Status And Management Of Patients With Severe Mental Disorders In Tianjin In 2016

Objective: Analyzing the distribution characteristics and general conditions of patients with severe mental disorders in Tianjin.Analyzing the effectiveness of the management and treatment program of severe mental disorder in this city in 2016.To make feasible suggestions for further improving the management and treatment of severe mental disorder in this city.Method: The community spermicists used a list of clues to investigate the suspected cases of resident population in their jurisdiction.Filling in the clues investigation registration form for the suspected patients found by the clues,they were clearly diagnosed by psychiatrists.The personal information of the patients who were clearly diagnosed was collected by the community spermicists and recorded in the national serious mental disorder information system.Mental health professional organizations at all levels regularly summarized the information of severe mental disorders diagnosed in this institution.Collect the patient’s personal information and input the information system andtransfer it to the primary medical institution where the patient was located.To follow up the patients who agreed to participate in the community management,and fill in the follow-up service record form and input the information system.The data of the project from the beginning to the end of 2016 were sorted out,and statistically analyzed by the SAS9.2.Analyzing the general conditions and distribution characteristics of severe mental disorders in this city by descriptive statistical methods.The differences between the gender,age,occupation,marital status,cultural level,economic status,and disease and other aspects of severe mental disorders were analyzed by chi-square test.Descriptive statistical methods were used to analyze the enrollment rate,management rate,standardized management rate,drug rate and regular drug rate of the management and treatment program of severe mental disorder in this city in 2016.Results:(1)By the end of 2016,there were 53,877 registered patients with severe mental disorder in the city,of whom 28009 were male,accounting for 51.99%,there were 25,868 women,accounting for 48.01%,the sex ratio is 1.08:1,and there were differences between the sexes in the urban and rural areas.(2)Severe mental disorders were mainly young adults,with the highest proportion of 45 ~ 59 age group,accounting for 38.47%,the second was the age group of 18~44,accounting for 33.10%,the proportion of under-18 s was the least,accounting for 2.02%.<44age,patients in rural areas were higher than those in urban areas.≥45age,urban patients were higher than those in rural areas.There were differences between urban and rural areas in different age groups.(3)The cultural level of severe mental disorders in this city was generally low,with 73.6% of the patients in junior high school and below,and 19.79% of those who are illiterate or semi-literate.In urban and rural areas,the rural areas were significantly higher than those in the cities of the patients of primary and below cultural level,and the cities with higher education levels were significantly higher than those in the rural areas.(4)The positive rate of family history was 5.4% in severe mental disorders,and there was a significant difference in family history between urban and rural areas.(5)The unmarried rate of severe mental disorders was 35.49%.The marital status of patients was significantly different between urban and rural areas,among them,unmarried patients and divorce patients in urban areas were more than those in rural areas,and married patients in rural were more than those in urban.(6)The maximum number of farmers with severe mental disorders was 17,487,accounting for 32.46%.Secondly,the number of laid-off or unemployed persons was 15,833,accounting for 29.39%.Only 3,686 people were on duty,accounting for 6.84%.Patients with farmers mainly in rural,laid-off or unemployed patients mainly concentrated in the city.(7)The number of poor severe mental disorders in the city was 14,440,accounting for 26.8%.The proportion of rural poor patients was higher than that of cities.The poverty rateof schizophrenia patients was 26.04%,the poverty rate of mentally retarded patients with mental retardation was 32.29%,and the poverty rate of patients with bipolar disorder was 18.59%.(8)The maximum number of schizophrenia patients was 31,035,accounting for 57.6%.Secondly,the number of patients with mental retardation with mental retardation was 13,445,accounting for 24.95%.The cities of schizophrenia patients were significantly higher than those in the rural areas,and the rural areas with mental retardation and mental retardation were significantly higher than those in the cities.(9)In 2016,the registered rate of severe mental disorders in this city was 3.55‰,The he ping district(4.47‰),the he xi district(4.29‰),and the ji zhou district(6.16‰)reached more than 4‰.The management rate of patients in the whole city was 83.06%,the standardized management rate was 75.34%,the drug rate was 72.92%,and the regular drug rate was 62.15%.From 2014 to 2016,the registered rate,management rate,standardized management treatment rate and standardized treatment rate of patients with severe mental disorders increased,the untreated periods and course of patients decreased year by year.Conclusion:(1)Since the establishment of the management and treatment program of severe mental disorder in this city,it has achieved good results in patient discovery,follow-up management and other aspects.(2)The group of severe mental disorders is large,and there are a large number of patients who are not screened in the community,so mental health work should be widely recognized and focused by the government,functional departments and the public.Especially schizophrenia patients are the most patients with severe mental disorder in this city,and schizophrenia will be the top priority of community prevention and control.(3)Severe mental disorders in the city are younger,low degree of culture,high rate of unmarried,health teaching should strengthen the mental health knowledge propaganda work,to guide the public have a correct understanding of mental illness to eliminate the stigma of the illness of patients and their families,to do a good job for premarital counseling education with mental illness.(4)With low unemployment rate and high disability rate,this city should vigorously develop community rehabilitation services and provide guarantee for patients to return to society.(5)The poverty rate of severe mental disorders in this city is high,and theylack adequate social security.We should help the poor patients to ensure the implementation of the monitoring responsibility,and ensure the effective connection of basic medical insurance,serious illness insurance,medical assistance and other insurance policies.Integrate the relief policies of severe mental disorders and reduce the family burden.(6)Continue to consolidate and improve the indicators of thecity’s management and treatment program of severe mental disorder,continue to find more patients,standardize the service process,strengthen staff training,and actively promote the comprehensive,whole-process and dynamic mental health service mode of “medical treatment in hospital,rehabilitation management in community”.(7)For the situation of the low drug rate and regular drug rate of severe mental disorders,it should be through the health education publicity to improve the patient’s medication compliance,as soon as possible to introduce the city’s free drug policy,to guarantee the basic drug needs of patients.