영국의 지역사회정신보건정책 개혁에 관한 연구: 신노동당 집권이후(1997~)를 중심으로 = Community Mental Health Policy Reform in the U. K.

국문 초록 (Abstract)

본 연구는 영국의 지역사회정신보건정책의 개혁이 이루어진 배경과 그 과정에 대한 탐색과 함께 상대적으로 많은 정신보건정책들을 수행해 온 것으로 알려진 영국에서는 신노동당 집권 이후 지역사회정신보건정책에 대한 자체 반성과 개혁 작업들이 어떻게 추진되어 왔는지 살펴보는데 그 목적이 있다. 영국은 탈시설화를 통해서 지역사회정신보건정책을 실행해 왔으나, 여러 가지 문제점들로 인해 개혁의 필요성이 학계와 전문(가)단체들과 정신장애인단체와 가족들에 의해서 제기되어왔다. 이러한 상황에서 신노동당정부는 구체적인 정신보건정책의 개혁을 위해 1999년부터 2001년까지 3년간에 걸쳐 7억 파운드(한화 약 1조 3천억원)을 투자하였고, 그에 따른 후속 조치들로 정신보건법의 개혁, 국가정신보건서비스준거틀(the National Service Framework for Mental Health) 도입, 정신보건서비스전달체계로 보호프로그램접근(Care Programme Approach)의 도입, 노인의 정신건강을 위한 정책 수립 그리고 정신장애인을 위한 고용 촉진 프로그램의 시행 등을 추진해 오고 있다. 신노동당 집권하의 영국 정신보건정책의 개혁은 서비스의 질 향상과 서비스의 지속성 확보, 그리고 효율성 증대에 핵심 목표가 담겨져 있었다. NHS와 사회복지서비스국 간의 긴밀한 협력체계는 보다 적절한 치료와 보호의 통합을 제공할 수 있었다. 이러한 개혁과제들은 영국의 21세기 정신보건정책의 첫 출발로 역사적인 자리매김을 한 것으로 평가받고 있다.

다국어 초록 (Multilingual Abstract)

This study examines the government's strategy for reforming and modernising mental health services for the adult population in the United Kingdom. The study discusses the importance of mental health, prevalent misunderstanding of mental illness, and the urgent need for modernisation of services in the U. K. It goes on to outline the government's broad plans for raising standards and promoting partnership in health and social services, and the establishment of National Service Frameworks and a National Institute for Clinical Excellence. It then states the government's vision of mental health services which are safe, sound and supportive, and analyses past failures. The government also set out means by which reforms have implemented under the National Service Framework for adult mental health, how investment has been targeted, and performance has been monitored and assessed. It is more likely that these changes have helped the British people to make good the failings of the present system, improve the quality and consistency of services, and increase efficiency across the board. In this respect the NHS and social services have worked more closely together and so provide proper integration of treatment and care. These reforms mark a new beginning for mental health provision in the U. K.

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