes and initiatives are discussed in relation to the above; primary health facilities, community (outside of primary healthcare), and digital/internet-based platforms, with a focus on how the three may interact synergistically to enhance successful integration and scale-up.
过去十年,针对基层医疗人群的精神、神经和物质使用障碍(MNS)的循证护理方案呈指数级增长;然而,这些方案很少能大规模推广。有人指出,成功整合和扩大规模存在一些障碍,如可接受性低、临床参与过程差、缺乏针对性资源以及利益相关者和政策支持不足。本综述描述并强调了一些有前途的计划的共同特征,这些计划通过基层医疗诊所、社区和数字平台提供精神卫生服务,重点介绍了那些显示出完全或部分扩大规模的证据的计划。本文围绕上述三个主题展开讨论;基层医疗设施、社区(基层医疗保健之外)和数字/互联网平台,并重点探讨了这三个主题如何协同作用以加强成功的整合和扩大规模。