精神专科医院从业现状及心理治疗的开展情况调查分析

Investigation and analysis of the working status and development situation of psychotherapy in psychiatric hospitals

目的·了解目前精神专科医院心理治疗的开展及相关人员从业的现况,为推动和促进国内精神卫生机构综合服务团队建设和心理治疗的行业发展提供建议。方法·在全国范围内选取96家精神专科医院,采用自编的调查问卷进行调查,实际共回收来自25个省级行政区的52家医院的反馈信息。结果·(1)根据ICD-10精神障碍分类标准,来精神专科医院就诊患者类型主要以精神分裂症、分裂型障碍和妄想性障碍为主,其次是情感障碍。(2)有50家(96.2%)医院开设有心理科门诊,有37家(71.2%)开设有心理科病房。(3)来精神专科医院心理科的患者类型主要是情感障碍、神经症、应激相关的及躯体形式障碍。(4)心理治疗师的构成为医师6人,临床心理师2人,护师1人。(5)被精神专科医院使用最多的前5名心理治疗技术是认知治疗、支持性心理治疗、行为治疗、团体治疗、家庭治疗。(6)44.2%的从业者认为单纯做心理治疗其收入水平太低。结论·在精神卫生机构的人员配备中,心理学专业人员跟以往研究相比虽然有所增加,但是所占比例仍然较小,与门诊和病房患者的需求量不能匹配。心理从业人员单靠心理治疗的收入较低,与期望的差距过大。政府和卫生行政相关部门及医院应给予心理服务事业更多的支持,促进机构和人员的发展。

Objective·To understand the current situation of psychotherapy applied and relevant personnel＇s working in psychiatric hospitals, and provide advice to facilitate and promote the integrated service team building of domestic mental health institutions and the industry development of psychological treatment. Methods·Ninety-six psychiatric hospitals in China were selected and self-compiled questionnaire was used during the investigation. The actual feedback was collected from 52 hospitals in 25 provinces. Results·① According to the classification criteria of ICD-10 mental disorder, patients mainly suffered from schizophrenia, schizotypal disorder and delusional disorder, followed by affective disorder, in the psychiatric hospitals. ② There were 50 （96.2%） hospitals with psychological outpatient clinics, and 37 （71.2%） hospitals were equipped with mental wards. ③ The main types of patients who came to the psychology department in the psychiatric hospitals were emotional disorders, neurosis, stress-related and physical form disorders. ④ The composition of psychotherapists was 6 physicians, 2 clinical psychologists, and 1 nurse. ⑤ The top five psychotherapy techniques used by the psychiatric hospitals were cognitive therapy, supportive psychotherapy, behavioral therapy, group therapy, and family therapy. ⑥ 44.2% of the practitioners working in this filed thought that the income had been too low if they only engaged in psychological treatment. Conclusion·In the staffing of mental health agency, compared to previous studies, the number of the psychology specialists increases, but it still makes up a small percentage, which does not match the needs of outpatient and ward patients. Psychological practitioners who rely on psychological treatment alone are in a lower income, and the gap between the expected income and actual income is too large. Government, health administration departments and hospitals should provide more support to psychological services and promote the development of institutions and personnel.