Social integration in global mental health: what is it and how can it be measured?
Social integration in global mental health: what is it and how can it be measured?
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DOI：
10.1017/s2045796012000303
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发表时间：
2013-03-01
影响因子：
8.1
通讯作者：
Susser, E.
中科院分区：
文献类型：
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作者：
Baumgartner, J. N.;Susser, E.
目的.全球精神卫生运动日益强调社会融合是精神卫生服务的一个关键成果。这就迫切需要更好地阐明和衡量这一成果。迄今为止，社会融合方面的工作大部分是在高收入国家开展的，并不能直接适用于各种社会文化环境。我们讨论有前途的概念和措施的社会融合与全球跨文化应用的潜力。然后，我们提出了一些挑战，制定全球和跨文化使用的措施，并提出了应对这些挑战的方法。虽然我们主要关注中低收入国家（LMIC）中患有严重精神障碍的成年人，但我们提出的问题也与儿童、其他精神障碍和精神疾病有关。我们确定并描述了四个不同的概念框架，在过去十年中出现的社会融合。然后，我们讨论了制定相应措施的挑战，以及制定全球跨文化措施的进一步挑战。我们认为，在许多以前和新兴的工作共享的一个关键概念是积极参与社区和公民生活。作为一个平台，为未来发展的全球跨文化措施的这一点和其他概念，我们提出了指导方针，并提出了可行的，以前使用的策略的例子。新出现的社会融合概念大有希望，但迄今为止，还没有适合全球跨文化使用的相应措施。我们认为，制定这些措施是可行的，它们的发展将促进社区精神卫生服务和全球精神卫生科学的发展。
Purpose. Global mental health movements increasingly highlight social integration as a key outcome for mental health services. This creates a pressing need to better articulate and measure this outcome. Much of the work in social integration thus far has been in high-income countries (HIC), and is not directly applicable across diverse socio-cultural environments. We discuss promising concepts and measures of social integration with potential for global cross-cultural application. Then, we present some of the challenges of developing measures for global and cross-cultural use, and suggest ways to confront these challenges. Although we focus primarily on adults with severe mental disorders in low- and middle-income countries (LMIC), the questions we raise are also relevant to children, other mental disorders and HIC.Findings. We identify and describe four distinct conceptual frameworks for social integration that have emerged over the past decade. Then, we discuss the challenge of developing corresponding measures, and the further challenge of developing global cross-cultural measures. We suggest that a key concept shared across much previous and emerging work is active participation in community and civic life. As a platform for future development of global cross-cultural measures of this and other concepts, we propose guidelines and present examples of feasible, previously used strategies.Summary. Emerging concepts of social integration hold great promise, but as yet, there are no corresponding measures suitable for global cross-cultural use. We propose that it is feasible to develop such measures, and that their development will facilitate the advance of community mental health services and the science of global mental health.