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目的了解《中华人民共和国精神卫生法》(《精神卫生法》)实施前后精神专科医院封闭式病房精神障碍患者入院方式及危险度评估的变化。方法采用问卷调查的方式,收集并比较《精神卫生法》实施前后某精神专科医院的两个封闭式病房入院患者的一般资料、入院方式及危险度差异。结果《精神卫生法》实施前后分别收集有效问卷129份和131份,两组患者一般资料差异无统计学意义(P均>0.05)。精神卫生法实施后,自愿住院患者比例增加,强制住院患者比例下降,差异有统计学意义(P<0.01);入院诊断均以精神分裂症为主,但《精神卫生法》实施后非精神分裂症患者比例有所增加(P<0.05);入院患者的危险度分级差异无统计学意义(P>0.05)。结论《精神卫生法》实施后封闭式病房自愿住院患者比例仍偏低,建议采取扩建开放式病房、规范非自愿住院程序等措施进一步落实自愿原则。
Objective To understand the changes of admission methods and assessment of risk in patients with closed ward mental disorder before and after the implementation of the Mental Health Law of the People’s Republic of China (Mental Health Law). Methods A questionnaire survey was conducted to collect and compare the general information, methods of hospitalization and differences in risk of admissions of patients in two enclosed wards of a mental hospital before and after the implementation of the Mental Health Law. Results Before and after the implementation of Mental Health Law, 129 valid questionnaires and 131 questionnaires were collected respectively. There was no significant difference in general information between the two groups (all P> 0.05). After the implementation of mental health law, the proportion of voluntary hospitalized patients increased, the proportion of compulsory inpatients decreased, the difference was statistically significant (P <0.01); schizophrenia was the main diagnosis of admission, but the “mental health law” after the implementation of non-schizophrenia (P <0.05). There was no significant difference in the grade of admission among the admitted patients (P> 0.05). Conclusion The proportion of voluntary hospitalized patients in closed wards is still low after the implementation of the Mental Health Act. It is suggested that further measures should be taken to further implement voluntary principles such as expanding open wards and regulating involuntary admission procedures.