Организация амбулаторной психиатрической службы в Новой Зеландии: прошлое, настоящее и будущее

Существующая система здравоохранения Новой Зеландии (маори. Аотеароа) переживает период значительных изменений. Реформация сферы охраны психического здоровья требует прогнозирования, оценки перспектив и накопленного опыта. Принципы оказания помощи в области психиатрии и наркологии и услуги в этой сфере претерпели ряд реформ: первая была связана с переходом от стационарной системы психиатрической помощи к амбулаторной, вторая — с последовательными попытками улучшения амбулаторной помощи. В данной статье мы представили обзор современной системы здравоохранения в области психиатрии и наркологии. Также в формате дискуссии мы обсудили влияние колониального исторического прошлого на психическое здоровье населения, появление психиатрической и наркологической амбулаторной службы в Новой Зеландии, а также проблемы на пути становления этих служб. Мы выделили пять ключевых областей, которые требуют пристального внимания в ходе текущего реформирования системы амбулаторной помощи. Была выявлена тенденция к уменьшению значимости индивидуализированных подходов к психическому благополучию, все системы и структуры должны учитывать социальный контекст, потребности людей, которым оказывается помощь, роль семьи пациента и его сообщества, культурную составляющую. Мы надеемся, что в будущем принципы оказания помощи и службы охраны психического здоровья Новой Зеландии будут в значительной степени ориентированы на разнообразие потребностей местного населения.

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