2020年中国精神卫生资源状况分析

The mental health resources in Chinese mainland by 2020

目的分析我国(不包括香港特别行政区、澳门特别行政区、台湾省)精神卫生资源分布及“十三五”期间变化情况,为制定全国精神卫生防治体系建设与发展规划等相关政策提供依据和参考。方法采用自编调查表对截至2020年底的全国精神卫生医疗机构进行调查,从类型、主办单位、所属行政级别、东中西部、省份、亚专科等方面对精神卫生医疗机构、床位、人员数量等相关数据进行描述性分析。结果截至2020年底,全国共有5936家精神卫生医疗机构,精神科开放床位798191张(5.65张/万人),精神科执业(助理)医师50124人(3.55名/10万人),注册护士139642人(9.89名/10万人)。5936家精神卫生医疗机构中,649家(1.09%)设有老年精神科病房,312家(0.53%)设有儿童精神科病房,1548家(26.08%)设有康复科。全国350个区县(12.31%)无精神卫生医疗机构,883个区县(31.05%)无精神科床位,主要集中在中西部地区。西部地区单位土地面积上精神科开放床位、医师和护士数量较中部相差4倍左右、较东部差7~11倍。结论2015—2020年全国精神卫生医疗机构数、床位数、精神科执业(助理)医师、护士数等大幅增长,但仍存在地域分布不均衡、亚专科发展滞后等问题;未来制定精神卫生防治体系建设与发展规划时,应进一步加强县级和中西部地区精神卫生资源建设;大力支持老年、儿童、康复等精神卫生亚专科发展。

Objectives To analyze the allocation of mental health resources in Chinese mainland and the change of these resources during the 13th Five-year Mental Health Plan period.This analysis will serve as evidence for developing future national mental health prevention and control policies.Methods The National Mental Health Program Office created one questionnaire to survey available mental health facilities by the end of 2020.Descriptive methods were used to analyze the mental health facilities,psychiatric beds,and mental health professionals from type,sponsor,administrative level,regions,and sub-specialities.Results By the end of 2020,5936 facilities were providing mental health services in Chinese mainland.798191 psychiatric beds(5.65 beds/10000 persons),50124 psychiatrists(3.55/100000 persons),and 139642 registered nurses(9.89/100000 persons)were located in these facilities.Of all these 5936 mental health facilities,649(1.09%)had geriatric psychiatric wards,312(0.53%)had child psychiatric wards,and 1548(26.08%)had rehabilitation departments.350 counties(12.31%)had no mental health facilities and 883 counties(31.05%)had no psychiatric beds in Chinese mainland,mainly in the mid-western regions.The numbers of psychiatric beds,psychiatrists,and registered nurses per unit land area in the western region were about 4 times lower than those in the middle region and 7-11 times lower than those in the eastern region.Conclusions The mental health resources in Chinese mainland increased significantly from 2015 to 2020,but there are still the problems of uneven geographical allocation of resources and lagged sub-specialities development.While formulating the construction and development plan for mental health prevention and control system in the future,we should further develop the mental health resources at the county level,and vigorously support to establish of mental health sub-specialities for the elderly and children,as well as mental health rehabilitation,particularly in the mid-western regions.