Mental health treatment outcomes in a humanitarian emergency: a pilot model for the integration of mental health into primary care in Habilla, Darfur.
Mental health treatment outcomes in a humanitarian emergency: a pilot model for the integration of mental health into primary care in Habilla, Darfur.
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DOI：
10.1186/1752-4458-3-17
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发表时间：
2009-07-21
影响因子：
3.6
通讯作者：
Cristofani S
中科院分区：
文献类型：
--
作者：
Souza R;Yasuda S;Cristofani S
没有说明在人道主义紧急情况下接受精神疾病治疗的病人的结果。无国界医生已发展一个模式，在人道主义紧急情况下，在精神科医生培训师的监督下，根据社区卫生工作者、临床干事和卫生顾问的能力，将精神健康纳入初级保健。我们的研究旨在描述首次参加精神卫生服务的患者的特征及其治疗后功能的结果。共有114名患者接受了心理健康护理，81名成年患者在基线、治疗开始后1个月和3个月使用简化功能评估工具进行了评估。大多数患者被诊断为癫痫（47%）和精神病（31%），从未接受过治疗。在随访方面，58%在1个月时就诊，48%在3个月时就诊。当比较基线与1个月时的残疾水平时，平均残疾评分从9.1（95%CI 8.1-10.2）降至7.1（95%CI 5.9-8.2），p = 0.0001。在1个月与3个月时，平均评分进一步降低至5.8（95%CI 4.6-7.0）p < 0.0001。研究结果表明，在人道主义紧急情况下，有可能将心理健康纳入初级保健。患有严重精神疾病和癫痫的患者特别需要心理保健。在人道主义紧急情况下将心理健康纳入初级保健的不同战略需要在简单性和可行性方面进行比较。
There is no description of outcomes for patients receiving treatment for mental illnesses in humanitarian emergencies. MSF has developed a model for integration of mental health into primary care in a humanitarian emergency setting based on the capacity of community health workers, clinical officers and health counsellors under the supervision of a psychiatrist trainer. Our study aims to describe the characteristics of patients first attending mental health services and their outcomes on functionality after treatment. A total of 114 patients received mental health care and 81 adult patients were evaluated with a simplified functionality assessment instrument at baseline, one month and 3 months after initiation of treatment. Most patients were diagnosed with epilepsy (47%) and psychosis (31%) and had never received treatment. In terms of follow up, 58% came for consultations at 1 month and 48% at 3 months. When comparing disability levels at baseline versus 1 month, mean disability score decreased from 9.1 (95%CI 8.1–10.2) to 7.1 (95%CI 5.9–8.2) p = 0.0001. At 1 month versus 3 months, mean score further decreased to 5.8 (95%CI 4.6–7.0) p < 0.0001. The findings suggest that there is potential to integrate mental health into primary care in humanitarian emergency contexts. Patients with severe mental illness and epilepsy are in particular need of mental health care. Different strategies for integration of mental health into primary care in humanitarian emergency settings need to be compared in terms of simplicity and feasibility.