• Title/Summary/Keyword: 정신보건서비스

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미국 정신보건제도의 개혁 방안에 대한 고찰 - 정신보건위원회의 활동을 중심으로 -

  • Hwang, Seong-Dong
    • 한국사회복지학회:학술대회논문집
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    • 2003.10a
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    • pp.395-405
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    • 2003
  • 최근 정신질환의 심각성과 정신보건의 증진에 대한 세계적 관심이 고조되면서 세계보건기구(WHO)와 미국 보건복지부(DHHS)에서는 잇달아 정신보건에 대한 연구 결과들을 발표하였다(United States Public Health Service Office of He Surgeon Central, 1999 & 2001, World Health Organization, 2001). 이러한 가운데 지난해 미국 정부는 대통령 직속의 정신보건위원회를 설립하여 현재 정신보건서비스제도가 드러내고 있는 다양한 문제점들을 파악, 분석하여 개선 방안들을 제안해 줄 것을 요청하였다. 미국 사회의 정신질환 및 정신보건과 관련된 서비스시스템을 개선하기 위한 이러한 획기적인 노력은 1997년 Carter대통령 쥐임 직후 구성된 정신보건위원회(President's Commission on Mental Health) 이후 약 25년 만에 이루어진 일로서 정신보건 분야뿐만 아니라 미국 사회 전반에 걸쳐 비상을 관심을 끌고 있다. 그리고 이러한 노력과 결과는 최근 들어 심각하게 노출되는 정신질환 및 사회병리 현상으로 어려움을 겪고있는 한국 사회에도 많은 시사점을 줄 수 있으리라 기대된다. 따라서 본 연구는 정신보건위원회의 활동을 중심으로 미국 사회의 정신보건에 대한 다양한 문제를 인식하고 이를 해결하기 위한 정신보건서비스제도 개선 방안을 고찰하는 것을 목적으로 한다. 연구의 주요 내용으로는 위원회의 설립 배경과 활동 경과, 정신보건제도의 다양한 문제점과 개혁 방안으로 구성되었다. 그리고 이러한 고찰은 우리나라 정신보건제도에 대한 인식과 발전 방향에 대한 새로운 조망을 도출해낼 수 있으리라 기대한다. 연구의 주요 방법으로는 각종 연구보고서와 기존 문헌을 이용한 문헌 연구를 활용하였으며, 기존 출간 자료나 통계에 밝혀지지 않은 사항은 정신보건위원회의 위원과의 직접 인터뷰를 통해 보완되었다.

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Type of Service Setting and Drinking Behavior in Persons with Major Mental Illnesses (정신보건서비스 환경에 따른 이용자들의 음주 행태)

  • Lee, Sun-Hae
    • Korean Journal of Social Welfare
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    • v.50
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    • pp.265-288
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    • 2002
  • The use of alcohol is recognized as having negative consequences on clinical and psychosocial outcomes in service users with major mental illnesses. This necessitates an introduction of intervention measures in domestic mental health service in Korea. Since research basis on which such measures are developed lacks, this paper aims at exploring drinking patterns of Korean service users and suggesting directions and strategies for intervention. The data came from 151 service users recruited at 14 service settings in Seoul Metropolitan area. The quantitative part of the data includes their recent drinking experiences in terms of patterns and severity; the qualitative part includes information on the drinking context. The data were compared among three types of service settings, each of which differs in physical availability of alcohol by their users. Each group revealed distinctive features in drinking patterns, the author thus suggested directions and strategies of intervention specific to type of service setting.

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Moderating Effects of Public Health Service Utilization Rate between Public Health Resources and Community Mental Health (지역사회 공공보건자원과 지역사회 정신건강의 관계에서 공공보건서비스 이용률의 조절효과)

  • Kim, Jae-Hee
    • Journal of the Korean Applied Science and Technology
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    • v.37 no.2
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    • pp.268-278
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    • 2020
  • This study aimed to identify the moderating effect of public health service utilization rate between public health resources and community mental health. The subjects included 144 local communities, from the data of 6th Community Health Plan and the 2015 Community Health Survey. Public health resources were measured by public health budget, public mental health budget and public mental health personnel; and mental health was measured by rate of perceived stress, rate of depressive mood and suicide rate. The hierarchical regression analysis was used to identify the moderating effects. The results were as followed. First, the effect of public mental health budget on rate of depressive mood was moderated by public health service utilization rate. Second, the effect of public mental health personnel on rate of depressive mood was moderated by public health service utilization rate. Third, the effect of public mental health personnel on suicide rate was also moderated by public health service utilization rate. Fourth, the effect of public health resources on mental health differed between the groups with high and low public health service utilization rate. In improving community mental health, the measures to improve the public health service utilization rate should be considered to ensure that reinforcing public health resources leads to the improvement of community mental health.

Present Conditions of Mental Health Care in Rural Areas: Community Mental Health Program of Public Health Center (농촌지역 정신보건관리실태: 보건소 지역사회정신보건사업)

  • Lee, Weon-Young;Kim, Dong-Moon
    • Journal of agricultural medicine and community health
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    • v.28 no.2
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    • pp.1-14
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    • 2003
  • Objectives: This paper introduces need and supply level of rural mental health care service and especially focuses on the evaluation for the community mental health programs of Public Health Centers(PHCs) in rural areas as the facilities for primary mental health care. Methods: We defined the need as prevalance rate and service utilization rate, for which reviewed the results of the epidemiological study of mental disorders using Korean Composite International Diagnostic Interview surveyed on a nationwide scale in 2001. Supply was appraised in terms of psychiatric beds and primary mental heath care facilities such as private psychiatric clinics, facilities for social rehabilitation, PHCs running community mental health programs. For this, we reveiwed a variety of annual reports related mental health published by Ministry of Health and Welfare. To evaluate the community mental health programs of PHCs in rural areas, we selected. randomly samples out of the 3rd community health plans including the contents of community mental health programs, which submitted by 89 rural counties and 44 cities mixed with rural areas, and used the program's guideline established by central government as a standard. Results: Prevalence rates of major psychiatric diseases such as schizophrenia, alcoholism, major depression, anxiety disorder were higher in rural area than in urban area and 8.9% of psychiatric patients in both areas stayed at homes contacted with mental health manpower more than one time during the last year. Psychiatric beds were sufficiently supplied, but urban area had less beds than rural area contrary to general health care service. Psychiatric clinics were supplied very insufficiently in rural areas and PHCs bridged the gap instead. However rural PHCs got less financial support for community mental health programs from higher positioned agencies than urban PHCs. Rural community health programs not supported hardly worked out. Conclusions: Central government should consider a special policy for rural primary mental health care, because private psychiatric clinics can't be introduced in rural areas due to demand-deficiency and the financial independence of rural counties was very vulnerable.

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The Trend of Inpatients in California State Hospitals and Its Implications for Mental Health Policies in Korea (캘리포니아주 주립병원 입원환자들의 변화 추세 및 한국 정신보건제도의 발전을 위한 정책적 함의)

  • Hwang, Sung-Dong
    • Korean Journal of Social Welfare
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    • v.39
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    • pp.350-373
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    • 1999
  • The patient population of U. S. state mental hospitals has changed drastically since the 1960s, when the deintstitutionalization movement began. This paper is designed to look at what happened to the number of inpatients of state hospitals in California during the last 150 years and, from this, to explore implications for the future of the mental health system in Korea, especially for the viability of mental hospitals. The data had been collected by field research(visits to state hospitals and State Department of Mental Health, and interviews with mental health administrators) and accessing statistical publications and various reports. Since the first state hospital opened in 1851 the statewide inpatient population of individuals who were mentally disabled has grown and peaked at 37,489 in 1959. The number of patients in state hospitals, however, began declining in the early 1960s and was reduced to 10,874 by 1971, and to 4,973 by 1986. As of 1997, there were only 4, 263 inpatients remaining in the state hospital system. This dramatic decrease slowed down somewhat in 1980s and 1990s, but this trend seems irreversible except for the inpatients referred by the court. Now the beds in state hospitals are filled with more and more forensic patients, which constitutes nearly 70% of the total inpatient population. Based on these findings, it is well expected that the number of inpatients of mental hospitals in Korea will also be reduced in a significant way as the community-based mental health care system is gradually replacing the traditional one. Mental hospitals need to introduce more diversified programs for the care of the mentally ill, and concurrently more vigorous aftercare programs are required in the community.

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Discourses on Mental Health Act Revision and Critical Analysis on Mental Health Promotion and Welfare Service Support Act (정신보건법 개정 담론에 근거한 정신건강증진 및 정신질환자 복지서비스 지원에 관한 법률 주요 쟁점 분석)

  • Kim, Moon Geun
    • Korean Journal of Social Welfare Studies
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    • v.47 no.3
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    • pp.85-111
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    • 2016
  • This study aims to analyse major changes of Mental Health Promotion and Welfare Service Support Act(MHPWSSA) and critically discuss these changes based on the major discourses on Mental Health Act revision. For this purposes this study reviewed literatures and government reports to understand human rights discourses, welfare discourses, and prevention discourses. Secondly, the major changes of MHPWSSA were analysed and discussed based on those discourses. This study found that MHPWSSA defined the concept of people with mental disorders narrowly, tightened the involuntary admission procedures, introduced welfare service support provisions and mental health promotion provisions. But this study shows that the new legislation may well be criticised due to neglect of the concept of disability and people with psychiatric disability, involuntary admission without mental capacity assessment, neglect of the basic values and principles of self determination and independent living common in welfare of the persons with disability. And the new legislation may be criticised due to overuse of the concept of mental health promotion as encompassing promotion, prevention, treatment and rehabilitation.

A Study of Influencing Factors on Linking Services among Mental Health Social Workers (정신보건사회복지사들의 서비스 연계실태 및 연계관련 요인)

  • Park, Mi-Eun
    • Korean Journal of Social Welfare
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    • v.51
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    • pp.63-91
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    • 2002
  • This article investigates 170 mental health social workers in order to find out the current status and influencing factors on linking services. The social workers of this study work at different kinds of mental health organizations(mental hospitals, mental health centers, mental rehabilitation facilities, mental residential facilities). The result from the research were 1) the degree of linking services is low, and the primary type of coordination is sharing of information and client referrals. The fund-raising and joint project cases are very poor. 2) based on personal and organizational characteristics, there arc significant differences between respondents' sex, education level, job-related status, experience in mental health field, mental health licence(personal factors), location, type of organization, and type of primary client(organizational factors). 3) the factors affecting service coordination among mental health social workers are experience in mental health field, current job-related experience(personal factors), education, location of organization, type of organization, and history of organization(organizational factors). Finally, the research recommends that establishment of cooperation system, service delivery system, and information network is needed in order to enhancing the function of service coordination among mental health social workers. Also, mental health professional associations and agencies should provide opportunity of discussion and training for mental health social workers, and develop the institutional devices to expand the content and type of service coordination.

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Factors Effected on Program Needs of the Elderly People with Mental Illness -Focused on the Nursing Home in Busan- (노인정신장애인의 프로그램 욕구에 미치는 영향 요인 -부산지역 정신요양원을 중심으로-)

  • Kim, Sun-Joo
    • The Journal of the Korea Contents Association
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    • v.8 no.10
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    • pp.198-207
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    • 2008
  • The purpose of this study supplies the basic data to plan the optimum mental health service that is reflected needs of the elderly people with mental illness by checking how their demographic-sociological distinctive feature and function level have an effect on their needs of mental health service by being absent situation of a study of the elderly people with mental illness. As results of analysis, the residental type, the disease period, and the decision person of admission-discharge control of demographic-sociological distinctive feature is much effect on needs of programs and also effect commonly on the needs of the health promotion program and the discharge support program. Generally, the function level of the elderly people with mental illness is favorable and the order of function level is the group activity program, the counseling program, and the resource network program.

Factors Influencing Use of Mental Health Helping Systems among College Students in Korea (한국대학생의 정신건강 원조체계 활용에 영향을 미치는 요인)

  • Lee, Sun-Hae;Chung, Sul-Ki
    • Korean Journal of Health Education and Promotion
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    • v.25 no.5
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    • pp.21-38
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    • 2008
  • Objective: This study examined the use of mental health helping systems among college students in Korea. A behavioral model of health service utilization was applied to examine factors influencing different types of helping systems. Methods: A total of 454 college students from four universities participated in the survey. A self-administered questionnaire measuring help-seeking behaviors including formal health and mental health services, informal helping system, peer group, and family support was used. Results: Respondents frequently turn to family members and peer group when in need, and age, sex, mental Health status, and attitude and knowledge on mental illness were significant factors affecting help-seeking behaviors of Korean students. While older students and those with more severe symptoms were more likely to seek help from formal resources, students with more severe symptoms were less likely to seek help from informal resources. Male students and those with negative attitude toward mental illness were less likely to ask peer groups for help. Conclusions: Study results indicate that informal resources and peer groups can be significant sources of social support for individuals in their late adolescence and young adulthood, however, their role as gateways to professional help is limited. Student counseling centers should take on a more active role in reaching out; implications for developing peer leaders as counselors and self-help groups are discussed.

Permanency Plan for Adults with Mental Illness : Focused on Mental Health System of New Zealand (성인정신장애인의 평생계획모형 : 뉴질랜드 정신보건서비스를 중심으로)

  • Seo, Mi-Kyung
    • Korean Journal of Social Welfare
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    • v.58 no.2
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    • pp.33-56
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    • 2006
  • Primary care takers, especially older parents, who live with and care for an adult child with mental illness struggle with the dilemma of who will provide for their child's social and emotional needs and physical care requirements when they can no longer care so. Therefore, 'Permanency plan(financial, residential, legal plan)' is very important for social integration and normalization of mental illness adults. This study aims to introduce the mental health systems in New Zealand and to investigate the permanency plan strategies(benefit, supplements, and the laws) of the government and community support services of NGOs through the interviews with team leaders of representative NGO, Te Korowai Aroha. Permanency plan strategies of New Zealand Government and NGOs are as follows. 1) Financial plans for adults with mental illness include main benefit(invalid benefit), various allowances(family allowance and disability allowance), and wage subsidies for employment. 2) The Government provide accommodation supplement and re-establishment grant for residential plan. And NGOs have supported accommodation program to provide support and accommodation that are important for social integration. 3) Adult mental illness is provided the support of welfare guardian and property manager under the Protection of Personal and Property Rights Act. According the results, this study concluded that social services for the mental illness which secure supported accommodation and benefits is strongly needed. At the same time, mental health delivery system is needed to make distinction between social services and clinical services.

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