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The role of psychiatrists into public mental health clinics has been hampered by a perceived restriction of the psychiatrist''s role to prescribing and sign-ing forms, limiting opportunities to engage in the kind of integrated care that attracted many physicians to this specialty. We propose a revision of the current model in a direction that maximizes the expertise of this specialist as well as other clinicians in the health care team. The basic unit would consist of a psychiatrist (with adequate background both in psychopharmacology and psychotherapy), an internist and four clinical psychotherapists, who may provide evidence-based treatment after the initial evaluation of the psychiatrist. Its functioning would emphasize repeated assessments, sequential combi-nation of treatments, and close coordination of team members. Re-invigorating the role of the psychiatrist in the context of a team in which role assign-ments are clear could result in better outcomes and enhanced recruitment of psychiatrists into the public sector. 相似文献
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DINESH BHUGRA SUSHAM GUPTA KAMALDEEP BHUI TOM CRAIG NISHA DOGRA J. DAVID INGLEBY JAMES KIRKBRIDE DRISS MOUSSAOUI JAMES NAZROO ADIL QURESHI THOMAS STOMPE RACHEL TRIBE 《World psychiatry》2011,10(1):2-10
The purpose of this guidance is to review currently available evidence
on mental health problems in migrants and to present advice to clinicians
and policy makers on how to provide migrants with appropriate and accessible
mental health services. The three phases of the process of migration and the
relevant implications for mental health are outlined, as well as the specific
problems of groups such as women, children and adolescents, the elderly, refugees
and asylum seekers, and lesbian, gay, bisexual and transgender individuals.
The concepts of cultural bereavement, cultural identity and cultural congruity
are discussed. The epidemiology of mental disorders in migrants is described.
A series of recommendations to policy makers, service providers and clinicians
aimed to improve mental health care in migrants are provided, covering the
special needs of migrants concerning pharmacotherapies and psychotherapies. 相似文献
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Summerfield D 《BMJ (Clinical research ed.)》2000,321(7255):232-235
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