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首页> 外文期刊>Journal of health & social policy >The impact of deinstitutionalization of psychiatric hospitals on psychological distress of the community in Canada.
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The impact of deinstitutionalization of psychiatric hospitals on psychological distress of the community in Canada.

机译：精神病院的非机构化对加拿大社区心理困扰的影响。

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OBJECTIVE: There has been a plethora of studies that evaluate the impact of deinstitutionalization of psychiatric services, but they have not examined whether this policy has had an impact on the broader community. The present study addresses this gap by evaluating the impact of the deinstitutionalization of psychiatric hospitals on the mental health of the general population in Canada. METHOD: This research builds on an empirical analysis of 40 years of the process of deinstitutionalization of psychiatric services in Canada (Sealy and Whitehead 2004). An experimental design is simulated through the use of a derived construct, earlier vs. later deinstitutionalization, in order to test whether the policy of deinstitutionalization has achieved the goal of decreasing levels of psychological distress for people in the community. This study attempts to rectify some of the methodological limitations of past evaluations by standardizing the rates of deinstitutionalization among the provinces and taking into consideration the impact of the interaction among levels of perceived social support and the various social correlates of psychological distress. Cross sectional data from the 1994/95 (n = 16,989) and the 1998/99 waves of the National Population Health Survey (n = 14,682) are used to measure levels of psychological distress. RESULTS: Provinces that implemented this policy earlier have levels of psychological distress that are significantly lower than the provinces that implemented deinstitutionalization later. All high risk groups (people with lower levels of income and education, younger people, people living in urban areas) have significantly lower levels of psychological distress in 1998/99 (as compared to 1994/95) with the exception of single parents in the provinces that implemented deinstitutionalization earlier. CONCLUSION: Based on the NPHS, the earlier implementation of deinstitutionalization is associated with lower levels of psychological distress of the community as compared to the provinces that implemented deinstitutionalization later.
机译：目的：已经有大量的研究评估精神病院非机构化的影响，但他们尚未检查该政策是否对更广泛的社区产生了影响。本研究通过评估精神病院的非机构化对加拿大普通人群的心理健康的影响来解决这一差距。方法：本研究建立在对40年加拿大精神科服务非机构化过程的实证分析上（Sealy和Whitehead 2004）。通过使用派生构造对早期非机构化和后期非机构化进行模拟，以测试非机构化政策是否已达到降低社区中人们心理困扰程度的目标。这项研究试图通过标准化各省之间的去机构化率，并考虑到感知到的社会支持水平与心理困扰的各种社会关联之间的相互作用，来纠正以往评估方法的局限性。来自1994/95年（n = 16,989）和1998/99全国人口健康调查（n = 14,682）波浪的横截面数据用于测量心理困扰水平。结果：较早实施该政策的省份的心理困扰程度明显低于较晚实施非机构化的省份。所有高危人群（收入和教育水平较低的人，年轻人，城市居民）在1998/99年度（与1994/95年度相比）的心理困扰水平均大大降低（在1994/95年期间除外）。较早实施非机构化的省份。结论：基于NPHS，与较后实施非机构化的省份相比，较早实施非机构化与降低社区心理困扰有关。

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