上海市严重精神障碍应急管理现状研究

Study on the current status of emergency management for severe mental disorders in Shanghai

  • 摘要:
    目的 调查上海市严重精神障碍应急管理现状,为建立健全严重精神障碍应急管理体系,提升应急管理能力提供对策和建议。
    方法 采用问卷调查及定性访谈对上海市17家区级精神疾病预防控制机构开展应急管理方面的调查研究,了解上海市严重精神障碍应急管理基本情况、应急队伍建设和人员情况、应急演练与培训情况、应急管理预案与规章制度情况、应急管理存在的问题等。
    结果 在应急管理机制及基本情况方面,上海市各区级精神疾病预防控制机构在人员队伍、保障经费、绿色通道等方面配备基本较为齐全,但在部分硬件设施配备方面较为欠缺,仍需进一步完善严重精神障碍应急管理工作机制。在应急队伍建设和人员情况方面,以35~<45岁、本科学历、从业10年以上者居多,且区级人员在本科及以上学历(90.27%)、临床专业(52.71%)、中级职称(57.24%)、从业10年以上者(69.90%)相比社区人员(分别为73.60%、28.86%、42.28%、43.62%)占比更大。在应急演练与培训情况方面,上海市各区级精神疾病预防控制机构在开展应急培训工作方面具有较大需求,且薄弱项目主要集中在应急服务规范、难点技巧和效果评价,教学形式选择主要集中在案例分析、模拟演练、互动讨论等方面。在应急管理预案与规章制度情况方面,上海市各区在严重精神障碍应急预案、应急处置领导小组、应急处置工作小组建设方面较为完善,约半数机构已建立除应急预案以外的严重精神障碍应急管理相关的其他规章制度。
    结论 上海市已初步建立严重精神障碍应急管理体系,但在严重精神障碍应急管理专题培训、应急管理机制、基层应急队伍建设等方面仍存在不足。建议进一步强化应急管理培训工作,加强应急管理人才队伍建设,逐渐建立更加完备的严重精神障碍应急管理机制。

     

    Abstract:
    Objective To investigate the current status of emergency management for severe mental disorders in Shanghai, and to provide countermeasures and suggestions for the establishment of a sound emergency management system for severe mental disorders and the enhancement of emergency management capability.
    Methods A questionnaire survey and qualitative interviews were used to conduct an investigation into the emergency management in 17 district-level mental illness prevention and control institutions in Shanghai, which includes the basic situation of emergency management for severe mental disorders, the construction of emergency response teams and personnel, emergency preparedness drills and training, emergency management plans and rules and regulations, and problems encountered in emergency management.
    Results In terms of emergency management mechanism and basic situation, resources such as personnel allocation, security funds and green channel were well equipped in each district-level mental illness prevention and control institution in Shanghai. However, the equipment of some hardware facilities was still insufficient to some extent. Therefore, further improvement on the emergency management mechanism for severe mental disorders was needed. With regard to the construction of emergency team and personnel allocation, the majority were those aged between 35‒<45 years old, with a bachelor’s degree, and more than 10 years of working experience. For example, 90.27% staff in district-level mental illness prevention and control institution had a bachelor’s degree or above, which was higher than that among the staff in community-level (73.60%); staff majored in clinical medicine in district-level institution accounted for the proportion at 52.71%, higher than that among the staff in community-level (28.86%); 57.24% staff in district-level institution had an intermediate professional title, higher than that among the staff in community-level (42.28%); and 69.90% staff in district-level institution had more than 10 years of working experience, higher than that among the staff in community-level (43.62%). In the aspect of emergency drills and training, all district-level mental illness prevention and control institutions in Shanghai had a high demand for emergency training, and the weak aspects mainly focused on lack of emergency service protocols, skills of addressing technical challenges, and construction of effectiveness evaluation system. Moreover, the teaching methods were primarily centered on case analysis, simulation drills, interactive discussions, and so forth. Concerning emergency management plans and rules and regulations, all districts in Shanghai had relatively established well-developed systems for emergency response plans, emergency response leadership groups, and emergency response operational task forces for severe mental disorders. About half of the institutions had established other rules and regulations related to emergency management of severe mental disorders in addition to emergency plans.
    Conclusion Shanghai has initially established an emergency management system for severe mental disorders, but it is still fragile in specialized training for emergency management of severe mental disorders, construction of emergency management mechanisms, and the building-up of grassroots emergency teams. Further priorities should include strengthening emergency management training, enhancing the construction of emergency management personnel teams, and gradually establishing a more comprehensive and integrated emergency management mechanism for severe mental disorders.

     

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