Integrating mental health into primary care: the policy maker’s perspective and experience in China

Xin, Yu; Jin, Liu; Hong, Ma

Finally, we do have a remarkable success story, in the form of an initiative in Chile, which could serve as a model for countries with far better developed health services. Alfredo Pemjean reveals the way in which bold and novel moves to reorganise mental healthcare have empowered primary care practitioners and enabled them to work more closely with specialist colleagues from hospital services, in order better to serve the population with mild to moderate disorders. While there are many strengths in the Chilean system, Dr Pemjean also points out that there are still outstanding weaknesses, which will need to be addressed in due course. One important problem, a recurring issue in these thematic papers, concerns the necessity of integrating community self-help with professional services; the value of building links between the public and psychiatric services is easier said than done. (Danwei ), to which they were assigned by government according to their work units. 'Dormitory form' community was closely linked to where people worked, and thus administration and super vision were simple, as was the provision of health services. In each Danwei, a clinic provided basic healthcare not only for its employees but also for the other residents of the International Psychiatry Volume 7 Number 1 January 2010 dormit ory. The old primary care service was based on this. In fact, the 'golden age' of community mental healthcare was at that time, when psychiatric hospitals extended their service to communities via the Danwei 's clinics in the cities and via 'barefoot doctors' in the rural areas. Home beds, occu pational therapy stations and shelter factories were set up in some cities and mobile mental health teams played important roles in the villages. Although this did not really represent the 'integration' of mental health into primary care, it was a good example of maximising the utilisation of the very limited mental health resources by stretching the psychiatric service, using administrative power, and mobilising family members (Shen et al, 1990; Zhang & Yan, 1990; Zhang, 1999) .