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호주의 정신보건 개혁에 관한 연구: 제4차 국가정신보건계획을 중심으로

Mental Health Reform in Australia: Focus on the Fourth National Mental Health Plan

신창식
국회입법조사처 (NARS)|2015.12|입법과 정책 (Legislation and Policy Studies)|제7권 제2호|pp. 471-499|DOI 10.22809/nars.2015.7.2.018

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키워드

Mental Health정신보건정신보건개혁Mental Health Reform호주의 정신보건정책국가정신보건전략국가정신보건계획Mental Health Policy in AustraliaNational Mental Health StrategyNational Mental Health Plan
주제분류정책학

초록

본 논문은 호주의 제4차 국가정신보건계획의 추진을 통한 정신보건개혁의 주요 내용과 그 성과에 대한 논의를 통해서 우리나라의 정신보건정책에 주는 함의를 찾는데 그 목적이 있다. 1993년부터 2014년까지 네 차례에 걸쳐 수립된 국가정신보건 5개년 계획은 지난 20년 동안 호주의 정신보건개혁의 광범위한 과정을 선도하는 중요한 정책 준거틀을 제공하였다. 2009년에 발표된 제4차 국가정신보건계획은 정신질환자의 사회통합과 회복, 정신질환의 예방과 조기 개입, 서비스 접근성 개선과 서비스 조정을 통한 보호의 지속성 확보, 서비스 질의 개선과 혁신, 그리고 책무성 제고를 위한 지속적인 성과측정과 보고 등을 정책우선순위를 설정하였다. 제4차 국가정신보건계획을 통한 정신보건개혁을 통해 정신질환자의 고용률 증가, 청년 정신질환자의 교육과 경제활동 참여율 증가, 정신질환자에 대한 지역사회 수용도의 향상, 정신질환자의 주거 안정, 초‧중등학교 교과과정을 통한 정신건강교육의 증가, 아동‧청소년의 1차 정신보건서비스 이용률 증가, 지역사회 내 자살율 감소, 퇴원 후 28일 이내 재입원률의 감소, 퇴원 후 지역사회보호서비스 이용률 증가, 정신질환자의 치료효과성 향상 등 많은 성과를 이루어냈다.

Abstract

The National Mental Health Plan has provided the overarching policy framework that has guided and extensive process of mental health reform in Australia for the last 20 years. The Fourth National Mental Health Plan committed governments to collaborative action in 34 areas designed to achieve reform at a national level in each of the five priority areas: social inclusion and recovery, prevention and early intervention, service access, coordination and continuity of care, quality improvement and innovation, and accountability-measuring and reporting progress. There are considerable progress and outcomes in participation rates by people with mental illness of working age in employment, participation rates by young people with mental illness of working age in education and employment, rates of stigmatising attitudes within the community, percentage of mental health consumers living in stable housing, rates of community participation by people with mental illness, rates of contact with primary mental health care by children and young people, and rates of suicide in the community under the Fourth National Mental Health Plan.

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