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Unlocking Patients with Mental Disorders Who Were in Restraints at Home: A National Follow-Up Study of China′s New Public Mental Health Initiatives
Guan, Lili1; Liu, Jin1; Wu, Xia Min1; Chen, Dafang2; Wang, Xun1; Ma, Ning1; Wang, Yan2; Good, Byron3; Ma, Hong1; Yu, Xin1; Good, Mary-Jo3
刊名PLOS ONE
2015-04-07
DOI10.1371/journal.pone.0121425
10期:4
收录类别SCI ; SSCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Multidisciplinary Sciences
研究领域[WOS]Science & Technology - Other Topics
关键词[WOS]MIDDLE-INCOME COUNTRIES ; HUMAN-RIGHTS ; SCALE-UP ; SERVICES ; CARE ; ILL
英文摘要

Background

In 2005, China implemented a demonstration program known as "686" to scale-up nationwide basic mental health services designed to improve access to evidence-based care and to promote human rights for people with severe mental disorders. As part of the 686 Program, teams "unlocked" and provided continuous mental health care to people with severe mental disorders who were found in restraints and largely untreated in their family homes. We implemented a nation-wide two-stage follow-up study to measure the effectiveness and sustainability of the "unlocking and treatment" intervention and its impact on the well-being of patients′ families.

Methods

266 patients unlocked from 2005 in "686" demonstration sites across China were recruited in Stage One of the study in 2009. In 2012, 230 of the 266 cases were re-interviewed (the Stage Two study). Outcome measures included the patient medication adherence and social functioning, family burden ratings, and relocking rate. We utilized pre-post tests to analyze the changes over time following the unlocking efforts.

Results

96% of patients were diagnosed with schizophrenia. Prior to unlocking, their total time locked ranged from two weeks to 28 years, with 32% having been locked multiple times. The number of persons regularly taking medicines increased from one person at the time of unlocking to 74% in 2009 and 76% in 2012. Pre-post tests showed sustained improvement in patient social functioning and significant reductions in family burden. Over 92% of patients remained free of restraints in 2012.

Conclusion

Practice-based evidence from our study suggests an important model for protecting the human rights of people with mental disorders and keeping them free of restraints can be achieved by providing accessible, community based mental health services with continuity of care. China′s "686" Program can inform similar efforts in low-resource settings where community locking of patients is practiced.

语种英语
WOS记录号WOS:000352477800058
项目编号WP/2008/CHN/01 ; D43TW009081
资助机构World Health Organization Representative Office in China ; Fogarty International Center of the National Institutes of Health in the United States
引用统计
被引频次:6[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/57519
专题北京大学精神卫生研究所
北京大学基础医学院
北京大学第二临床医学院_放射科
北京大学第三临床医学院_口腔科
北京大学精神卫生研究所_精神科
作者单位1.Peking Univ, Hosp 2, Inst Mental Hlth, Key Lab Mental Hlth,Minist Hlth, Beijing 100871, Peoples R China
2.Peking Univ, Sch Publ Hlth, Beijing 100871, Peoples R China
3.Harvard Univ, Sch Med, Dept Global Hlth & Social Med, Boston, MA USA
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GB/T 7714
Guan, Lili,Liu, Jin,Wu, Xia Min,et al. Unlocking Patients with Mental Disorders Who Were in Restraints at Home: A National Follow-Up Study of China′s New Public Mental Health Initiatives[J]. PLOS ONE,2015,10(4).
APA Guan, Lili.,Liu, Jin.,Wu, Xia Min.,Chen, Dafang.,Wang, Xun.,...&Good, Mary-Jo.(2015).Unlocking Patients with Mental Disorders Who Were in Restraints at Home: A National Follow-Up Study of China′s New Public Mental Health Initiatives.PLOS ONE,10(4).
MLA Guan, Lili,et al."Unlocking Patients with Mental Disorders Who Were in Restraints at Home: A National Follow-Up Study of China′s New Public Mental Health Initiatives".PLOS ONE 10.4(2015).
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