ABSTRACT

Public administration of mental health policy is an area that raises issues about human rights and dignity, equality of access to high-quality mental health services and the adequacy of financial resources. Globally, most people with mental health problems lack access to care services due mainly to the limited number of trained specialists, the stigma and discrimination associated with mental illnesses, and fragmented service delivery models. A widespread response to the growing demand for integrated care is the establishment of e-mental health services engaging primary and secondary healthcare specialists from different disciplines. In Estonia, evidence-based e-mental health solutions are being introduced to improve access to mental healthcare and to reduce the costs associated with treatment. However, awareness of the benefits of e-mental health solutions remains limited among healthcare professionals and the wider population. This article draws on findings from EU-funded research projects to examine the challenges Estonia faces in adopting e-mental health solutions. The author shows how the lack of public investment in evidence-based e-mental health interventions and the reluctance of relevant professionals to engage with e-mental health technologies have resulted in legal uncertainty, hindering full implementation of e-mental health policy in mental health services.

摘要

精神卫生政策的公共管理是一个领域，涉及人权和尊严，获得优质精神卫生服务的机会均等以及财政资源是否充足等问题。在全球范围内，大多数有精神健康问题的人无法获得护理服务，这主要是由于受过培训的专家数量有限，与精神疾病相关的污名和歧视以及服务提供模式分散。对综合护理不断增长的需求的广泛回应是建立电子精神卫生服务，吸引来自不同学科的一级和二级保健专家。在爱沙尼亚，正在引入基于证据的电子心理健康解决方案，以改善获得精神保健的机会并减少与治疗有关的费用。然而，在护理专业人员和更广泛的人群中，对电子心理健康解决方案的好处的认识仍然很有限。本文借鉴了欧盟资助的研究项目的研究结果，以研究爱沙尼亚在采用电子心理健康解决方案方面面临的挑战。作者表明，缺乏基于证据的电子精神卫生干预措施的公共投资以及相关专业人员不愿使用电子精神卫生技术如何导致法律上的不确定性，从而阻碍了在精神卫生领域全面实施电子精神卫生政策服务。