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| | Changing needs and perspective for psychiatry and mental health services in Taiwan | | 2006-5-26 6:55:10 Hai-Gwo Hwu, M.D. |  Professor and Chairman, Department of Psychiatry, Hai-Gwo Hwu, M.D.1.2.3)
College of Medicine and National Taiwan University Hospital1)
Professor, Department of Psychology, College of Science; Institute of Epidemiology,
College of Public Health, National Taiwan University2)
Investigator, National Health Research Instiute3)
Taipei, Taiwan
Ifind six interested areas regarding mental health needs in modern Taiwan Society. Area 1 is the mental health issue related to the changes in population structure. There are 4 situations created mental health problem in this area. Such as (1) increased aging population (age over 64,7.6%and 9% in 1995 and 2002, respectively) (2) decreased children-adolescent population; (3) issue of foreign brides and related issue of childrearing; (4) issue of foreign labor workers. The mental health problem in this area will be of quantitative as well of qualitative ones For examples, the foreign brides and the child-rearing issue will create mental health problem resulted from the inter-cultural interaction.
Area 2 is the mental health related to the changes in social-economic condition. These are 4 situations in this area, such as (1) Taiwan businessmen working abroad, especially in China; (2) political unstability of Taiwan; (3) development-stagnation of economic situation, and (4) children being educated abroad. Due to globalization of business activity and educational program, separation of family members with close relatives becomes prevalent. Unstability of political situation and stagnation in economic development also created uncertainty in living and frustration.
Area 3 is the changed living style of modern Taiwan society. There are 3 situations in this area, such as (1) no chance of getting relaxed in daily life, (2) feeling not belonged to others: (3) decreased family function, A living style of being too busy will make the life to be too instrumental. Interpersonal relationship becomes loose All these conditions are against human nature and are detrimental to mental health
Area 4 is the stress-related problematic behaviors in modern Taiwan There are 4 categories of mental health problems, such as (1) high prevalence of psycho-physiological response; (2) feeling not belonged to otheres, (3) family violence; (4) suicide problem Due to the ignorance of the existence of mental state of being stressful, the individual is unaware of his /her own unhealthy mental state, he cost is un-measurable.
Area 5 is the care-needs of patients and their family of major psychiatric disorders. There are 4 main topics of concerns: (1) stigma problems; (2) community rehabilitation; (3) lack of support for the families providing long-term care; and (4) early detection and early intervention.
Based on the achievement of neurobiological study on major psychiatric disorder, such as schizophrenia, new approach to tackle these everlasting mental health problems need to be invented.
Area 6 is related to health care systems .I identify three subjects of interests; (1) issue related to National Health Insurance (NHI); (2) Mental Health Law, and (3) potential legal problem in psychiatric service.
The design of global budget system in NHI, inadequacy of psychotherapists and counselors, as well as rehabilitation, long-term care for mental ills, all put great impact on psychiatric service in Taiwan.
In order to meet all these potential needs of psychiatry and mental health, new strategy of mental health work has to be considered. I considered we need a new era of mental health movement in Taiwan based on Diathesis-stress etiological model, rather than stress model based on psychological theory only.
This new movement has to include the neuroscience knowledge useful for mental health promotion. Besides, the new mental health movement has to be of nation-wide campaign and has to be operable in daily living activities.
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Ministry of Health, (2003) No.013
ICP:No.040657