A critical review of mental health and mental health‐related policies in China: More actions required

In China, there are over 170 million people suffering from mental illness. However, there is a lack of a critical review of the policies governing the provision of mental health services. Drawing on the framework of mental health policy developed by the WHO, this article critically examines mental health policies regarding legislation, financing, model of care and delivery, as well as manpower and the training of mental health professionals in China. This analysis raises a number of policy‐related questions concerning the lack of community‐based psychiatric services, inadequate coverage of mental health services in the rural areas, poor standard of education and an insufficient number of trained mental health professionals, and insufficient protection of the human rights of people with mental illness. The article ends by urging the various levels of governments to make a firm commitment to improve mental health care for people with mental illness in China.     

社会工作方法在社区工作中的应用-以合肥市标准化示范社区建设为例

从我国社区建设的实践来看,社区社会工作包括社区服务、社区社会救助、社区卫生、社区治安和社区教育等五个方面的主要内容.本文立足于标准化示范社区建设的实践,运用社会工作的理论与方法,对当前社区工作中的工作方法进行了探讨.虽然专业性社会工作服务机构相对缺乏,但是很多社区工作者已经运用了诸多社会工作方法与技巧,为社会工作的本土...     

Why Ugandan rural households are opting to pay community health insurance rather than use the free healthcare services

Twikirize JM, O'Brien C. Why Ugandan rural households are opting to pay community health insurance rather than use the free healthcare services Uganda reintroduced free healthcare in 2001, but today, nine years later, less than 30 per cent of the population are using these services. This study investigated why rural households were under‐utilising the government's free health services and turning to community health insurance instead. A survey carried out on 260 randomly selected households was triangulated with qualitative data gained from 3 focus groups and 12 in‐depth interviews. The findings showed that 21 per cent of the households always accessed the government's free health services, while 79 per cent used private health services. The reasons given were poor quality services, including frequent drug stock‐outs, unmotivated and insufficiently trained health personnel, and overcrowding. Factors influencing enrolment in community health insurance included easier access to healthcare, financial protection against the cost of care, better quality care and benefits related to mutual assistance. This has both practical and policy implications, which are discussed in this article.     

社会工作方法在社区工作中的应用——以合肥市标准化示范社区建设为例

从我国社区建设的实践来看,社区社会工作包括社区服务、社区社会救助、社区卫生、社区治安和社区教育等五个方面的主要内容。本文立足于标准化示范社区建设的实践,运用社会工作的理论与方法,对当前社区工作中的工作方法进行了探讨。虽然专业性社会工作服务机构相对缺乏,但是很多社区工作者已经运用了诸多社会工作方法与技巧,为社会工作的本土化提供了一条可行的实践路径。最后,对社会工作方法在社区工作中推广和应用退出了操作性建议。     

我国农村社区卫生服务的现状与对策

农村社区卫生服务是我国卫生事业改革的重要课题,也是建设社会主义新农村的重要内容。经过近些年的努力,我国农村社区卫生服务取得了较大成绩,但仍然存在硬软件、资金、管理及服务内容不到位等方面的问题,基于当前现状,应着力从服务理念、政府主导功能、多元化资金渠道、信息化建设以及服务评估制度等方面加以完善。     

我国农村社区卫生服务的现状与对策

农村社区卫生服务是我国卫生事业改革的重要课题,也是建设社会主义新农村的重要内容。经过近些年的努力,我国农村社区卫生服务取得了较大成绩,但仍然存在硬软件、资金、管理及服务内容不到位等方面的问题,基于当前现状,应着力从服务理念、政府主导功能、多元化资金渠道、信息化建设以及服务评估制度等方面加以完善。     

Youth and parent perceptions of aftercare supports at discharge from residential care

While much is known about youth struggles after reintegration into the home and community settings following stays in out‐of‐home care, little is known about appropriate supports for aftercare, or parent (see Note ¹ ) and youth perceptions during this critical transition period. This study seeks to begin to address these questions through surveys evaluating youth (n = 48) and parent (n = 48) perceptions of (i) transition planning, family preparedness and aftercare; (ii) youth preparedness for the transition period across major life domains (e.g. education, health care, relationships); and (iii) the importance of specific aftercare supports and services. Results indicate differences between youth and parents on perceptions of need for continued supports, likelihood of participation in aftercare programs; and youth preparedness for success in relationships, family and independent living domains. In contrast, similarities were found on youth and parent ratings regarding the importance of specific services and supports, with both groups indicating supports in education as most important and supports in mental health as least. Study limitations, future research and implications are provided.     

Utilization of Community-Based Social and Health Services Among Foreign Born Hispanic American Elderly

ABSTRACT

This study examined factors associated with the utilization of community-based social and health services among foreign born elderly Hispanic Americans. The data came from a nationwide probability sample of Hispanic Americans age 65 and older including 296 Mexico-born Mexican Americans, 571 Cuba-born Cuban Americans, and 247 respondents from other Hispanic countries. Being a Cuba-born Cuban American, living alone, having poorer self-rated health and living below poverty level were positively related with the utilization of community-based social services. Cuban Americans with more limitations in activities of daily living (ADL) used more community-based health services. Among Mexico-born Mexican Americans, those who lived alone used more social as well as health services while those who were married used more social services. Those with greater limitations in ADL used more health services. Among other foreign born Hispanic Americans, going to church, living alone and living below poverty status, were positively correlated with the utilization of social services. Respondents with better English language ability were less likely to use community based health services. Elderly men and people who rated their health as poorer or had more ADL limitations were more likely to use these services. Implications of these findings for health and social services are discussed.     

城市社区老人心理健康服务现状调查——来自重庆市主城社区的调查数据

以重庆市主城社区老人为调查对象,从老人的基本情况、心理健康状况、心理健康服务需求、心理服务支持系统等方面的调查数据进行详细分析,得出了家庭、邻里同辈群体是老人心理健康的重要支持系统、需要建立完善的城市社区老人心理健康服务体系等结论。     

打工子弟学校社会工作的实践与反思——以北京市打工子弟学校教育援助项目为例

打工子弟虽然大多已有条件接受基础教育,但他们普遍存在社会适应、城市融入、人际交往的能力差以及亲子沟通障碍等问题。为了解决这些问题,帮助打工子弟在大城市健康成长,我们尝试在两所北京市打工子弟学校运用学校社会工作的方法开展了一系列服务,包括个案、小组和社区教育等。通过这些服务,服务对象在个人卫生习惯、人际交往等方面比以前有了显著改善,不少打工子弟尊重和关心他人的意识增强,架设了学校、打工子弟、打工子弟家长三位一体的沟通桥梁。但是,我们的服务也暴露出了一些不足,比如个案工作开展得不够深入、社会动员不够等。导致这些问题的原因包括实习学生经验不足和未能充分利用社会支持系统等方面。以上问题,希望在今后进一步服务过程中能够加以避免和克服。     

城市社区老人心理健康服务现状调查——来自重庆市主城社区的调查数据

以重庆市主城社区老人为调查对象,从老人的基本情况、心理健康状况、心理健康服务需求、心理服务支持系统等方面的调查数据进行详细分析,得出了家庭、邻里同辈群体是老人心理健康的重要支持系统、需要建立完善的城市社区老人心理健康服务体系等结论。     

社区教育扩延：家庭综合服务中心特色项目资源的整合与利用

在社会管理创新背景下催生的家庭综合服务中心的蓬勃发展为广州社区教育带来了前所未有的机遇。家综为社区居民提供多元化的社区公共服务,其中包括社区教育服务。家综在向社区居民提供社区教育服务有着天然的优势。找准整合切入点,完善制度建设,健全社区教育工作网络,引导家综积极融入社区教育发展大局,整合、利用以家综为代表的社区民间组织力量,为社区教育增添新动力。     

广州市越秀区社区健康教育的实践与探索

社区健康教育在促进社区居民健康,改善社区居民生活质量,以及在健康社区的建设中发挥着重要的作用。针对越秀区社区健康教育工作开展中面临的一些困难,广州市越秀区社区教育学院一院通过社区健康教育项目"健康直通车"的实施,将健康教育融入社区教育中,探索出有效促进社区健康教育发展的实践路径,通过对"健康直通车"项目实施成效的分析,提出了进一步推动越秀区社区健康教育发展的建议。     

Local Voices in an Internal Market: The Case of Community Health Services*

This paper presents findings from a study of contract specification and implementation in community health services (CHS). In this paper, we focus on one aspect of that study: the role of local people in informing the assessment of health needs and in determining the provision of community health services in the context of the NHS “internal market”. The paper is based on fieldwork undertaken in three districts within one region. Analysis of data obtained from these localities suggests that while there appears to be a genuine commitment to the principle of local involvement, ideas about how that involvement can be built into the activities of either purchasers or providers are less transparent.     

The Role of Housing Managers in the Implementation of Community Care

This article will outline the response of housing management to the implementation of community care policy in the North East. It will locate housing's role within the broader development of community care policy, and briefly review the reasons for housing's relatively late arrival as a key partner, alongside social services and health, in the planning and delivery of services. Using information gathered from interviews with housing professionals, part-time housing students, voluntary organizations, and workers within health and social services, it outlines and evaluates five main factors which appear to be affecting the successful integration of housing management into the process of planning and delivering community care services in the North East.     

HEALTH NEEDS OF MIGRANT VIETNAMESE WOMEN IN SOUTH‐WEST BRISBANE: AN EXPLORATORY STUDY

This study was conducted in the southwest area of Brisbane, Australia, and is designed to explore and assess the health needs of Vietnamese migrant women. The needs of this group are becoming increasingly urgent due to ageing of the original immigrant refugee community and decreased capacity for support from their children and families. The study used a qualitative research strategy involving focus groups and in‐depth interviews with Vietnamese women between 18–65 years and interviews with Vietnamese health care providers. It shows that the women have had to deal with culture shock, low self‐esteem, lack of friends and relatives, unrecognized professional skills and most importantly in health terms, low socioeconomic status. Significant barriers to access health services and to improved health and well‐being were also identified, such as language difficulties, transportation, time, and knowledge about health education. Recognition of specific requirements of sub‐populations as well as broader socio‐economic and cultural determinants of health should be a guide to more effective planning and implementation of health promotion strategies. The changing needs, over time, of these sub‐populations should also be recognized.     

The role of "Theatre for Development" in mobilising rural communities for primary health care: the case of Liwonde PHC Unit in southern Malawi

The improved health conditions that are essential for development may depend more upon the self-help motivation of local people than upon the provision of Western-style health facilities. Such motivation can be created by the culturally-appropriate dissemination of health education at the community level. This article describes an effective health improvement strategy implemented in three villages in southern Malawi during the late 1980s. After an introduction, the paper presents an overview of current strategies used in Malawi for the dissemination of primary health care information and notes that these strategies have failed to reach the rural population. Next, the paper describes the health status of two of the villages, Mbela and Mwima, before the introduction of the Liwonde Agricultural Development Division Primary Health Care Program. None of the three village involved had access to modern health care facilities. This program involved the joint efforts of the community, a primary health care team, and the Chancellor College Theatre for Development. The paper continues by presenting a conceptual model of the process. Community involvement was assured by the election of the members of village health committees and the delivery of health training to two members of each committee. The Theatre for Development used interactive dramatic techniques and participatory research activities in Mwima and Mbela to help the communities assess their health needs and possible solutions in conjunction with the introduction of primary health care activities. The article also contrasts the Theatre for Development technique with the focus group approach and notes that the latter may not be successful in motivating self-help efforts. Finally, the relative success of the Theatre for Development methodology used in the two villages is described by comparing health indicators with those before the intervention and with those in the third village where this approach was not used in conjunction with introduction of primary health care services.     

青少年社区教育的探索——以“小天使行动”为例

家庭、学校和社区对于青少年的成长都有重要的作用,其中前两者的作用往往被人们所重视,但是社区这个层面的作用并没受到充分重视。针对青少年社区教育服务的缺失,本文以广州市仁爱社会服务中心主办,粤港社工系师生策划和实施的一个社会实践课程为案例,探讨青少年社区教育的方法。     

Community Mental Health Services in a Remote Rural Area

A programme was developed by the authors to provide community mental health services to an isolated rural region situated within the large catchment area of a state psychiatric hospital. The programme functioned without psychiatrist or medical officer in the team. The authors believe their programme to be effective and economical both of monetary cost and of the scarce services of psychiatrically trained professional workers. They hope it will serve as a model for other community mental health workers.     

Interpersonal Behaviour in Relation to Aboriginal Programs

Over recent years there has been increased concern for the health, education and welfare of aboriginal people. Many of the newer programs in these areas are worthwhile. As health, education and welfare services are directed at people, greater understanding of interpersonal behaviour is needed by administrators and fieldworkers if outcomes are to be improved. The importance of interpersonal behaviours such as looking, listening, talking and touching is noted. The distinctiveness of these behaviour patterns in aboriginal society is examined and their impact on programs discussed.