中国精神卫生的现状、挑战与应对：从服务体系运行风险看治理与专业能力建设

Mental health in China: current status, challenges, and responses—governance

中文关键词:  精神卫生  服务体系  医保支付  社区康复  去机构化

英文关键词:Mental health  Service system  Medical insurance payment  Community rehabilitation  Deinstitutionalization

中文摘要:

      【】本文系统梳理了我国精神卫生服务的核心内涵、现阶段面临的核心挑战以及未来发展路径。精神卫生既是保障个体正常履职、维系良好社会功能的重要基础,更是衡量一个国家精神文明建设水平的重要标志。当前,我国精神卫生服务体系发展承压前行,既存在个别骗保事件引发的行业信任危机、长期积累的结构性深层矛盾,也面临全球精神卫生领域共性难题与我国本土化特色问题交织的多重挑战。应对策略包括服务体系从以医院为中心转向以服务体系为中心、医保支付从费用控制转向价值导向、治理模式从服务扩张转向质量优先、强化专业能力与多学科整合等。整体而言,我国精神卫生服务正从扩张期迈向成熟期,未来发展关键在于系统性的体系升级与结构性优化。

英文摘要:

      【】This paper systematically reviews the core connotations of mental health services in China, the major challenges currently faced, and the pathways for future development. Mental health is not only a fundamental prerequisite for individuals to perform their duties effectively and maintain good social functioning, but also an important indicator of a country’s progress in spiritual civilization. At present, the development of China’s mental health service system is proceeding under considerable pressure, confronting not only a crisis of public trust triggered by isolated cases of insurance fraud and deep?seated structural problems accumulated over time, but also a complex interplay of global common challenges in mental health and issues specific to the Chinese context. Proposed coping strategies include shifting the service system from a hospital?centric model to a service?system?centered approach, reforming health insurance payment from cost containment to value?based purchasing, transitioning governance from service expansion to quality prioritization, and strengthening professional competence and multidisciplinary integration. Overall, China’s mental health services are transitioning from a phase of rapid expansion to one of maturation, with the key to future development lying in systematic upgrading and structural optimization of the entire system.