西班牙的心理衛生保健：「自治共同體」下從精神醫療改革到社區本位照護

Mental Health Care in Spain: From Psychiatric Reform to Community-based Care within the “State of Autonomies”

西班牙如今已是民主國家，融入歐盟並擁有全民覆蓋且免費的醫療服務。從社區模式開展，心理衛生照護與社會服務和反毒品網絡相互合作，但到目前為止，這個進展一直很複雜。在這篇綜述中，作者描述了自上世紀70年代後期開始的精神醫療改革過程，當時正好與獨裁統治結束，以及「自治共同體」的創立同時。正如同這個國家領土統治的特殊性一樣。西班牙已經對19個自治區中的每一個實施了心理衛生計劃。作為一個例子，我們闡述了最富有的自治區之一馬德里，和最貧窮之一的安達盧西亞的心理衛生組織，以解釋和分析他們如何應用社區模式和與其他服務的協調。

Nowadays Spain where is a country that lives in democracy, is integrated into the European Union and with a universal coverage and free healthcare services. Being carried out from a community model, mental health care has been coordinated with social services and the antidrug agency network. But until now the process has been complex. In this overview, the authors are describing the process of psychiatric reform since the late 1970s, when was coinciding with the end of the dictatorship, and the creation of the “State of Autonomies.” As in this peculiarity of the territorial ordination of the country, Spain has had mental health plans of each of the 19 autonomous entities. As an example, we are illustrating two the mental health organizations – one of the richest autonomous communities, Madrid, and one of the poorest autonomous communities, Andalusia – to explain and analyze how they have applied the community model and coordination with other services. 西班牙如今已是民主國家，融入歐盟並擁有全民覆蓋且免費的醫療服務。從社區模式開展，心理衛生照護與社會服務和反毒品網絡相互合作，但到目前為止，這個進展一直很複雜。在這篇綜述中，作者描述了自上世紀70年代後期開始的精神醫療改革過程，當時正好與獨裁統治結束，以及「自治共同體」的創立同時。正如同這個國家領土統治的特殊性一樣。西班牙已經對19個自治區中的每一個實施了心理衛生計劃。作為一個例子，我們闡述了最富有的自治區之一馬德里，和最貧窮之一的安達盧西亞的心理衛生組織，以解釋和分析他們如何應用社區模式和與其他服務的協調。