百万精神病人只有32万床位 A mental patient only 320000 beds

　　

不愿入院、治疗费用高、后期服务跟不上等拖了病患回归社会“后腿” Admission to、Treatment cost of high、Later bad service etc drew the patient to return the society“Hind legs”

　　精神病患者持刀致人伤亡屡有发生，造成一定程度的社会恐慌，也再度引发人们对社会上的重症精神病患者的关注。重症精神病人已经纳入大病救助范畴，对于这些病人该如何管理？精神病人伤人，到底谁之过？对社会上精神病人的管理难点在哪里？

Mental patients disengaged cause person casualties sometimes occur，Cause some degree of social panic，Also has to society by people of severe mental patients attention。Severe mental patient had brought into a serious illness relief category，For these patients how to management？Mental patient hurt，Exactly who's？The mental patient management difficulties in where？

　　

何时有暴力行为不容易确定 When violence have not easy to determine

　　“正常的时候，可能和常人没什么区别，但发病时却有很大的破坏性。”

“normal，May and ordinary people make no difference，But when the disease but very destructive。”

　　“患有精神疾病的人伤人已经不是孤立事件了，之所以出现这种情况，与患者不能及时并坚持治疗有关。”济南市精神卫生中心心理科主任朱君说，重症精神疾病主要包括精神分裂症、双向情感障碍、精神发育迟滞伴发的精神障碍等，“在15岁以上人群中，重症精神病的患病率为1%左右，而其中具有暴力倾向的占10%左右。”

“Mental illness is not isolated incident hurt people......，The reason that has this kind of situation，And patients can't timely and stick to the treatment。”Jinan city psychiatric mental health center director zhu jun said，Severe mental disease mainly including schizophrenia、Two-way emotional problems、Mental retardation of comorbid psychiatric disorders, etc，“In the 15 years old or above the crowd，The prevalence of severe mental illness for about 1%，And one of the violent 10% or so。”

　　但对于这种有暴力倾向的精神疾病患者，何时会有暴力行动，却不容易确定。“有的此类精神疾病患者，正常的时候，可能和常人没什么区别，但发病时却有很大的破坏性。”朱君表示，因此对于如何预防这类精神病患者的暴力问题，确实有很大的难度。

But for this kind of violent mental health patients，When there will be violence，It is not easy for sure。“Some such a mental illness，normal，May and ordinary people make no difference，But when the disease but very destructive。”Zhu jun said，So as to how to prevent this type of mental patients of the problem of violence，Do have a lot of difficulty。

　　“造成这种情况的原因，有的是因为患者没有得到及时的治疗。”朱君说，由于有的亲属担心影响患者的声誉等而隐瞒患者的病情，不能及时带患者就诊。

“The reasons for this cause，Partly because patients did not get timely treatment。”Zhu jun said，Due to some relatives worry affect the person's reputation, etc and hide the patient，Can't take patients in hospital。

　　朱君说，不久前，就有一对夫妇把孩子送进该院，经检查后发现其病情已经很严重，但该夫妇却不承认，坚持说，“俺孩子没什么大毛病，就是有点脾气不好”。

Zhu jun said，Not long ago，Just one couple who send their children to the hospital，After the inspection found its illness is serious，But the couple did not admit，insisted，“The an children nothing much wrong with，It is a bit bad temper”。

　　据了解，我国目前精神病患者达1亿人，而目前呈递增态势。

According to understand，Our country at present the mental patients to 100 million，And at present have increased situation。

　　

缺乏法律依据，强制入院困难 Lack of legal basis，Hospital difficult compulsory

　　“这几年‘被精神病’的事报道很多，对那些想让我们去接的，我们一般不敢接。”

“Over the past few years‘Be mental illness’Many of the reports，For those who want to let us to pick up，We generally can't answer。”

　　这种有暴力倾向的精神病人，不能强制送进医院吗？　　“由于现在精神卫生法还没有颁布，现在对于强制入院没有统一的依据。”济南市精神卫生中心副院长杨红梅说，像北京一些省份制定了精神卫生条例，而我省和济南市目前还没有相关条例。“这几年‘被精神病’的事报道很多，我们压力很大，对那些想让我们去接的，我们一般不敢接。”

This kind of violent mental patient，Cannot enforce sent to the hospital？“Due to the health law has not issued now spirit，Now compulsory for hospital no unified basis。”Jinan mental health center, vice President of the YangGongMei said，Some provinces like Beijing formulated the mental health ordinance，And our province and jinan no current regulations。“Over the past few years‘Be mental illness’Many of the reports，We are under a lot of pressure，For those who want to let us to pick up，We generally can't answer。”

　　杨红梅表示，现在该院只接受家属、公安、民政等送来的患者，经检查，却需要住院治疗的，才收治入院。

YangGongMei said，Now the only accept the families、Public security、Civil administration and send patients，Through the check，But need hospitalization，Were only hospital。

　　杨红梅说，“虽然公安可以强制将有暴力倾向的患者送院，但这种情况往往在悲剧发生后才执行，在预防潜在危险方面作用不大。”

YangGongMei said，“Although the public security could force will be violent patients in hospital，But this tragedy often before implementation，In the prevention of potentially dangerous effect is not big。”

　　杨红梅同时表示，对于那些能够强制入院的，费用问题又没做出相关规定。“患者不是亲属送来，家里不缴费，而相关部门送来的，又没有配套经费。有的患者就说，‘要钱没有，要不就给我们送回家’。”

YangGongMei also said，For those who can force of the hospital，Cost problems didn't make relevant regulations。“Patients is not sent relatives，Home not pay cost，But the relevant departments of the sent，And there is no matching funds。Some patients said，‘Want money no，Or to bring our home’。”

　　

没钱治疗，只能锁家里 No money treatment，Can lock home

　　精神类疾病大都需要长期服药，许多家庭都被拖垮。所以有的家庭送来病人，就不管了。

Psychiatric disease mostly need medication for a long time，Many families have been disrupted。So some families send patients，No matter the。

　　精神病患即使及时得到治疗，但治疗的长期性和高费用也经常让家属失去耐心。

The mentally ill even though to be treatment，But the treatment of the protracted nature and high cost also often bring their families lose patience。

　　山东省精神卫生中心一位主治精神病的专家介绍，虽然现在重型精神病患者山东省达100万人，但全省床位才32万张。

Shandong province mental health center a indications of psychiatric experts，Although now heavy mental patients shandong province of 1 million people，But the bed only 320000 copies。

　　他告诉记者，山东省精神卫生中心750张床位使用率将近100%，而26日上午截止到11点半，山东省精神卫生中心挂号人数就达166人。“我们尽量想办法保证重型精神病患者得到治疗，但有时也无能为力。”

He told reporters，Shandong province mental health center 750 beds utilization rate almost 100%，And 26, until half past eleven in the morning，Mental health center in shandong province, the number of registered reached 166 people。“We always try to ensure that heavy mental patients get the treatment，But sometimes can do nothing。”

　　另据相关资料，目前我国注册的精神科医师不足两万人，每10万人仅有精神科医师1.46名，只有国际标准的四分之一。“这也是造成很多患者得不到很好治疗的原因。”省精神卫生中心医教科副主任苏磊告诉记者。

The other according to relevant material，At present our country registered psychiatrists, less than twenty thousand people，Every 100000 people only psychiatrist of 1.46，Only a quarter of the international standard。“This is also causes many patients have a very good reason for treatment。”Save YiJiao mental health center of vice director of division of SuLei told reporters。

　　高昂的医疗费用也可能成为精神病患者治疗的拦路虎。

The high medical costs may also become a psychiatric treatment obstacle。

　　朱君介绍，在该院住院每月需花费3000-4000元左右。“现在在济南，新农合能报销70-80%，职工医保能报80%左右，而城镇居民医保也能报40-50%，可即便能报销这么多，但由于精神类疾病大都需要长期服药，许多家庭都被拖垮。所以有的家庭送来病人，就不管了。有的可以出院了，也找不到家属。”

Zhu jun introduced，In the hospital takes 3000-4000 a month yuan。“Now in jinan，New farming can submit an expense account with 70-80%，Health-care worker can offer 80% or so，And medical insurance for urban residents also can sign up for 40-50%，But even if can submit an expense account so much，But because mental diseases are mostly need medication for a long time，Many families have been disrupted。So some families send patients，No matter the。Some can discharge from hospital，Also can not find the families。”

　　“精神疾病的复发率在85%以上，几乎所有的患者都需要长期，甚至是终生服药。”朱君说，如果患者在医院，肯定能照顾周到、按时吃药，但费用肯定相对会高一些。因此，不少家属没钱将患者送到医院，有的只能“锁”在家里。

“Mental disease recurrence rate of more than 85%，Almost all of the patients have to long-term，Even the lifelong medication。”Zhu jun said，If patients at the hospital，Sure can take care of thoughtful、Medicine on time，But the cost will be relatively sure a few higher。so，Many families have no money patients will be taken to the hospital，Some can only“lock”At home。

　　

社区服务跟不上，回归社会有困难 Community service can't keep up，To return the society with difficulty

　　“有的家属担心影响患者的名声，不愿意社区卫生站知道这种事，许多患者家属都央求我们不要把病历转到社区。”

“Some families worry that affect the person's reputation，Don't want to know the things WeiShengZhan community，Many patients' families all begged us not to turn the medical records to the community。”

　　朱君介绍，随着以人为本理念的推行，现在对精神疾病患者的治疗目标也发生了变化，“以前是控制患者症状，而现在的目标是要恢复患者的社会功能，所以要尽量让患者回归社会。”因此，送患者到社区进行康复也成了这题中之义，而且此举也能降低患者家庭的负担。

Zhu jun introduced，With the implementation of the person-centered idea，Now on the mental health patients to treatment goals also change，“Before the control symptoms，And now aim is to restore the social function of patients，So to try to let patients to return the society。”so，Send patients to community rehabilitation has become the problem of righteousness，And it also can reduce the burden of the family。

　　“可现在的问题是，社区康复的效果不是很好。”朱君说，“有的患者回家吃了一段药后，觉得没症状了，患者家属也就不监督患者吃药了。而社区卫生服务机构因为人员少等各种原因，服务又跟不上。而对于那些家庭贫困的，相关部门又没有具体措施。”

“But the question now is，Community rehabilitation effect is not very good。”Zhu jun said，“Some patients go home for a period after the medicine，Don't feel symptoms，Family members of the patients will not take medicine supervision and patients。And community health services for various reasons such as less personnel，Service and couldn't keep up with。And for those of the families are poor，Relevant departments and no specific measures。”

　　朱君说，还有许多病人家属并不配合，“有的家属担心影响患者的名声，不愿意社区卫生站知道这种事，许多患者家属都央求我们不要把病历转到社区。”

Zhu jun said，And many of the patient's family does not cooperate，“Some families worry that affect the person's reputation，Don't want to know the things WeiShengZhan community，Many patients' families all begged us not to turn the medical records to the community。”

　　山东省精神卫生中心医教科主任张敬悬表示，国家应该进一步加大对救助精神病患者的投入，“这是最佳的解决途径，因为精神病患者越来越多，高昂的治疗费用也不是普通老百姓承担得起的。”

Shandong province mental health center of director of division of YiJiao cell suspension said，Countries should further to increase aid the investment of mental illness，“This is the best solution，Because mental patients more and more，Expensive treatment cost also is not ordinary people to afford。”

　　张敬悬说，病人家属在防止精神病患者致伤致亡过程中起到无可替代的作用，平时应该多观察精神病患者的表现，一有反常就应该有所警觉。

Cell suspension said，To prevent the patient's family mental illness of injury to wu process has played an irreplaceable role，At ordinary times should observe the performance of mental illness，A have unusual should be on guard。

　　济南心理卫生协会副会长张洪涛说，社会义工参与可以帮助精神病患者康复。他还建议，政府和社会应该加大对精神病患者的管理与服务，如发现精神分裂症状较严重者，要及时向公安局、街道办等汇报。(记者 李钢 郭静 刘帅 张泰来)

Jinan mental health association, vice President of ZhangHongTao said，Social volunteers can help mental patients recover。He also suggested that，The government and the society should intensify the psychotic management and service，Such as the discovery of schizophrenia symptoms more serious，In time to apply to the public security bureau、Neighborhood report such as。(Reporter LiGang GuoJing LiuShuai ZhangTai)