浙江省基层心理健康服务人员配置现状及公平性研究  

Status quo and fairness of the basic mental health service personnel in Zhejiang Province

作　　者：王维丹 张人杰[3] 王淑敏[1,2] 徐松泉 丁娇儿[1,2] 程康月 WANG Weidan;ZHANG Renjie;WANG Shumin;XU Songquan;DING Jiaoer;CHENG Kangyue(Mental Health Center of Zhejiang Province,Hangzhou,Zhejiang 310012,China;Tongde Hospital of Zhejiang Province,Hangzhou,Zhejiang 310012,China;Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou,Zhejiang 310051,China)

机构地区：[1]浙江省精神卫生中心,浙江杭州310012 [2]浙江省立同德医院,浙江杭州310012 [3]浙江省疾病预防控制中心,浙江杭州310051

出　　处：《中国农村卫生事业管理》2021年第12期903-909,共7页Chinese Rural Health Service Administration

基　　金：浙江省软科学研究计划(2019C35058)。

摘　　要：目的探讨浙江省基层心理健康服务资源配置现状及其公平性,为进一步加强心理健康服务提供参考。方法采用描述性分析方法明确浙江省基层医疗卫生机构及乡镇(街道)、村(社区)社会心理服务站点的心理健康服务人员配置现状,运用洛伦兹曲线、基尼系数分析其配置公平性,采用卡方检验比较国家试点地区和非试点地区的差异。结果 (1)截至2019年底,浙江省11个市基层共有心理健康服务人员26 022名,其中基层医疗卫生机构20 285名,包括精神卫生防治人员19 581名、精神卫生专业执业加注医生704名;乡镇(街道)、村(社区)的社会心理服务站点共有心理咨询师1 766名,精神卫生社工3 971名。心理咨询师占基层心理健康服务人员总数的6.36%,兼职1 544名(71.74%),平均年龄41.21±10.45岁,本科学历972名(55.04%),除临床医学、心理学之外的其他专业614名(34.77%),心理咨询相关工作经验不足5年者1 156名(65.52%)。(2)基尼系数结果提示,全省基层心理健康服务人员总量及精防人员、心理咨询师、精神卫生社工按人口配置公平性优于按地理面积配置的公平性,精神卫生专业执业加注医生配置公平性最差。试点市和非试点市心理咨询师的性别、年龄、专业差异存在统计学意义(χ^(2)=4.175,P<0.05;χ^(2)=30.417,P<0.001)。结论浙江省基层心理健康服务人员数量快速发展,但总量不足与配置不均衡问题共存,需进一步加强人才队伍建设,优化人员结构,提升基层心理健康服务供给能力;推动社会心理服务体系建设工作高质量发展。Objective To explore the status quo and equity of mental health service resources allocation in Zhejiang Province, and to provide reference for further strengthening mental health service. Methods Descriptive analysis was made to clarify the current situation of mental health service personnel allocation in primary health institutions, towns(streets) and villages(communities) social psychological service stations in Zhejiang Province. Lorentz curve and Gini coefficient were used to analyze the allocation fairness. Chi square test was used to compare the differences between national pilot areas and non-pilot areas. Results By the end of 2019, there were 26 022 mental health service personnel in 11 cities of Zhejiang Province, of whom 20 285 worked in primary health institutions, including 19 581 intensive care doctors and 704 mental health practicing physicians;there were 1 766 psychological counselors and 3 971 mental health social workers in towns(streets) and villages(communities) psychological service stations. Psychological counselors accounted for 6.36% of mental health service personnel in primary health institutions, among whom 1 544(71.74%) were part-timers. The average age was 41.21±10.45 years old. There were 972(55.04%) with bachelor’s degree, and 614(34.77%) with majors other than clinical medicine and psychology. A total of 1 156(65.52%) had less than 5 years of working experience in psychological counseling. The results of Gini coefficient showed that the fairness of allocation of mental health service personnel, intensive care doctors, psychological counselors and mental health social workers according to population was better than that according to geographical area, and the fairness of allocation of mental health practicing physicians was the worst. There were significant differences in gender, age and specialty between pilot cities and non-pilot ones(χ^(2)=4.175, P<0.05;χ^(2)=30.417, P<0.001). Conclusions The number of mental health service personnel in primary health institutions of Zhejia

关 键 词：心理健康 资源配置 公平性 基尼系数 

分 类 号：R197[医药卫生—卫生事业管理]