Психическое здоровье населения Австралии и проблемы реформирования амбулаторной психиатрии

Австралия была одной из первых стран, в которой 30 лет назад была разработана и внедрена национальная программа по психическому здоровью. Такой национальный подход противоречил федеральной структуре страны, согласно которой федеральное правительство несёт ответственность за оказание первичной врачебной медико-санитарной помощи, а правительства штатов и территорий ― за экстренную и стационарную помощь в области психического здоровья. Такая схема привела к значительным расхождениям между юрисдикциями. Кроме того, вторичная (специализированная) помощь, часто оказываемая в амбулаторных условиях, осталась за рамками этого механизма управления. Данная статья исследует описанную дилемму и её последствия для амбулаторной психиатрической службы, а также предлагает ключевые шаги к более эффективной реформе внебольничной психиатрической службы.

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