30 years of reform and opening up, Chinese is at a critical stage of social transformation, due to the change of lifestyle, pain, indifference, social competition is fierce, Choufu, uneven distribution, insomnia, mental imbalance, violence, murder, Dutch act events such as employment, unemployment, It is often seen.; health care, interpersonal relationship and personality deviation, addiction, etc. one of the social problems in a certain period of time is difficult to solve in our country is still in question; it is generally decreased the psychological defense mechanism and coping with life stress events and lacking of ability, genetic and biological factors, the factors causing China's various types of mental disorders prevalence is rising. Shanghai mental health center director Xie Bin said that the incidence of mental illness is about 17.5%.
WHO recommended diagnostic manual for I4-10, namely the standard diagnosis of mental disorders; at present our country still follow the "classification and diagnostic criteria of mental disorders China" (CCMD-2), will be divided into 10 categories of mental disorders, mental disorders such as brain organic psychosis, caused by psychoactive substance, common mental disorders, affective split disorder (depression, mania), paranoid psychosis, anxiety, insomnia, mental retardation, children with autism, autism, personality disorder, obsessive-compulsive disorder, these are mental illness.
WHO 2001 report describes about suffering from various brain and mental disorders in patients with a total of 450 million people in the world today, every 4 people have 1 people with a mental disorder occurred in a certain period of their life, mental health is a serious social problem and the existence of [1]. Chinese Center for Disease Control and Prevention in 2009 according to data released, China's current severe mental illness is more than 16 million [2] (including 6 kinds of diseases, namely, schizophrenia, affective disorders, schizoaffective psychosis, paranoid psychosis, epilepsy caused by mental disorders, mental retardation associated with mental disorders), about 10% of the adult patients the potential accident tendency, risk assessment in more than 3, has become one of the important factors of family and social unrest. Our country is in the social transition period, all kinds of mental disorders patients high, is the result of many factors.
Facing the present situation of mental diseases, and mental health professionals and bed set up worrying, according to the "third national mental health working conference compilations" (2001) data, found that the national psychiatric beds of about 134227 [3]. Zhu Ziqing survey of psychiatric beds in our country, the overall lack of regional distribution and unbalanced development the average utilization rate of only beds, investigation of the present situation of China psychiatric professionals 75.2%[4]. Yan Ling, physician in 60.18% people without an undergraduate degree, secondary school students accounted for 18.13%, 41.13% people have not started in psychiatry, professional team structure is not reasonable, education and continuing medical education needs to be strengthened.
In 2010 there were 1650 mental health institutions in the country, and the number of psychiatric beds was 228100. Psychiatric beds are mainly distributed in the psychiatric hospital, accounting for 86.4% of the total number of beds; organizers including government departments, enterprises, individuals, institutions and social organizations, government departments in the host, the total number of beds in the 88.4%. density of psychiatric beds in the national average of 1.71 / million, Shanghai and Beijing the highest, the Tibet autonomous region psychiatric beds to 0 national psychiatric hospital bed utilization rate was 92.4%, the average hospitalization days was 45 D.
Shaanxi public hospital (two and three) the establishment of a psychiatric has 2, and for the general hospital and military hospital, the main stay in first episode psychosis patients; health department has 3, the civil affairs department in charge of the public security system has 4, 1, 3 of total private psychiatric hospital. Number of beds in 1300. Shaanxi's population of 36 million 50 thousand people, less than 1 per million people.
Mental disease with high incidence rate, high recurrence rate, high disability rate, and high Dutch act of violence, treatment for a long time, the characteristics of high rate of loss of the social function, clinical in treatment of acute phase also takes a long time to maintain treatment, lead to increased medical costs; a special population (schizophrenia patients in veterans) hospitalized in the civil administration psychiatric hospital long-term, with prolonged hospitalization time, increasing age, somatic comorbidity increased year by year, the final treatment to the main body disease. The present situation is: first, the psychiatrist clinic medical disease beyond the practicing physician treatment scope, in accordance with the "medical practitioners", "mental health law" is obviously illegal; if cured, the doctor may, in case of a problem, all is caused by violations of doctors. Second, in the general hospital, just think of a psychotic patients and normal people living together in a room, the results can be imagined, so the general hospital is generally reluctant to treat patients with mental disorders hospitalized. The guardian, third patients with long-term hospitalization, patients admitted to the hospital, all the medical problems are special care hospital, long visit, when the body, do not fit, do not understand, even to the hospital to make unreasonable demands. These caused great distress to the hospital and medical staff.
With the widespread society to accelerate the pace of life and social competition, more and more people living and working pressure, impetuous, anxiety, restlessness, palpitations and other mental health problems reflected more and more can not be ignored, the construction of the mental health service system highlights the importance of.
Because of China's basic national conditions, mental health infrastructure is weak, professional shortage of mental diseases and low recognition rate, mental health science knowledge is insufficient in patients with persistent disease; government investment limited health resources are relatively scarce, around the medical technology level is uneven, patients and their families for mental illness "stigma" young patients have, employment, marriage, family and other issues, these have greatly influenced the development of mental health, become a bottleneck restricting the development of the mental hospital. How to break the spirit of the high incidence of the disease, fewer hospital beds, psychiatrists the lack of discipline development is slow, hospitalization period is long, doctors face problems and problems of multidisciplinary collaboration, but the problem is not urgent psychiatric hospital urgently needs to solve, is an important part of the reform of the supply and demand side. The author discusses this problem as follows.
1 reform measures
1.1 increase government investment to solve the problem of inadequate medical service resources. The current national psychiatric professional staff is very short, only more than 20 thousand psychiatric specialist, only 16 million of serious mental illness, medical services are not met, no more or less regard for the diagnosis and treatment of psychological, personality, youth, elderly, neurotic disorder. National population of 1 billion 300 million per million people have a bed number of 1.03 [3], compared with developed countries, the gap is larger. Mental health is an important part of the basic public health, which should be put into the government to alleviate the difficulty of mental patients and meet the needs of patients. Recently, the national health and health conference held in Beijing, President Xi Jinping stressed that there is no national health, there is no comprehensive well-off. National Health also includes mental and psychological health, only the national health, accelerate the construction of healthy China, in order to achieve the great rejuvenation of the Chinese dream to lay a solid foundation.
1.2 increase personnel training. The spirit of science and other disciplines as a graduate student to undertake the medical work of clinical complex, Difficult miscellaneous diseases still lack of experience, in clinical several years of temper, can become a qualified psychiatrist. Hospital development, talent is the key, the hospital leadership should intensify in personnel training, training, training, commissioned by the signing of the superior hospital study, in a short time learning, lectures and other forms to increase and improve the level of expertise, and strive to shorten the gap between the domestic and the world advanced level. Because of the reality of mental health professional income and status and the subject is significantly lower than that of medical graduates (i.e. mental health direction) to persons engaged in this profession is very few, but diverted or engaging in other professional. So, how to retain talent, take a good ladder, training talent, is a leader should consider the first issue.
1.3 increase the introduction of academic leaders, improve business level. With the opening of the state of the practice of multiple doctors, the hospital should strive to introduce talent, through the introduction of talent, can promote a large area of local talent to improve the medical level.
1.4 improvement in the hospital environment is essential. With the improvement of people's living standards, the requirements of the hospital environment are also getting higher and higher. In hospital must separate the severity of patients, conditions can be set up single rooms; while patients with active area of relatively large, beautiful environment; should also facilitate medical staff to facilitate supervision, prevent accident happening.
1.5 strengthen the medical staff's sense of responsibility. The medical staff fully understand the thoughts and mental state of patients, to carry out targeted treatment, regular inspection unit, abnormal timely treatment.
1.6 public hospitals give full play to the nature of public welfare, highlighting its social role and contribution. General secretary Xi Jinping in the national health conference pointed out: to adhere to the basic public health services, and constantly improve the system, expand services and enhance the quality, let the people to enjoy a fair and continuous system, prevention, treatment, rehabilitation, health promotion and health service. Therefore, public hospitals should not only strive to improve the quality and level of medical and health services, and community needs more follow-up, home assessment, songyisongyao, under the guidance of medication, rehabilitation measures to make a difference, fully embodies the public basic medical and health services, so that the masses benefit.
1.7 General Secretary Xi Jinping pointed out at the National Conference on health and health:
To exert the enthusiasm of the medical staff, from the aspects of improving salary and development space, practice environment and social status, care for physical and mental health of medical personnel, enhance medical personnel occupation sense of honor through various forms, create a whole society and medical heavy guard the good atmosphere. Our health and health workers to promote and practice the socialist core values, strengthen the construction of medical ethics and self-discipline, to provide the best service for the people's health and health. This is the requirement of all levels of hospitals, but also the new requirements of the psychiatric hospital.
1.8 development of general hospital psychiatry. In our country, once suffering from mental disorder, the patients and their families have a sense of shame would not exist, visits to the psychiatric hospital, so that a large number of psychiatric patients not timely treatment, delay the best treatment time. National Planning Commission has asked the guardian to set up more than two public hospitals psychiatric (psychological), but so far there is still a psychiatric hospital. In the general hospital, there are a wide range of mental health, there is a huge demand for mental health services and the need for liaison consultation. Therefore, the establishment of psychiatric department in the general hospital, these patients can be screened out in a timely manner to specialist treatment, both to reduce the burden of medical treatment of the general hospital, but also to help patients get timely treatment.
1.9 community rehabilitation is an important place for follow-up treatment of mental illness. At present, our country in the psychiatric treatment mode is: the acute condition improved after treatment in the hospital, into the family, but I do not know the treatment of mental illness is a long process, it takes a long time to maintain the patient's condition improved after treatment, can reduce recurrence and restore social function. In developed countries, the patients were treated with rehabilitation and rehabilitation guidance, which has a complete set of medical teams to guide the rehabilitation and psychological treatment. Therefore, how to develop the community mental health service in our country as soon as possible is one of the important tasks of mental rehabilitation. At present, the hospital has been trying to carry out day ward, social rehabilitation and other projects have achieved good results, it is worth promoting.
1.10 strengthen liaison consultation. There are a large number of contact consultation between general hospital and psychiatric hospital, in order to complement each other's professional advantages, provide treatment programs to ensure timely treatment of patients. At the same time, we should strengthen the role of psychology, social workers, family members, and restore the social function of patients.
1.11 support the community to do medicine, to make up for the shortage of public hospitals short board. State support shehuibanyi, where conditions open psychiatric hospital, the formation of orderly competition with public hospitals, is conducive to the patients timely; but also is beneficial to the development of grading clinics and two-way referral work.
2 outlook
Psychiatry is the study of human brain thinking, behavior, emotion and behavior of a subject, the biological indicators of mental disease diagnosis is not characteristic, biological, social and psychological factors can lead to mental disorders, the diagnosis and treatment of difficult over all subjects. The spirit of the cause of the disease in the world are discussed, the conclusion unable to agree on which is right.
In recent years, with the development of new antipsychotic drugs, the positive symptoms of mental illness have been quite satisfactory, but there are still many negative symptoms to improve the effect is not ideal. Mental health work in China is facing a hitherto unknown challenge, on the supply side reforms, mental health has aroused great attention of the society, only attach importance to mental health, in the 2 one hundred year goals, remove the negative factors, to protect the people of mental health, in order to build a harmonious society.
Reference
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