《精神卫生法》对“被精神病”现象规制之评析

为有效防止“被精神病”,《精神卫生法》作了较详尽的规定,但在“送、诊、治”三个环节及再次诊断和鉴定等程序上仍存在一些不足.在对其进行深入分析的基础上,提出进一步完善的建议:严格规范强制送治主体,细化送治程序；重新确立精神障碍诊断权及宣告权的行使主体；完善强制住院治疗制度及强制住院患者的出院制度.     

“被精神病”现象的解构与消弭

“被精神病”现象严重侵害了公民基本人权、危害了社会公共安全.其产生的根源在于权力的泛滥、权利的漠置、程序的单一和监督的缺失.要根治这一现象,必须尽快加强法制建设和程序完善,加强事前鉴定和事后监督,加强异议申诉和司法救济,完善精神卫生统一立法,有效监督行政权力,保障公民正当权利.     

保安处分视角下精神病人强制医疗范式探析

精神病人刑事强制医疗的刑法实体法依据只有总则第十八条,实践中关于精神病人的刑事强制医疗程序并无统一标准而适用各异.保安处分是西方大陆法系国家广泛接受和适用的一种方法,从保安处分理论之本意出发,应该完善我国精神病人刑事强制医疗,重塑保安处分视角中的精神病人强制医疗.     

强制戒毒机构医疗工作存在的问题及对策

强制戒毒是我国戒毒工作的主要形式,是国家有关法规赋予强制戒毒机构的重要职能,针对目前强制戒毒所医疗工作存在的问题,如强制戒毒机构基本医疗条件欠缺、戒毒治疗手段单一、医疗经费不足等,为改善医疗工作薄弱的现状,从提高认识、重视队伍建设、加强缺席化等方面提出了对策。     

强制戒毒机构医疗工作存在的问题及对策

强制戒毒是我国戒毒工作的主要形式,是国家有关法规赋予强制戒毒机构的重要职能,针对目前强制戒毒所医疗工作存在的问题,如强制戒毒机构基本医疗条件欠缺、戒毒治疗手段单一、医疗经费不足等,为改善医疗工作薄弱的现状,从提高认识、重视队伍建设、加强缺席化等方面提出了对策.     

患者视角:医生应该告知医疗差错吗?——全国10城市4000名住院患者问卷调查研究报告之三

通过问卷调查和访谈,了解患者对医疗差错的认知以及对医师告知医疗差错的态度和评价.结果发现,大多数患者对医师告知医疗差错有强烈的要求,但认为其合理要求在现实中没有得到充分满足.大部分患者表示,如果医师主动告知医疗差错有可能会原谅医生,但医师出于对个人利益的过多考虑和专业精神的缺乏往往不能主动揭露差错.建议通过推行不良事件报告制度、规范医疗责任保险、加强风险意识宣传、开展告知技能培训以及专业精神教育,以促进医师正确对待医疗差错,实施诚信医疗,维护医患和谐.     

中美医疗责任保险之比较研究

医疗责任保险是转移损害、分散风险的有效方法之一。为促进我国医疗责任保险的发展 ,对中美医疗责任保险的市场主体、产品供给、运营环境、运作实践和医界的保险意识进行比较分析 ,借鉴美国的先进经验 ,从社会系统工程的角度提出我国医疗责任发展对策     

精神科及内科患者医疗决策能力评估的研究进展

在人们活动的任何领域中,当个体到达成熟年龄时一种特别的契约就自然生效。除非有足够的证据,否则我们将从法律上假定他／她的精神能力能够承担这种变化。医疗服务也遵循这一原则。就临床决策而言,首先对决策能力进行检测是患者权利的合法保障。     

再论《精神卫生法》的自愿原则——基于私法自愿原则的比较

我国《精神卫生法》在"送"、"诊"、"治"、"出"四个环节全面确立了自愿原则。该原则渊源于私法领域,是指精神障碍患者(含疑似)在法定无害的前提下自主决定一方对其提供的精神卫生服务的接受、中止或终止的单方意愿。与私法自愿原则相比,该原则具有单方性、相对性、双方地位不平等性、实施标准国际性、相对方必须接受等特征。精神卫生健康权利兼具"自由"和"权利"的双重属性决定了其自愿原则的特殊性:精神障碍患者单方自愿的决定权和医疗机构必须接受的法定义务的统一。     

中美医疗损害责任制度改革之比较研究

医疗损害责任已成为现代社会普遍的医疗法律问题。中美两国医疗损害责任制度改革正朝着相反的方向发展。诉讼机制在美国医疗损害责任中的作用由强变弱，医疗诉讼起诉由易变难，医疗损害赔偿由不限制到相对限制，行政管理式的医疗过错责任制度由无到逐渐提议。我国医疗损害责任制度改革恰恰相反，即诉讼制度的作用由弱变强、医疗损害起诉由难到易，医疗损害赔偿由相对限制到不限制、行政管理式的医疗过错责任制度从有到无。我国医疗损害责任制度的改革趋势值得反思。建议借鉴美国医疗损害责任制度改革的经验。     

19世纪西方医学对精神疾病诊治的影响

精神疾病是现代困扰人类的主要疾病之一。通过总结19世纪西方医学对精神疾病的认识及主要治疗方法,拟展现这个世纪中治疗方法随观念变化和实践深入而发展的轨迹,旨在说明19世纪是西医精神病学发展史上的重要时期,并揭示其与现代精神疾病治疗的历史传承性。     

心理疾病自我污名:心理康复的一个高危因子

心理疾病自我污名是心理疾病患者内化公众的消极刻板印象、偏见和歧视,形成自我偏见和歧视的现象.心理疾病自我污名会给患者带来一系列的负面影响,是心理康复过程中的一个高危因子.自我污名可能是通过引发患者的消极认知、负面情感和自我歧视行为来危及心理康复过程的.对自我污名的干预应针对患者和社会公众分别加以实施.未来可以从理论构建、测量工具和干预措施的改进,以及去污名与心理康复的融合等方面展开自我污名本土化的研究.     

Sexual Intimacy,Mental Illness,and Homelessness

The current article reviews the literature on sexuality among individuals with a severe mental illness (SMI) who have experienced homelessness, a topic that has received little attention in the research literature, particularly from a community psychology perspective. The review begins with a synthesis of the literature on SMI and sexuality, followed by a review of the available literature on SMI, homelessness, and sexuality. It concludes with an interpretation of the findings using community psychology values and principles. The findings highlight the importance of intimate relationships to recovery for many individuals with an SMI who have experienced homelessness. Policy implications for homeless shelters and housing interventions are discussed.     

Trauma‐Informed Care for Individuals with Serious Mental Illness: An Avenue for Community Psychology's Involvement in Community Mental Health

Individuals with serious mental illness are at particularly high risk for trauma; however, service environments with which they interact may not always be trauma‐informed. While community mental health and other human services settings are moving toward trauma‐informed care (TIC) service delivery, a variety of TIC frameworks exist without consensus regarding operationalization, thereby leading to challenges in implementation. TIC is principle‐driven and presents substantial overlap with community psychology values and competencies, including ecological frameworks, second‐order change, empowerment, and citizen participation. One way to address barriers to TIC implementation is to draw on the strengths of the field of community psychology. With a particular emphasis on the applicability of TIC to individuals with serious mental illness, this paper identifies key implementation issues and recommends future directions for community psychologists in clarifying the service framework, its adaptation to specific service contexts, and improving delivery through consultation and evaluation. Community psychologists may work with various disciplines involved in the TIC field to together promote a more conscious, actionable shift in service delivery.     

Poverty and Serious Mental Illness: Toward Action on a Seemingly Intractable Problem

This paper examines the issue of poverty among people with serious mental illness (SMI), positioning it as a key issue to be confronted by community mental health systems and practitioners. The paper reviews three perspectives on poverty, considering how each sheds light on poverty among people with SMI, and their implications for action: (a) monetary resources, (b) basic needs, and (c) capabilities. The paper argues that community mental health programs and systems are currently unable to address poverty as they are overly focused on individual‐level interventions that, on their own, cannot raise people out of poverty. The paper calls for a social justice value, informed by the concept of citizenship, as a necessary complement to the recovery concept that has informed community mental health practice for almost 25 years. Finally, the paper argues that community psychologists, with their concepts, methods, and values, are well positioned to contribute to this important issue. However, it also contends that addressing poverty requires collaboration from community psychologists with researchers and practitioners from other fields and domains of expertise to begin to make progress.     

Patient Responsiveness to a Sleep and Circadian Intervention in a Sample of Adults With Serious Mental Illness

Understanding patient responsiveness, a component of fidelity, is essential as it impacts treatment outcome and ongoing use of treatment elements. This study evaluated patient responsiveness—operationalized as receptivity to treatment modules and ratings of the usefulness and the utilization of treatment elements—to the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TranS-C) in a sample of adults with serious mental illness (SMI) and sleep/circadian dysfunction. Adults with SMI and sleep/circadian dysfunction (N = 104) received TranS-C in a community mental health setting. Independent raters rated TranS-C sessions to assess receptivity. At posttreatment and 6-month follow-up, participants completed a usefulness scale, utilization scale, the PROMIS Sleep Disturbance (PROMIS-SD) and Sleep-Related Impairment (PROMIS-SRI) scales, DSM-5 Cross-Cutting Measure (DSM-5-CC), and Sheehan Disability Scale (SDS). Receptivity was rated as somewhat to fully understood, and predicted a reduction on the DSM-5-CC. On average, participants rated TranS-C as moderately useful and utilized treatment elements occasionally. Ratings of usefulness were associated with the PROMIS-SD, PROMIS-SRI, and DSM-5-CC at posttreatment, but not with the SDS. Ratings of utilization were not associated with outcome. The findings add to the literature on patient responsiveness, an implementation outcome, and provide data on the utility of TranS-C within a community mental health setting.     

South African Muslim Psychologists' Perceptions of Mental Illness

This study explored perceptions of mental illness in a sample of 10 female Muslim psychologists in a South African city to determine the influences of religion (and Islam specifically) on their understanding of the aetiology and treatment of mental illness. Participants responded to a semi-structured interview. The data from the interviews were thematically analyzed. Four themes emerged from the analysis: mental illness as maladaptive coping, religion as a resource for wellbeing, influences of personal religiosity on therapy and openness to collaborative treatment     

Pilot Effectiveness of a Stress Management Program for Sheltered Homeless Adults With Mental Illness: A Two-Group Controlled Study

This study examined the effectiveness of a stress management intervention for sheltered homeless adults with mental illness. Twelve intervention participants received a 6-week, 1-hour psychoeducation group combined with a 20-minute meditation. Eleven matched pairs did not receive intervention and served as controls. At 1 week post study, intervention participants reported a statistically significant reduction in perceived stress (Z=??2.285, p < .02, d=??1.176) compared to controls. No differences were found at 1 week post study between intervention and control participants on reported quality of life. This study provides pilot data on the effectiveness of an occupation-based stress management program for sheltered homeless adults and warrants further study.     

合并精神疾病患者剖宫产术麻醉优化与医患安全保障

合并精神疾病患者接受剖宫产术时,由于此类患者的特殊性,患者以及其家属、医务人员心理表现都有别于普通情况。合理遵守此类患者的如下麻醉方案优化原则：麻醉操作可以实施原则、麻醉效能有效控制原则、避免诱发或加重精神疾病原则、患者无痛和新生儿安全原则、术后镇痛衔接原则、全程心理干预原则和替代麻醉预案制定原则,同时科学制定患者围术期如下管理规章制度：应急程序的及时启动、患者家属及监护人的沟通与知情同意、麻醉前后特定病房或医疗单位的建立和麻醉医疗期间医患合法权益的保障,只有这样医患双方安危和权益才能得到最佳保障。     

Gender Differences in Reactions to Mental Illness Labeling: The Role of Agency and Communion

Numerous individual characteristics influence responses to receiving a mental health diagnosis, including gender. This study sought to determine how gender influences reactions to being labeled as depressed or not depressed, which were categorized as falling into themes of communion or agency. Using the themes developed by Niedzwienska (2003), 168 college students’ responses to depression labels were coded as a part of a laboratory experiment. The results indicate that the expected sex differences do exist, but multivariate analyses indicate that the choice of communal themes was influenced by sex but the use of agency themes was not influenced by sex.