DALIAN CHINA  DALIAN CHINA
Notice of the general office of Dalian Municipal People's Government on Printing and Distributing Dalian Mental Health Work Plan ( 2018 - 2020 )
2018-11-15

The people's governments of the districts, cities and counties, the administrative committees of the pilot zones, the relevant departments of the municipal government and the relevant units:

With the approval of the municipal government, the "Dalian Mental Health Work Plan (2018 - 2020)" is hereby printed and distributed to you. Please combine with the actual situation and earnestly implement it.

Dalian Municipal People's Government General Office

November 15, 2018

 

Dalian Mental Health Work Plan ( 2018 - 2020 )

According to the Notice of the General Office of the State Council on Forwarding the National Mental Health Work Plan ( 2015 - 2020 ) of the Health and Family Planning Commission and other departments (Distributed by National General Office [ 2015 ] No. 44 ) and “the Circular of the General Office of Liaoning Provincial People's Government on Printing and Distributing and Implementing the Implementation Plan of the National Mental Health Work Plan ( 2015 - 2020 ) (Distributed by Liaoning Government General Office [ 2015 ] No. 99 ), this Plan is formulated in order to effectively solve the serious problems in the current mental health work in our city and promote the comprehensive development of the mental health cause.

 

I The Background

The mental illness has the problems of high prevalence rate, high recurrence rate, high disability rate and low treatment rate. The patients’ living conditions are difficult and have become a heavy burden to our society and family. By the end of 2017, the registration rate of patients with severe mental disorders in our city was 4.25 ‰, the management rate was 90.18 %, the standardized management rate was 84.13 %, and the condition stability rate was 96.55 %. All patients with severe mental disorders above grade 1 in the city enjoyed the policy of "awarding compensation for patients with severe mental disorders". The city has set up a psychological aid hotline and a psychological crisis intervention team, effectively preventing the occurrence of accidents and disasters. However, patients with mental illness have large medical expenses, low expense reimbursement and unstable condition, and there are still potential dangers of causing accidents and disasters. Although the Health and Family Planning Department, Public Security Department and other departments have strengthened screening through various means, there are still patients who are not in charge in the society, and the data entered in the information system is still a certain gap from the actual data.  Mental health professionals are not enough, mental health resources are unevenly distributed, there are no specialized mental hospitals in Zhongshan District and Changhai County, and there are no psychiatric hospitals in their district general hospitals. The community rehabilitation system in our city has not yet been established. Social discrimination is widespread and there are few scientific visits. In order to promote the all-round development of mental health in our city, it is particularly important to further improve the mental health prevention and control system and strengthen the mechanism construction.

 

Ⅱ The Overall Demands

To strengthen mental health work is an urgent need to improve the medical and health system and solve the in-depth contradictions in the development of social medical and health undertakings, and it is also an important measure to guarantee and improve people's livelihood, promote the release of labor potential and promote economic and social development. All regions and departments should start from the overall situation of promoting healthy economic development and maintaining social stability and harmony, fully understand the importance of doing a good job in mental health work, adhere to the basic principle of " government-led, department-linked, social participation, people-oriented and public welfare" and make scientific plans to vigorously promote the overall development of mental health cause in the city. 

 

Ⅲ The Work Goals

By 2020, a comprehensive management mechanism for mental health services will be generally formed in the city, with government leadership, joint management of various departments, wide participation of social organizations, and responsibilities of families and units. Give full play to the role of Dalian regional medical center, establish and improve mental health prevention, treatment and rehabilitation service system and network suitable for the level of economic and social development based on professional mental health institutions as the main body, psychiatry departments of general hospitals as the auxiliary, basic-level medical and health institutions and community rehabilitation institutions for mental diseases. Improve the system of help and rescue for patients with mental disorders, and significantly reduce the occurrence of major accidents and disasters. Actively create a social atmosphere of understanding, accepting and caring for patients with mental disorders, improve the whole society's understanding of the importance of mental health, promote the mental health development of the public and promote the harmonious development of society.

 

1. Improve the coordination mechanism of comprehensive management of mental health.

City, district and county (pilot zone), the two levels, set up a joint meeting system of mental health departments, and town ( street ) sets up a comprehensive mental health management team involving comprehensive management, health and family planning, public security, civil affairs, justice, disabled people's federation, aging and other departments. By the end of 2018, on the basis of the original town (street) integrated mental health management team, the integrated mental health management team will be extended to all towns (streets) of the city, and a comprehensive department linkage management mechanism will be completely established.

 

2. Establish and improve the mental health service system and network.  Strengthen planning and guidance, strengthen the construction of mental health professional institutions in districts, cities and counties (pilot zones), and build mental health professional institutions in districts, cities and counties (pilot zones) that are not covered by municipal institutions according to the needs, while other districts, cities and counties (pilot zones) set up psychiatric departments at least in a qualified comprehensive hospital. By 2020, all districts, cities and counties (pilot zones) will be covered by mental health professional institutions or psychiatric departments of comprehensive hospitals.

 

3. Strengthen the construction of the teams of mental health prevention and control personnel. 

All regions should fill up mental health professionals in accordance with national requirements, strengthen professional training, enhance professional quality and improve treatment capacity. By the end of 2018, the number of psychiatric practitioners (assistants) in the city will reach 261, and 100 % of primary medical and health institutions will be equipped with at least one full-time or part-time mental health prevention and control personnel. In 2020, the number of psychiatric practitioners (assistants) in the city will reach 269, and the number of psychiatric practitioners (assistants) in every 100,000 people in the districts, cities and counties (pilot zones) will meet the requirements of the national mental health work plan. 

 

4. Implement the management tasks of treatment of serious mental disorders.  All regions should rely on mental health professional institutions to set up compulsory medical wards, effectively link up the basic medical insurance, urban and rural residents' serious illness insurance, medical aid and emergency aid for diseases, and give full play to the overall effect, so that patients can enjoy medical security and medical aid policies to the maximum extent. Cases of causing accidents, especially murders, are to be significantly reduced, and patients who have caused accidents will receive compulsory medical treatment or hospitalization in a timely manner according to law. By the end of 2018, the management rate of registered patients with severe mental disorders will reach more than 81 %, and the management rate of schizophrenia will reach more than 65 %.  By 2020, the management rate of registered patients with severe mental disorders will reach more than 85 %, and the treatment rate of schizophrenia will reach more than 80 %.

 

5. Comprehensively improve the prevention and control capacity of the mental health system. 

Establish a consultation and referral system for mental health professional institutions to provide scientific and standardized diagnosis and treatment services for patients. To carry out the pilot work of comprehensive prevention and treatment of Alzheimer's disease and depression. By 2020, the city's treatment rate of depression will be increased by 50 % from 2015. Relying on the city's psychological crisis intervention center, the city will strengthen the construction of psychological crisis intervention team and improve the ability of psychological crisis intervention. In case of emergencies, the city will be able to carry out psychological assistance in a timely and scientific manner as needed. 

6. To promote the establishment of mental disorder rehabilitation system project.  To carry out the construction of demonstration project of community rehabilitation institutions for mental disorders, promote the expansion of community rehabilitation institutions, encourage and guide social resources to provide community rehabilitation services for mental disorders through government purchase of services, and promote the return of patients with mental disorders to society. By the end of 2018, more than 40 % of the districts, cities and counties (pilot zones) will carry out community rehabilitation work, and the community rehabilitation services for patients living at home will remain above 30 %. By 2020, more than 70 % of the districts, cities and counties (pilot zones) will carry out community rehabilitation work, of which 50 % of patients living at home will receive community rehabilitation services. 

 

7. Create a good social atmosphere concerned about mental health. 

Extensive publicity activities of mental health education have been carried out, with the all-area coverage reaching 100 %, continuously improving the awareness rate of mental health knowledge among ordinary people in urban and rural areas and students in schools. By the end of 2018, the awareness rate among ordinary people in urban and rural areas and students in schools will reach 65 %, 45 % and 75 %, respectively. By 2020, the awareness rate among ordinary people in urban and rural areas and students in schools will reach 80 %, 60 % and 90 %, respectively.

 

Ⅳ. The Work Tasks

1. Establish and improve the mental health prevention and control system.  Establish a joint meeting system and information sharing mechanism for mental health work and organize regular meetings. Strengthen the construction of the city's mental health prevention and control team, and the cities, districts, cities and counties (pilot zones) are equipped with full-time mental health prevention and control personnel; Rationally allocate the mental health resources in the city;  Guide primary medical and health institutions to strengthen the management of patients with severe mental disorders; Strengthen the assessment of mental health professional institutions; Guide the establishment of compulsory medical wards;  Explore the management mode of psychological counseling institutions and formulate policies to support psychological professionals to engage in psychological treatment in medical institutions; Implement the standards of diagnosis, treatment and nursing charges formulated by the provincial price departments, which reflect the labor value of medical personnel and conform to the characteristics of mental health work; Coordinate all departments to supervise and assess the implementation of the Plan.  [Led by the Municipal Health and Family Planning Commission, coordinated by the Municipal Comprehensive Management Office, the Municipal Development and Reform Commission (the  Price Bureau), the Municipal Education Bureau, the Municipal Public Security Bureau, the Municipal Civil Affairs Bureau, the Municipal Finance Bureau, the Municipal Human Resources and Social Security Bureau, the Municipal Editorial Commission Office, the Municipal Disabled Persons' Federation and other departments.]

 

2. Increase supervision and inspection efforts, establish an accountability mechanism. Strengthen the investigation, research, organization, coordination, supervision and guidance of mental health work, incorporate the rescue work for patients with serious mental disorders into the annual evaluation of comprehensive management of social security (construction of safe Dalian), intensify the inspection and evaluation, and supervise and investigate the responsibilities of those cases (events) that have caused serious accidents by patients with serious mental disorders due to lack of attention to work, inadequate supervision and late treatment in accordance with the “Implementation Methods of Dalian Leadership Responsibility System for the Sound Implementation of Comprehensive Management of Social Security”.  Comprehensive management organizations at all levels shall coordinate with relevant departments at the same level to promote the establishment of comprehensive mental health management teams in villages and towns (streets).  (Led by the Municipal Comprehensive Management Office, coordinated by the Municipal Health and Family Planning Commission, the Municipal Public Security Bureau, the Municipal Civil Affairs Bureau, the Municipal Justice Bureau, the Municipal Finance Bureau, the Municipal Human Resources and Social Security Bureau, the Municipal Disabled Persons' Federation and other departments)

 

3. Organize and carry out mental health education in schools to realize the mental health of students in schools. Municipal colleges and vocational colleges generally set up psychological counseling and psychological crisis intervention centers (rooms) with full-time teachers, and primary and secondary schools set up psychological counseling rooms with full-time or part-time teachers.  Establish a working mechanism for students' mental health education, formulate a pre-plan for dealing with unexpected psychological crisis on campus, establish a stable coordination mechanism for students' psychological crisis intervention with mental health professional institutions, carry out mental health education and realize mental health from an early age. Municipal colleges and universities should strengthen the training of relevant knowledge and skills for the staff of their psychological counseling agencies and student workers, provide timely medical guidance or referral services for patients with suspected mental disorders among patients seeking medical treatment or help, and establish a stable coordination mechanism for psychological crisis intervention with mental health professional institutions. (Led by the Municipal Education Bureau, coordinated by the Municipal Health and Family Planning Commission and the Municipal Disabled Persons' Federation, etc.)

 

4. Establish an emergency response mechanism to maintain social harmony and stability. Prevent and deal with suspected mental disorder patients who have committed or are at risk of causing accidents, and Establish an emergency response mechanism for the police. Strengthen the investigation, visit and management of patients with serious mental disorders such as causing accidents and disasters, strengthen the management mechanism for patients with serious mental disorders linked by departments, and cooperate with relevant departments, and implement management responsibilities in coordination to prevent causing accidents and disasters. In accordance with the requirements of "manage what needs to be managed, receive all needs to be received and treat all must be treated", we should do a good job in the management of treatment.  (Led by the Municipal Public Security Bureau, coordinated by the Municipal Justice Bureau, the Municipal Comprehensive Management Office, the Municipal Civil Affairs Bureau, the Municipal Finance Bureau, the Municipal Health and Family Planning Commission, the Municipal Disabled Persons' Federation and other departments)

 

5. Improve the social assistance system to achieve full coverage of medical assistance for poor patients. Improve the social assistance system that conforms to the characteristics of diagnosis and treatment of mental disorders. For those people meeting the minimum living guarantee conditions, the civil affairs departments should include them in the minimum living guarantee in a timely manner; For those who do not meet the minimum living conditions but do have difficulties, or who still have difficulties after obtaining the minimum living guarantee, they should be helped to solve their basic living difficulties through temporary assistance and other measures. Do a good job in the effective connection between medical assistance and other medical security policies, bring all eligible poor patients into the scope of medical assistance, and raise the level of assistance in due course. (Led by the Municipal Civil Affairs Bureau, coordinated by the Municipal Human Resources and Social Security Bureau, the Municipal Health and Family Planning Commission and other departments )

 

6. Do a good job in the management and control of troublemaking patients in special places and implement compulsory medical treatment. Special places such as prisons, detention centers and compulsory isolation drug rehabilitation centers should strengthen psychological counseling and guidance for the personnel under supervision, strengthen the management of the patients who caused the accident, so that all patients can receive compulsory medical treatment or hospitalization according to law, and the compulsory treatment of mental patients should be implemented in accordance with the Criminal Procedure Law of the People's Republic of China. Strengthen the monitoring and treatment of patients with severe mental disorders in key places. (Led by the Municipal Judicial Bureau and the Municipal Public Security Bureau, coordinated by the Municipal Health and Family Planning Commission and other departments )

 

7. Actively play the role of social security, and effectively reduce the economic burden of patients. Ensure that patients with severe mental disorders enjoy the coverage of the medical security system. For patients with mental disorders, especially those with severe mental disorders, timely treatment should be ensured to alleviate the patient's condition as much as possible. Patients, who have participated in the medical insurance, in accordance with the relevant provisions of the medical insurance, should pay the relevant medical costs to reduce the burden on their family and the society. For those poor patients who are not insured and meet the conditions, they should be assisted by the relevant departments to help them participate in the basic medical insurance according to the relevant provisions of the medical insurance. In accordance with the relevant provisions of the country and the provinces, the payment scope of basic medical insurance for eligible therapeutic rehabilitation services for mental disorders will be gradually expanded; Do a good job in the basic medical insurance, serious illness insurance, medical assistance and other medical security systems. (Led by the Municipal Human Resources and Social Security Bureau, coordinated by the Municipal Civil Affairs Bureau, the Municipal Finance Bureau, the Municipal Justice Bureau, the Municipal Disabled Persons' Federation, the Municipal Health and Family Planning Commission, etc.)

 

8. Do a good job in rehabilitation services and actively guide patients to integrate into social life. Conscientiously implement the relevant provisions of the Law of the People's Republic of China on the Protection of Persons with Disabilities and the requirements for the prevention and rehabilitation of mental disabilities set forth in China's program for the development of the cause of persons with disabilities, implement an open management mode conducive to the participation of mental disabilities in social life, establish and improve a service mechanism linking medical rehabilitation with community rehabilitation, and strengthen the technical guidance of mental health professional institutions to community rehabilitation institutions. Strengthen the protection of rehabilitation services for mentally disabled patients in special groups such as demobilized soldiers, destitute people, low-income personnel and supervised personnel. With the improvement of security capability, the scope of payment of basic medical insurance for eligible mental security therapeutic rehabilitation services will be gradually expanded. Do a good job in the lottery public welfare fund project for the poor mentally disabled. To carry out the demonstration project of community rehabilitation institutions for mental disorders, to promote the expansion of community rehabilitation institutions, to encourage and guide social resources to provide community rehabilitation services for mental disorders through the purchase of services by the government, and to promote the return of patients with mental disorders to society. (Led by the Municipal Civil Affairs Bureau, coordinated by the Municipal Health and Family Planning Commission, the Municipal Disabled Persons' Federation, the Municipal Finance Bureau and other departments )

 

9. Actively carry out mental health promotion work and intensify mental health publicity. Relying on the city's psychological aid hotline and psychological crisis intervention center, it provides public welfare services for mental health.  Comprehensive hospitals and other specialized hospitals should provide psychological health guidance to patients, and primary medical and health institutions should provide psychological health guidance to residents within their jurisdiction. Propaganda departments should give full play to the role of traditional media and new media, widely publicize the core knowledge of the spirit and typical cases of patients overcoming mental diseases, guide the public to correctly understand mental disorders and psychological behavior problems, and correctly treat patients with mental disorders. Standardize the reporting of accidents and incidents, avoid using the term "mental illness" for reporting without identification, and reduce the negative impact. Education, women's federations, trade unions, the Communist Youth League, judicial administration, aging and other units should carry out mental health education activities for students, rural women, left-behind children, professional groups, supervised personnel, the elderly and other key groups. (Led by the Municipal Health and Family Planning Commission, coordinated by the Municipal Education Bureau, Municipal Justice Bureau and other departments)

 

V. Safeguard Measures

1)    Strengthen organizational leadership. All regions should incorporate mental health work into the overall plan for local national economic and social development, strengthen the responsibility of the government, make clear the responsibility of the department, cooperate closely, form the resultant force, and ensure that the policies and measures issued are connected with each other; In order to promote the sustained, healthy and stable development of mental health, all regions should take into account the work of treating and rescuing the patients with mental disorders, training professional talents and ensuring the operation of professional institutions, so as to ensure the effective implementation of all tasks.

2)    Implement departmental responsibilities. In accordance with the provisions of “Mental Health Law of the People's Republic of China” and the relevant policy requirements, all relevant departments should conscientiously perform their duties and form joint efforts to ensure that the work is carried out in a practical manner. Comprehensive management departments should give play to the advantages of comprehensive management and solve key and difficult problems of mental health work. All relevant departments should formulate specific work measures in accordance with their respective responsibilities and speed up implementation.

3)    Guarantee fund input. All regions should include funds for mental health work in their respective financial budgets, increase financial input in accordance with the needs of mental health work, and ensure the funds required for mental health work, and strengthen the performance evaluation of task completion and financial funds use to improve the efficiency of the use of funds. Promote basic public health services and the management and treatment of severe mental disorders, and implement various support policies for mental health professional institutions. It is necessary to establish a diversified financing mechanism, actively open up channels of investment and financing for mental health and public welfare undertakings, and encourage social capital to invest in mental health services and community rehabilitation.

4)    Strengthen supervision and evaluation. According to the plan, each area shall make the specific implementation plan, supervise and evaluate the progress, quality and effectiveness of the work. Implement key tasks as an important matter of government supervision. In 2020, the organization carries out the final effect evaluation of the implementation of the plan.