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A New Agenda for Optimizing Investments in Community Mental Health and Reducing Disparities
American Journal of Psychiatry ( IF 15.1 ) Pub Date : 2022-05-23 , DOI: 10.1176/appi.ajp.21100970
Margarita Alegría 1 , Jenny Zhen-Duan 1 , Isabel Shaheen O'Malley 1 , Karissa DiMarzio 1
Affiliation  

The Biden-Harris Administration’s FY22 budget includes $1.6 billion for the Community Mental Health Services Block Grant program, more than double the FY21 allocation, given the rising mental health crises observed across the nation. This is timely since there have been two interrelated paradigm shifts: one giving attention to the role of the environmental context as central in mental health outcomes, the other moving upstream to earlier mental health interventions at the community level rather than only at the individual level. An opportunity to reimagine and redesign the agenda of mental health research and service delivery with marginalized communities opens the door to more community-based care interventions. This involves establishing multisector partnerships to address the social and psychological needs that can be addressed at the community level rather than the clinical level. This will require a shift in training, delivery systems, and reimbursement models. The authors describe the scientific evidence justifying these programs and elaborate on opportunities to target investments in community mental health that can reduce disparities and improve well-being for all. They select levers where there is some evidence that such approaches matter substantially, are modifiable, and advance the science and public policy practice. They conclude with specific recommendations and the logistical steps needed to support this transformational shift.



中文翻译:

优化社区心理健康投资和减少差距的新议程

拜登-哈里斯政府的 22 财年预算包括用于社区心理健康服务整笔拨款计划的 16 亿美元,这是 21 财年拨款的两倍多,因为全国范围内出现了日益严重的心理健康危机。这是及时的,因为有两个相互关联的范式转变:一个关注环境背景在心理健康结果中的核心作用,另一个向上游移动到社区层面的早期心理健康干预,而不仅仅是在个人层面。重新构想和重新设计心理健康研究议程和边缘化社区服务提供的机会为更多基于社区的护理干预措施打开了大门。这涉及建立多部门伙伴关系,以解决可以在社区层面而非临床层面解决的社会和心理需求。这将需要转变培训、交付系统和报销模式。作者描述了证明这些计划合理性的科学证据,并详细阐述了针对社区心理健康进行投资的机会,这些投资可以减少差异并改善所有人的福祉。他们选择有证据表明此类方法非常重要、可以修改并推动科学和公共政策实践的杠杆。他们以支持这一转型转变所需的具体建议和后勤步骤作为结尾。和报销模式。作者描述了证明这些计划合理性的科学证据,并详细阐述了针对社区心理健康进行投资的机会,这些投资可以减少差异并改善所有人的福祉。他们选择有证据表明此类方法非常重要、可以修改并推动科学和公共政策实践的杠杆。他们以支持这一转型转变所需的具体建议和后勤步骤作为结尾。和报销模式。作者描述了证明这些计划合理性的科学证据,并详细阐述了针对社区心理健康进行投资的机会,这些投资可以减少差异并改善所有人的福祉。他们选择有证据表明此类方法非常重要、可以修改并推动科学和公共政策实践的杠杆。他们以支持这一转型转变所需的具体建议和后勤步骤作为结尾。推进科学和公共政策实践。他们以支持这一转型转变所需的具体建议和后勤步骤作为结尾。推进科学和公共政策实践。他们以支持这一转型转变所需的具体建议和后勤步骤作为结尾。

更新日期:2022-05-23
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