| BackgroundWith the rapid development of social economy and fierce social competition in China,mental health problems have seriously affected human health,which has attracted great and wide attention from relevant departments of the country.The importance of mental health services has become increasingly prominent,and mental health services have also received more and more attention.With the popularization of mental health knowledge and the improvement of people’s living standards,the demand for mental health services is increasing.As an indispensable part of health resources,the fair allocation of mental health resources not only affects the fair allocation of health resources,but also affects the development of mental health services.ObjectiveTo understand the distribution of mental health resources in Shandong Province and the fairness of its allocation;to provide data support and basis for the government and related departments to formulate mental health work plans,improve mental health service systems and safeguard measures,and rationally allocate mental health resources in Shandong Province.MethodsAccording to the survey plan formulated by the National Mental Health Project Office,the National Mental Health Resource Questionnaire was adopted for the investigation.Shandong provincial and local municipal Health and Family Planning Commissions issued questionnaires,and health institutions in the relevant municipalities and their districts filled in the information and submitted them to the Shandong Mental Health Project Office.Each project office was responsible for the collection,filing and review of the survey data,and the Shandong Mental Health Project Office verified the missing items and obvious errors.The data was double-entered and collated by Epidate 3.1,and descriptively analyzed by SPSS 16.0 software.According to population distribution,geographic area allocation and per capita GDP configuration,the Lorenz curve was separately drawn to calculate the Gini coefficient(Gini)and Index of dissimilarity(ID),in order to carry out an equity evaluation of mental health human resources and bed resource allocation.Results1.By the end of 2015,there were 178 different kinds of mental health institutions in Shandong province covering 125 counties or districts with a coverage rate of 91.24%.Among these mental health institutions,there were 73 psychiatric hospitals,89 psychiatric or psychological departments in general hospitals,7 independent psychiatric or psychological clinics,7 psychiatric or psychological departments in hospitals of traditional Chinese medicine,and 2 mental rehabilitation facilities.Weifang city had the largest number of mental health institutions,while Liaocheng city had the smallest,with only 1 mental health institution.The distribution of different kinds of mental health institutions was uneven,which were mainly distributed in middle and eastern area of Shandong province.2.Among all the 178 mental health institutions,there were 142(84.02%)institutions equipped with psychiatric or psychological beds.The authorized size of psychiatric or psychological beds in Shandong province was 18230 and the actual data was 22055.The utilization rate of these beds was 95.86%.In 2015,the average length of stay in psychiatric or psychological department was 71 days each person.There were 2.24 psychiatric beds per 10000 persons.In terms of psychiatric beds,the Gini coefficient for population distribution was less than 0.3,which was in a fair level for the resource distribution;the Gini coefficient for geographic area allocation was between 0.3 and 0.4,which was in a relatively fair level;and the Gini coefficient for per capita GDP configuration was between 0.5 and 0.6,which was in an unfair state.ID indicated the same results as Gini coefficient.3.The number of mental health practitioners in Shandong province was 8262,including 1991(24.10%)medical practitioners,221(2.67%)assistant medical practitioners and 5201(62.95%)registered nurses.In Shandong province,there were 2.25 mental health(assistant)medical practitioners and 5.28 registered nurses per 100000 persons.In terms of mental health(assistant)medical practitioners and registered nurses,the Gini coefficient for population distribution was less than 0.3,which was in a fair level for the resource distribution;the Gini coefficient for geographic area allocation was between 0.3 and 0.4,which was in a relatively fair level;and the Gini coefficient for per capita GDP configuration was between 0.5 and 0.6,which was in an unfair state.ID indicated the same results as Gini coefficient.4.There were 57(32.02%)’mental health institutions setting up rehabilitation department or occupation recreational therapy room,with 759 practitioners.There were 0.77 rehabilitation practitioners per 100000 persons.In terms of service objects,there were 38 rehabilitation departments(,,occupation recreational therapy rooms only serving for inpatients,accounting for 66.67%;and the other 19 institutions serving for inpatients and homebound patients.There’s no institutions only serving for homebound patients.5.There were 96(53.93%)mental health institutions setting up prevention and treatment department,with 397 practitioners and average 4.14 practitioners in each institution,among which there were 218(54.91%)full-time staff.Weifang city had the largest number(13)of institutions setting up prevention and treatment department;and there was no prevention and treatment department in Dongying city.Shandong province had spent 8711500 yuan on mental health prevention and treatment in 2015,with Jinan city spending the most(1561100 yuan)and Dongying,Jining,Laiwu,Linyi,Dezhou and Liaocheng spending none.ConclusionThere are insufficient mental health resources in Shandong province,with maldistribution of institutions and low allocation of psychiatric beds.The mental health human resources are relatively deficient,with irrational structure,especially in deficiency of mental health prevention and treatment practitioners as well as rehabilitation practitioners,in which most prevention and treatment practitioners are part-time staff.Shandong province should pay much more attention to the reasonable distribution of mental health resources,and increase the investments on mental health,to standardize the cultivation and allocation of mental health practitioners. |
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