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Ten years integrated care for mental disorders in the Netherlands

机译:荷兰十年精神疾病综合护理

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Background and problem statement: Integrated care for mental disorders aims to encompass forms of collaboration between different health care settings for the treatment of mental disorders. To this end, it requires integration at several levels, i.e. integration of psychiatry in medicine, of the psychiatric discourse in the medical discourse; of localization of mental health care and general health care facilities; and of reimbursement systems. Description of policy practice: Steps have been taken in the last decade to meet these requirements, enabling psychiatry to move on towards integrated treatment of mental disorder as such, by development of a collaborative care model that includes structural psychiatric consultation that was found to be applicable and effective in several Dutch health care settings. This collaborative care model is a feasible and effective model for integrated care in several health care settings. The Bio Psycho Social System has been developed as a feasible instrument for assessment in integrated care as well. Discussion: The discipline of Psychiatry has moved from anti-psychiatry in the last century, towards an emancipated medical discipline. This enabled big advances towards integrated care for mental disorder, in collaboration with other medical disciplines, in the last decade. Conclusion: Now is the time to further expand this concept of care towards other mental disorders, and towards integrated care for medical and mental co-morbidity. Integrated care for mental disorder should be readily available to the patient, according to his/her preference, taking somatic co-morbidity into account, and with a focus on rehabilitation of the patient in his or her social roles.
机译:背景和问题陈述:精神障碍综合护理旨在涵盖不同医疗机构之间用于精神障碍治疗的协作形式。为此,它需要在多个层面上进行整合,即将精神病学整合到医学中,将精神病学话语整合到医学话语中;精神保健和一般保健设施的本地化;和报销系统。政策实践说明:在过去的十年中,已经采取了一些措施来满足这些要求,从而通过开发包括结构性精神病咨询在内的合作医疗模式,使精神病学朝着综合治疗精神障碍的方向发展。在荷兰的几个医疗机构中均有效。这种协作式护理模型是在几种医疗护理环境中进行综合护理的可行且有效的模型。生物心理社会系统也已被开发为综合护理评估的可行工具。讨论:精神病学的学科已从上个世纪的反精神病学转向了解放的医学学科。在过去的十年中,这与其他医学学科合作,在精神疾病综合治疗方面取得了重大进展。结论:现在是时候将这种护理概念进一步扩展到其他精神疾病,以及医学和精神合并症的综合护理。应根据患者的喜好,考虑到躯体合并症,并应着重于患者在其社会角色中的康复,对患者进行精神障碍综合护理。

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