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      Number and characteristics of medical professionals working in Chinese mental health facilities Translated title: 中国精神卫生机构中的专业人员数量和特征

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          Abstract

          Background

          Mental disorders account for a substantial proportion of the total disease burden in China but the number, distribution and characteristics of the mental health professionals available to provide services for mentally ill individuals is unknown.

          Aim

          Describe the distribution and characteristics of medical professionals working in mental health facilities around China.

          Methods

          Information on the numbers and characteristics of health professionals working in mental health facilities in China in 2010 was obtained from the Statistical Information Center of the Ministry of Health and the population-adjusted ratios and characteristics of these mental health professionals were compared across the seven geographic regions of the country.

          Results

          Among the 757 specialized mental health facilities identified, 649 (86%) were psychiatric hospitals. A total of 68,796 medical professionals (5.16/100,000 population) were working in these facilities, including 20,480 psychiatrists (1.54/100,000) and 35,337 registered nurses (2.65/100,000). Over 98% of these medical professionals worked in psychiatric hospitals. Among the psychiatrists, 29% only had a technical school degree and 14% had no academic degree at all; among the nurses, 46% had no academic qualifications. The duration of employment as a psychiatrist or as a psychiatric nurse was longer among medical professionals working in the economically less dynamic northern parts of the country. The population ratios of licensed physicians and registered nurses working in mental health facilities were significantly higher than average in the relatively wealthy eastern and northeastern parts of the country.

          Conclusions

          Almost all mental health professionals in China work in specialty psychiatric hospitals. The numbers and geographic distribution of trained mental health professionals in China are grossly inadequate to meet the mental health needs of the population. China has a much smaller mental health workforce per 100,000 residents than other upper-middle-income countries, and the range of professionals who provide mental health services is much narrower.

          Translated abstract

          背景

          精神障碍在我国疾病总负担中占有相当大的比例,但可提供于精神障碍患者心理卫生服务的专业人员数量,分布和特点还是未知数。

          目的

          全面了解我国精神卫生机构人力资源分布现状和特点。

          方法

          从卫生部统计信息中心获得2010年在中国精神卫生机构中工作的卫生技术人员的数量和特征,比较七个地理区域精神卫生专业人员的人口比例和特征。

          结果

          在757家精神卫生机构内,649家(86%)是精神病院。在这些机构内卫生技术人员共计68,796人(5.16人/10万人口),包括精神科医师20,480人(1.54人/10万人口)和注册护士35,337人(2.65人/10万人口)。超过80%的卫生技术人员都工作在精神病院。29%的精神科医生人仅具有技校学历,而14%的精神科医生没有学位。在护士中有46%的护士没有学历。我国经济比较落后的北部地区精神科医生或护士的工龄较其长。在我国相对较富裕的东部和东北部地区,精神卫生机构中执业医师和注册护士的人口比例要高于平均水平。

          结论

          我国几乎所有的精神卫生技术人员都工作在精神科专科医院。训练有素的卫生技术人员在数量和地区的分布上远远无法满足人们对卫生健康的需求。与其他中上等收入国家相比,我国每10万人口拥有的精神卫生资源较少,所能提供精神卫生服务的专业人员范围也较窄。

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          Most cited references16

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          Biostatistical Analysis

          Designed for one/two-semester, junior/graduate-level courses in Biostatistics, Biometry, Quantitative Biology, or Statistics, the latest edition of this best-selling biostatistics text is both comprehensive and easy to read. It provides a broad and practical overview of the statistical analysis methods used by researchers to collect, summarize, analyze, and draw conclusions from biological research data. The Fourth Edition can serve as either an introduction to the discipline for beginning students or a comprehensive procedural reference for today's practitioners.
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            Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys.

            Mental disorders are major causes of disability worldwide, including in the low-income and middle-income countries least able to bear such burdens. We describe mental health care in 17 countries participating in the WHO world mental health (WMH) survey initiative and examine unmet needs for treatment. Face-to-face household surveys were undertaken with 84,850 community adult respondents in low-income or middle-income (Colombia, Lebanon, Mexico, Nigeria, China, South Africa, Ukraine) and high-income countries (Belgium, France, Germany, Israel, Italy, Japan, Netherlands, New Zealand, Spain, USA). Prevalence and severity of mental disorders over 12 months, and mental health service use, were assessed with the WMH composite international diagnostic interview. Logistic regression analysis was used to study sociodemographic predictors of receiving any 12-month services. The number of respondents using any 12-month mental health services (57 [2%; Nigeria] to 1477 [18%; USA]) was generally lower in developing than in developed countries, and the proportion receiving services tended to correspond to countries' percentages of gross domestic product spent on health care. Although seriousness of disorder was related to service use, only five (11%; China) to 46 (61%; Belgium) of patients with severe disorders received any care in the previous year. General medical sectors were the largest sources of mental health services. For respondents initiating treatments, 152 (70%; Germany) to 129 (95%; Italy) received any follow-up care, and one (10%; Nigeria) to 113 (42%; France) received treatments meeting minimum standards for adequacy. Patients who were male, married, less-educated, and at the extremes of age or income were treated less. Unmet needs for mental health treatment are pervasive and especially concerning in less-developed countries. Alleviation of these unmet needs will require expansion and optimum allocation of treatment resources.
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              Mental health systems in countries: where are we now?

              More than 85% of the world's population lives in 153 low-income and middle-income countries (LAMICs). Although country-level information on mental health systems has recently become available, it still has substantial gaps and inconsistencies. Most of these countries allocate very scarce financial resources and have grossly inadequate manpower and infrastructure for mental health. Many LAMICs also lack mental health policy and legislation to direct their mental health programmes and services, which is of particular concern in Africa and South East Asia. Different components of mental health systems seem to vary greatly, even in the same-income categories, with some countries having developed their mental health system despite their low-income levels. These examples need careful scrutiny to derive useful lessons. Furthermore, mental health resources in countries seem to be related as much to measures of general health as to economic and developmental indicators, arguing for improved prioritisation for mental health even in low-resource settings. Increased emphasis on mental health, improved resources, and enhanced monitoring of the situation in countries is called for to advance global mental health.
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                Author and article information

                Journal
                Shanghai Arch Psychiatry
                Shanghai Arch Psychiatry
                SAP
                Shanghai Archives of Psychiatry
                Editorial Department of the Shanghai Archives of Psychiatry (Shanghai, China )
                1002-0829
                October 2013
                : 25
                : 5
                : 277-285
                Affiliations
                [1]Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
                [2]The President’s Office, Shanghai Jiao Tong University School of Medicine, Shanghai, China
                [3]Office of Mental Health, Chinese Center for Disease Control and Prevention, Beijing, China
                Author notes
                Article
                sap-25-05-277
                10.3969/j.issn.1002-0829.2013.05.003
                4054572
                24991167
                6286ff53-aeba-4b29-81fc-2e11f4c78bce
                Copyright © 2013 by Editorial Department of the Shanghai Archives of Psychiatry

                This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/4.0/

                History
                : 29 January 2013
                : 26 April 2013
                Funding
                Funded by: Ministry of Health Center for Disease Control and Prevention
                Award ID: CDC-MH 2011-3
                This study was funded by the Ministry of Health Center for Disease Control and Prevention (CDC-MH 2011-3)
                Categories
                Original Article
                Psychiatry

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