本文调查要点 This paper investigates points

　　

贫困患者救治状况 Poor patients in treatment

　　

患者家属日常生活 Families with daily life

　　

医务人员工作现状 Medical personnel work situation

　　

精神病救治之困难 Psychiatric treatment of difficult

　　穿过竹林中窄窄的村路，来到一村民家的二层小楼前。

Through the bamboo forest narrow village road，In one village came to the second floor of MinGu before the house。

　　72岁的万婆婆为《法制日报》记者搬来竹椅，说她女儿犯病去住院了。婆婆紧紧拉住四川省都江堰市玉堂镇卫生院精神防治科医务人员高文红的双手，一劲儿说“感谢你们，感谢你们”。

The 72-year-old all things for her mother-in-law《Legal daily》Reporters move to bamboo chair，Said her daughter sick to go to hospital。The mother-in-law tightly hold dujiangyan city of sichuan province YuTang town health hospital spirit, the medical staff of the prevention and control GaoWenGong hands，YiJinEr said“Thank you，Thank you”。

　　眼前这栋村居是万婆婆儿子的住家，老两口居住在近旁一间低矮破旧的平房里。

The village is in the sight of all the homes of her son，The old couple living in near a low shabby bungalow。

　　重性精神病患者挥舞着砍柴的砍刀，高声怒骂并疯狂追逐前去接他住院的医生、村干部

Heavy nature mental patients waving to cut wood cutting，Loudly the nu scold and crazy to meet him in hospital after the doctor、Village cadres

　　2009年夏天，四川省都江堰市精神卫生中心防治科主任钟志坚与玉堂镇残联干部来到这里，目睹了万婆婆女儿的悲惨境况。“她40岁了，蜷缩在平房门前那个只有几平方米的小砖房的那张床上，邻居有10年几乎没见过她”。

In the summer of 2009，Dujiangyan city of sichuan province mental health center of director of division of prevention and control ZhongZhiJian and YuTang town cadres recommended here，Witnessed all the tragic situation mother-in-law daughter。“She is 40 years old，Crouching in the bungalow door that are only a few square meters of the small brick building on that bed，Neighbors have almost 10 years have not seen her”。

　　万婆婆告诉记者，女儿婚姻失败后精神异常，饭端到面前不吃，蓬头垢面，屎尿粘身，摔砸东西，随意打人。有村民围拢过来聆听，一中年女村民插话说，万婆婆女儿曾在村路上裸身疯跑，“好吓人啊”。

All her mother-in-law told reporters，Daughter after a failed marriage spirit is unusual，The dinner before to not eat，Unkempt appearance，Excrement and urine stick，Fell to hit thing，Hit somebody。Have the villagers gathered round come over to listen，In a female villagers cut in said，All the way in the village had her mother-in-law daughter naked body crazy run，“Formidable ah”。

　　作为成都市“阳光救助”的“解锁对象”，高文红为万婆婆女儿建立了健康档案，联系都江堰市精神卫生中心的专职医生对她进行诊治。1个月后，万婆婆和老伴儿第一次入院探视时惊呆了-——“她说妈妈来啦，爸爸来啦”。

As chengdu“Sunshine relief”of“Unlock object”，GaoWenGong all her mother-in-law daughter established health records，Contact dujiangyan city of mental health center full-time doctor at her diagnosis and treatment。After a month，All her mother-in-law and for the first time when hospital visits including his wife stunned--“She said mother come，Dad!”。

　　万婆婆说：“我眼泪落下来。”女儿10年没这样说过话。

All she said：“My tears fall down。”Daughter 10 years not that spoke。

　　“这次她又犯病，我们没有钱，政府管了她，回来再犯怎么办？”万婆婆极度忧虑。

“This time she and sick，We have no money，The government was in charge of her，Come back again？”All her mother-in-law extremely worried。

　　从万婆婆家出来，钟志坚又驾车来到都江堰市中兴镇卫生院，载上医务人员李一，前往另一名重性精神疾病患者家。

All house out from her mother-in-law，ZhongZhiJian and driven to dujiangyan zte town health hospital，In li on medical personnel，To another heavy nature of mental health patients home。

　　远远看到患者家，李一就回想起那天惊心动魄的经历——重性精神病患者挥舞着砍柴的砍刀，高声怒骂并疯狂追逐前去接他住院的医生、村干部，将停在他家院外的3辆轿车车窗全部砸烂。

Far from home to see patients，Li will recall that thrilling experience--heavy sexual mental patients waving to cut wood cutting，Loudly the nu scold and crazy to meet him in hospital after the doctor、Village cadres，Will stop in his home outside the hospital three cars of all Windows smashed。

　　都江堰市精神卫生中心医生卿王兵在避让追逐时摔倒，左脸蹭在泥地上。记者在医院采访卿王兵时，见他脸部偌大一块淤伤未消，泛着青紫。他说幸好摔倒，那砍刀恰恰在摔倒瞬间砍到他的衣裳，不然腰身就要中刀。

Dujiangyan mental health center in a doctor wang geological hazards when chasing down，Ceng left face in the mud。The reporter interviewed in hospital a wang bing，See his face so large a bruising not disappear，Pan with purple。He said fortunately fell down，The one in the fall to his clothes cut moment，Otherwise girth knife in the will。

　　走进这家院落，患者哥哥为记者沏上热茶，他今年47岁，患者小他8岁。哥哥的右眼被弟弟打得视网膜脱落，现已失明。患者母亲78岁，老婆婆告诉记者，儿子18岁发病，去成都看病花掉好几万元，十几年来病没医好，家里真是没钱再医。

Go into the yard，Patients for journalists on which brother hot tea，He 47 years old this year，Patients small he was eight。Brother right eye be brother played off the retina，Now blind。Patients with 78-year-old mother，The old woman told reporters，Son of 18，Go to see a doctor spend several ten thousand yuan of chengdu，More than ten years disease didn't healed，Home is really didn't have the money to d。

　　“他在外面打了人家，自己当时不晓得，后来人家找机会报复他，砍断过他的手筋，砍伤过他的大腿、脚杆儿。”哥哥说，弟弟也可怜，他知道是自己先前惹的事。

“He was out playing the somebody else，That don't know，Afterwards somebody else to find opportunities to take him，Cut his hand muscle，Cut down his thigh injury、Feet GanEr。”Brother said，Brother also poor，He knew his earlier is the fault of the matter。

　　记者走进患者居住的屋子，那是院落一角简陋的平房，屋内仅有一张木床、一张木桌，桌上和抽屉里有几个药瓶，瓶里都有剩余药片。老婆婆告诉记者，儿子不愿吃药，骗家人说吃过药了。患者哥哥拉开另一抽屉，里面塞满空烟盒，哥哥说弟弟整夜睡不着，抽烟凶得狠。

The reporter walks into patients live in the house，That is a compound of humble bungalow，The house only a piece of wood、A wooden desk，The table and there are several bottles of drawer，The bottle is remaining tablets。The old woman told reporters，Son is not willing to take medicine，Cheat the family said had medicine。Patients with open another brother drawer，Inside with empty cigarette case，Brother said the younger brother couldn't sleep all night，Smoking fierce sore。

　　谈话中，老婆婆多次提到“政府阳光救助”。记者了解到，这项救助是指成都市政府针对贫困重性精神疾病患者实施的救助。

conversation，The old woman mentioned many times“The government aid”。The reporter understands，The aid is to point to chengdu city government for poor heavy nature of the implementation of the aid of mental health patients。

　　记者后来得知政府阳光救助标准是：残联部门资助未参保人员参加城乡基本医疗保险，对参保标准不足者补足，2009年要求至少达到每年每人200元，2010年以后提高到每年320元；患者一次性享受费用最长时间不超过3个月、费用不超过6600元的住院医疗救治。在按参保水平报销后，符合低保条件的患者由民政部门按政策实施医疗救助，剩余部分由残疾人就业保障金承担。

The reporter learned that government aid is sunshine standard：Recommended funding did not join protect personnel to the department of urban and rural basic medical insurance，To protect the standard complement the disease，2009 requires at least a year to 200 yuan per person，2010 years later increased to 320 yuan per year；Patients with the longest time not disposable enjoy cost more than three months、Cost no more than 6600 yuan of medical treatment of be in hospital treatment。According to submit an expense account ginseng in the level，The patients with low conditions by the civil affairs departments according to the policy implementation medical treatment，By the rest of the employment for benefits。

　　“我们的救助标准又有提高，一次性医疗救助的金额上限现在提升到7500元。”成都市卫生局疾控处处长贾勇说，事实上提升救助标准仅仅是一整套新政大盘中的一项细目。

“Our aid standard and improve，The maximum amount of disposable medical relief now increase to 7500 yuan。”Chengdu city health bureau of CDC everywhere JiaYong long said，In fact ascension aid is only a set of standard of a New Deal the details。

　　“我们财政的富裕程度与沿海差距比较大，但在西部和中部，我们算是解决得比较好的。”贾勇沉默片刻说，“要想一夜之间解决这个问题是不可能的，只能循序渐进。”

“Our financial richer and coastal gap is larger，But in the western and central，We have to solve better。”JiaYong were silent for a while，“To solve this problem overnight is impossible，Can only gradual。”

　　如果不把精神卫生医务人员的待遇通过系统的激励方法改善，最后还是留不住人

If you don't put the mental health treatment through the system of medical personnel incentive methods to improve，Finally do not leave

　　天降小雨。

Rain of heaven。

　　成都市第四人民医院首席精神科卫生专家秦小荣引领记者前往成都市金牛区天回社区卫生服务中心。那里地处城乡接合部，由于附近被确定为旧城改造地区，这里四周的民房和商铺已变成一片残垣断壁。

Chengdu fourth people's hospital chief psychiatric health experts QinXiaoRong lead reporter of jinniu district, to return to the community health service center。There is located in the urban and rural joints，Due to the nearby was identified as the old city reconstruction regions，The houses and shops around here has become a piece of broken walls。

　　“我们刚刚调试好5台电脑，昨晚就被盗了。”中心主任杜红英正在向院长王乙汇报，《法制日报》记者此时走进他们谈话的房间。　　秦小荣说，天回社区卫生服务中心与金牛区中医医院挂有两块牌子，实为同一单位。该中心最先成为成都市首批“686项目”示范单位，多年来对重性精神病管理模式进行了持续不懈的探索。

“We just tested 5 computers，Last night was stolen。”Center director DuGongYing are to the WangYi report，《Legal daily》The reporter went into their conversation at this time of the room。QinXiaoRong said，Day back to community health service center and jinniu district, there are two pieces of traditional Chinese medicine hospital hang brand，Actually the same unit。The center of chengdu first became the first“686 project”Demonstration unit，For many years to heavy mental management mode of persistent exploration。

　　44岁的杜红英在这家社区医院工作26年，她与两名同事兼职担负起该院防治精神疾病的繁重工作，数年来持续走访辖区精神疾病患者的家庭，为患者建立档案，督促、掌握患者服药情况并注意用药反应，掌握病人动态变化。

44 years old in this community hospital DuGongYing 26 years，She and two colleagues to take responsibility for prevention and control of the part-time mental disease heavy work，For years under the last visit mental illness family，Establish archives for patients，urged、Master patients and pay attention to drug reaction to medication，Master the dynamic change patients。

　　“近年来，登记健康管理档案入册的精神疾病患者逐渐增多。”杜红英告诉记者。

“In recent years，Health management files into the book registration of mental health patients to increase gradually。”DuGongYing told reporters。

　　记者跟随金牛区卫生局疾控中心副主任毛丹梅和杜红英一同前往社区一患者家巡访。毛丹梅在路上说，杜红英和两名同事与辖区精神病患者建立起长期密切的合作关系，得到患者和家属的充分信任。而全区13家社区卫生服务中心在6年里有6家中心更换了社区精神卫生防治人员，其中有两个社区更换过不止1名防治人员。

Reporters follow jinniu district health bureau deputy director of the centers for disease control and MaoDanMei and DuGongYing going with a home visit the community patients。MaoDanMei said on the way，DuGong and two colleagues and jurisdiction mental patients set up long-term close cooperation relations，Get trust of patients and their families。And the home and community health service center in six years have six center replacement community mental health control personnel，There are two community had more than one change control personnel。

　　2004年，成都全市拥有精神科医生334人、精神科护理人员807人。2000年至2004年，全市精神科医生流失59人，护士流失73人。

2004 years，Chengdu the city has psychiatrist 334 people、Psychiatric care personnel 807。From 2000 to 2004，The psychiatrist erosion 59 people，The nurse loss of 73 people。

　　记者曾向都江堰市中兴镇卫生院公共卫生防治科科长李凯询问收入，他说与同院临床医生收入相比，该科医务人员每月收入要低5倍以上。

The reporter had to dujiangyan zte township health centers public health prevention coco long n.syed ask income，He said with clinical doctors compared the income，The medical personnel to low monthly income more than 5 times。

　　成都市卫生局疾控处处长贾勇接受记者采访时说：“精神卫生机构兼具医疗和公共卫生两种属性，如何管理？我们目前还没有一个明确的路线。”贾勇表示，他个人认为精神卫生机构应该属于由国家完全“包起来”的医疗机构，而不应像其他综合性医疗机构那样，把它推进公立医院改革的浪潮之中。

Chengdu city health bureau of CDC everywhere long JiaYong told reporters：“Mental health agencies both medical and public health two attributes，How to manage？We have a clear line。”JiaYong said，He personally think mental health agencies should belong to by national completely“Wrapped up”Medical institutions，And should not like other comprehensive medical organization like that，Pushed it into the reform tide of public hospital。

　　“现在我很困惑这件事。”贾勇告诉记者，社区防治工作经费主要来自上级拨款，而这些拨款专款专用，不能提现为个人待遇，从事临床工作医务人员的经费可以提现为待遇。尤其在医疗和公共卫生混杂的机构，包括社区乡镇医院，从事临床的医务人员与从事公共卫生的医务人员收入的差别肯定要大得多。

“Now I'm confused about it。”JiaYong told reporters，Community prevention and control work mainly comes from the grant funds，And these appropriations earmarking，Can't carry for individual treatment，Clinical medical staff engaged in work of the funds may carry for treatment。Especially in the medical and public health hybrid institution，Including township community hospital，Engaged in clinical medical staff engaged in public health and the medical personnel of income differences certainly much greater。

　　“我们医院如果不靠政府，仅靠业务收入是生存不下去的。”成都市第四人民医院院长黄吉林认为，“现在的生活环境已变为市场环境，如果不把精神卫生医务人员的待遇通过系统的激励方法改善，最后还是留不住人。”

“Our hospital if not by the government，Only on business income is not live。”Chengdu people's hospital HuangJiLin think of the fourth，“Now living environment has become the market environment，If you don't put the mental health treatment through the system of medical personnel incentive methods to improve，Finally do not leave。”

　　不单是收入问题，潜在的人身伤害也令人忧心。记者走进成都市第四人民医院住院病房采访，住院部三科主任李奕从医30年，在这家医院工作22年。她告诉记者，医护人员在病房里与患者密切接触，有时会遇到肢体侵害，但最令她担心的是病人与病人发生伤害，相比起来，医护人员受到的伤害就排在后一位了。(记者杜萌)

Not only is the income，Potential personal injury also alarming。The reporter walks into chengdu people's hospital ward fourth interview，The inpatient department director of the medical profession LiYi sorted in 30 years，In the hospital 22 years。She told reporters，Medical personnel in the hospital room close contact with the patient，Sometimes will meet body violation，But most make her worry is patient and patient happening damage，contrast，Medical personnel from the bottom of the damage a。(Reporter DuMeng)