Professor Te-Jen Lai, Chung Shan Medical University
Associate Professor Chia-Ming Chang, Chang Gung Memorial Hospital, Linkou
In the 2018 NHRI forum “Discussion and Assessment the Care Needs of Patients with Mental Disorders in the Community”, we reviewed many international and domestic literatures about community mental health care, discussed through the expert meetings and conference, surveyed the care needs of patients with mental disorder in the community, visited Australia community mental health, and proposed six major difficulties of community mental health in Taiwan, including: (1) lack of the continuity from the hospital to the community, and integration between health, labor, and social-welfare systems; (2) the quality of community mental rehabilitation institutes is uneven, unclear, and seems to have re-institualization; (3) not focus on the needs of family and patients with mental disorder; (4) the stigma and preoccupation of mental disorder are still existed; (5) the family still bear the care burden of patients with mental disorder; (6) the assessment system of patients with physical and mental disorder is not well-implemented and connected with their needs.
We suggest recovery-oriented community mental health care should be the major goal in the future. We also suggest four directions, including：(1) to promote the level, resources, quality and quantity of Department of Mental and Oral Health, inter-department and inter-ministry cooperation; (2) to integrate diverse education, health, social welfare, and employment system with mental health care and social services; (3) to establish comprehensive, adequate, and professional community mental health case manager teams; (4) to create the support and friendly community to the family and patients with mental disorder.
In 2019 NHRI forum proposal, ”Developing a diverse, integrated, friendly, and recovery oriented community mental health care system”, we have four objectives: (1) to develop diverse, integrated community mental health care models and programs; (2) to improve the management and quality of community mental health care institutes; (3) to strengthen the community care visits, case managers, and care quality; (4) to connect recovery needs and long-term care policy.
According these objectives, we will complete the works, including: (1) to connect multiple resources, medical, social, and Alliance for the Mentally Ill of R.O.C.,Taiwan and to develop diverse community mental health care models and programs; (2) to review national health insurance reimbursement, admission and discharge criteria and care indicators and to improve the management and quality of community mental health care institutes; (3) to use comprehensive and effective case management and to connect community care visit, home care, and social safety; (4) to develop the long-term care system of patients with mental disorder and to connect multiple recovery needs of patients with mental disorder in the community.