Setting priorities for mental health care in Nepal: a formative study.
Setting priorities for mental health care in Nepal: a formative study.
复制标题
DOI：
10.1186/1471-244x-13-332
复制
发表时间：
2013-12-05
期刊：
影响因子：
4.4
通讯作者：
Komproe IH
中科院分区：
文献类型：
--
作者：
Jordans MJ;Luitel NP;Tomlinson M;Komproe IH
迫切需要解决心理健康问题的巨大治疗差距，特别是在低收入环境中。将一揽子护理纳入常规初级卫生保健被认为是扩大精神卫生保健的战略，但需要更多地了解最可行和最有效的方法。该研究采用了综合方法设计，包括让一个专家小组参与确定优先事项的工作，举办讲习班以制定变革理论，并与主要利益攸关方进行深入的定性访谈和焦点小组讨论。每一步研究的结果都被用来为下一步研究提供信息。与会者强烈赞同建立一个兼顾保健设施和社区两方面的护理制度。与增加获得和需求、保证精神药物的可持续供应、充足的人力资源和确保家庭积极参与有关的问题被列为优先关注领域。这项研究强调了发展心理健康服务的许多已知障碍。与此同时，它为尼泊尔克服这些挑战提供了独特的途径和具体建议。
There is an urgent need to address the massive treatment gap for mental health problems, especially in low income settings. Packages of care integrated in routine primary health care are posited as a strategy to scale-up mental health care, yet more needs to be known about the most feasible and effective way to go about this. The study follows a combined methods design that includes engaging an expert panel in a priority setting exercise, running workshops to develop a Theory of Change and conducting in-depth qualitative interviews and focus group discussions with key stakeholders. The results of each research step were taken forward to inform the subsequent one. There was strong endorsement for a system of care that encompasses both the perspectives of health facility and the community. Issues related to increasing access and demand, guaranteeing a sustainable supply of psychotropic medicine, adequate human resourcing, and ensuring positive family involvement came up as priority areas of attention. The study underlines many of the known barriers in developing mental health services. At the same time it provides a distinct pathway and concrete recommendations for overcoming these challenges in Nepal.