How mental health care should change as a consequence of the COVID-19 pandemic
How mental health care should change as a consequence of the COVID-19 pandemic
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DOI：
10.1016/s2215-0366(20)30307-2
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发表时间：
2020-09-01
影响因子：
64.3
通讯作者：
Arango, Celso
中科院分区：
文献类型：
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作者：
Moreno, Carmen;Wykes, Til;Arango, Celso
COVID-19大流行的不可预测性和不确定性;相关的封锁，物理距离和其他遏制策略;以及由此导致的经济崩溃可能会增加心理健康问题的风险并加剧健康不平等。初步研究结果表明，对以前健康的人，特别是对预先存在心理健康障碍的人，会产生不利的心理健康影响。尽管全球卫生系统存在异质性，但已努力调整精神卫生保健的提供以适应COVID-19的需求。通过公共心理健康应对措施和调整心理健康服务来解决心理健康问题，主要侧重于感染控制，改变获得诊断和治疗的机会，确保对心理健康服务使用者的护理的连续性，并关注新的心理疾病病例和心理健康问题高危人群。专家、临床医生和服务使用者应制定可持续的精神卫生保健提供系统调整方案，并应专门设计以减少卫生保健提供方面的差异。对精神卫生临床实践中的健康和服务使用结果进行全面和持续的评估，对于确定哪些实践应该进一步发展，哪些应该停止至关重要。在这份立场文件中，一个由临床医生、心理健康专家和心理健康服务使用者组成的国际小组聚集在一起，反思COVID-19对心理健康带来的挑战。世界的相互联系使社会容易受到这种感染，但它也提供了基础设施，通过传播良好做法来解决以前的系统故障，这些做法可以导致持续，有效和公平地提供精神卫生保健服务。因此，COVID-19大流行可能是改善心理健康服务的机会。
The unpredictability and uncertainty of the COVID-19 pandemic; the associated lockdowns, physical distancing, and other containment strategies; and the resulting economic breakdown could increase the risk of mental health problems and exacerbate health inequalities. Preliminary findings suggest adverse mental health effects in previously healthy people and especially in people with pre-existing mental health disorders. Despite the heterogeneity of worldwide health systems, efforts have been made to adapt the delivery of mental health care to the demands of COVID-19. Mental health concerns have been addressed via the public mental health response and by adapting mental health services, mostly focusing on infection control, modifying access to diagnosis and treatment, ensuring continuity of care for mental health service users, and paying attention to new cases of mental ill health and populations at high risk of mental health problems. Sustainable adaptations of delivery systems for mental health care should be developed by experts, clinicians, and service users, and should be specifically designed to mitigate disparities in health-care provision. Thorough and continuous assessment of health and service-use outcomes in mental health clinical practice will be crucial for defining which practices should be further developed and which discontinued. For this Position Paper, an international group of clinicians, mental health experts, and users of mental health services has come together to reflect on the challenges for mental health that COVID-19 poses. The interconnectedness of the world made society vulnerable to this infection, but it also provides the infrastructure to address previous system failings by disseminating good practices that can result in sustained, efficient, and equitable delivery of mental health-care delivery. Thus, the COVID-19 pandemic could be an opportunity to improve mental health services.