A New Agenda for Optimizing Investments in Community Mental Health and Reducing Disparities.
A New Agenda for Optimizing Investments in Community Mental Health and Reducing Disparities.
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DOI：
10.1176/appi.ajp.21100970
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发表时间：
2022-06
期刊：
影响因子：
--
通讯作者：
DiMarzio K
中科院分区：
文献类型：
--
作者：
Alegría M;Zhen-Duan J;O'Malley IS;DiMarzio K
考虑到全国各地观察到的心理健康危机不断上升，贝蒂斯-哈里斯政府的22财年预算包括16亿美元的社区心理健康服务块赠款，是21财年拨款的两倍多。这是及时的，因为有两个相互关联的范式转变：一个是注意环境背景的作用，在心理健康的结果为中心;第二个移动上游到早期的心理健康干预措施，在社区一级，而不仅仅是在个人一级。有机会重新设想和重新设计与边缘化社区的心理健康研究和服务提供的议程打开了大门，以更多的社区为基础的护理干预措施。这涉及到建立多部门伙伴关系，以满足可在社区一级而不是临床一级解决的社会和心理需求。这将需要改变培训、交付系统和偿还模式。我们描述了证明这些计划合理性的科学证据，并详细阐述了对社区精神卫生进行投资的机会，这些投资可以减少差距，改善所有人的福祉。我们选择杠杆，有一些证据表明，这种方法的重要性很大，是可以修改的，并推进科学和公共政策实践。最后，我们提出了支持这一转型转变所需的具体建议和后勤步骤。
The Biden-Harris Administration’s FY22 budget includes $1.6 billion to the Community Mental Health Services Block Grants, more than double the FY21 allocation, given the rising mental health crises observed across the nation. This is timely since there have been two inter-related paradigm shifts: one giving attention to the role of environmental context as central in mental health outcomes; and a second moving upstream to earlier mental health interventions at the community level rather than only at the individual level. An opportunity to re-imagine and redesign the agenda of mental health research and service delivery with marginalized communities opens the door to more community-based interventions of care. This involves establishing multi-sector partnerships to address the social and psychological needs that can be addressed at the community-level rather than clinical level. This will require a shift in training, delivery systems and reimbursement models. We describe the scientific evidence justifying these programs and elaborate on opportunities to target investments in community mental health that can reduce disparities and improve well-being for all. We select levers where there is some evidence that such approaches matter substantially, are modifiable, and advance the science and public policy practice. We finalize with specific recommendations and the logistical steps needed to support this transformational shift.
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DOI：
10.1001/jama.2016.4226
发表时间：
2016-04-26
期刊：
JAMA
影响因子：
--
作者：
Chetty R;Stepner M;Abraham S;Lin S;Scuderi B;Turner N;Bergeron A;Cutler D
通讯作者：
Cutler D
影响因子：
7.2
作者：
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通讯作者：
Shrout, Patrick E.
DOI：
10.1007/978-1-4419-7261-3_19
发表时间：
2011-01-01
期刊：
HANDBOOK OF THE SOCIOLOGY OF HEALTH, ILLNESS, AND HEALING: A BLUEPRINT FOR THE 21ST CENTURY
影响因子：
--
作者：
Alegria, Margarita;Pescosolido, Bernice A.;Canino, Glorisa
通讯作者：
Canino, Glorisa
影响因子：
4.5
作者：
Agarwal, Smisha;Sripad, Pooja;Warren, Charlotte E.
通讯作者：
Warren, Charlotte E.
影响因子：
5.5
作者：
Brady TJ;Murphy L;O'Colmain BJ;Beauchesne D;Daniels B;Greenberg M;House M;Chervin D
通讯作者：
Chervin D