Mental Health Services and Global Trade

描述(由申请人提供)：这项研究将追求三个具体目标：1)完善概念框架和方法，以澄清精神健康服务和全球贸易之间的关系；2)评估主要群体关于全球化和精神健康服务的决定和行动：美国政府机构、跨国银行和贸易组织、国际和国家健康组织、跨国公司和倡导团体；以及3)提出将全球化和精神健康服务联系起来的政策建议。该申请解决了NIMH小额赠款计划的优先事项，因为它提出了一项探索性研究，对于经验丰富的NIMH资助的研究人员来说，这代表着研究方向的重大变化。经济全球化引发了有关精神卫生服务的根本问题。世界银行和其他国际贷款机构促进了以前在公共部门提供的健康和公共健康服务，包括精神健康服务的减少和私有化；这一激烈辩论的方向影响了世界卫生组织、泛美卫生组织和美国国立卫生研究院的政策。跨国公司(管理保健组织、咨询公司、制药和医疗设备公司以及工业公司)的扩张伴随着美国和其他国家精神卫生服务日益私有化。拟议的工作源于以前关于医疗和心理健康服务出口和医疗补助管理的医疗保健实施情况的研究，包括分析关于全球化和精神健康服务的研究和档案文献；与政府机构、跨国银行和贸易组织、国际和国家健康和精神健康组织、跨国公司和倡导团体的代表进行访谈；以及评估这些组织在公共领域的报告。该项目将产生几个产品：两篇期刊文章；报纸和杂志的专栏和类似文章；一本书；以及心理健康服务、政策研究、公共卫生、社会科学和管理的课程模块。

DESCRIPTION (provided by applicant): This study will pursue three specific aims: 1) to refine a conceptual framework and methodological approach for clarifying the relationships between mental health services and global trade; 2) to assess the decisions and actions of major groups concerning globalization and mental health services: U.S. government agencies, multinational banking and trade organizations, international and national health organizations, multinational corporations, and advocacy groups; and 3) to present policy recommendations that link globalization and mental health services. The application addresses the priorities of the NIMH Small Grants Program since it proposes an exploratory study that represents a significant change in research direction for an experienced, NIMH-supported investigator. Economic globalization raises fundamental issues concerning mental health services. The World Bank and other international lending agencies have fostered reduction and privatization of health and public health services, including mental health services, previously provided in the public sector; this intensely debated orientation has affected policies of the World Health Organization, the Pan American Health Organization, and the U.S. National Institutes of Health. Expansion of multinational corporations (managed care organizations, consulting firms, pharmaceutical and medical equipment firms, and industrial corporations) has accompanied the increasing privatization of mental health services in the United States and other countries. Growing from previous research on the exportation of managed care and the implementation of Medicaid managed care for medical and mental health services, the proposed work includes an analysis of the research and archival literature on globalization and mental health services; interviews with representatives of government agencies, multinational banking and trade organizations, international and national health and mental health organizations, multinational corporations, and advocacy groups; and assessment of these organizations' reports available in the public sphere. This project will lead to several products: two journal articles; op-ed and similar articles for newspapers and magazines; a book; and a curriculum module for mental health services, policy studies, public health, social sciences, and management.