经济学人下载:竞选的失败者 心理疾病要走出阴影

Britain
英国

Mental Health: Out of the shadows
心理疾病：走出阴影

Mental illness is at last getting the attention, if not the money it needs.
即便不是急需的财政援助，心理疾病至少争取到了它所该有的关注。

Mental health care has long been the poor relation of its physical counterpart.
心理健康医疗一直以来都和其相对应的生理健康医疗相比之下处于劣势。

The stigma of mental illness remains heavy.
人们严重保持对心理疾病的羞耻态度。

One in six adults in England has been diagnosed with a common mental disorder such as depression or anxiety.
在英国，每六个成人里面就有一个已经被诊断出患有常见的心理疾病如抑郁症或焦虑症。

Yet at least two-thirds of people diagnosed receive no treatment for their condition.
然而至少三分之二确诊的人没有针对自己的问题接受治疗。

In 2012 the Health and Social Care Act created a legal responsibility for the government to give the same priority to mental health as it gives to physical health.
在2012年，《健康和社会照顾法》规定了一个法律义务，那就是政府应当把心理健康和生理健康视为同样重要的事情。

Now the prime minister, Theresa May, has added her voice.
现在首相特蕾莎·梅对此发表了讲话。

In a speech on January 9th Mrs May warned that mental health had been “dangerously disregarded”.
在一月九号的一次演讲上，梅女士强调心理健康一直以来极其地不被重视。

She promised to transform attitudes to mental illness, including a special focus on children and young people. (Government figures show that three-quarters of mental-health problems start before the age of 18.)
她承诺会转变对待心理疾病的态度，包括对儿童和年轻人的特别关注。（政府的调查数据显示四分之三的心理健康问题在18岁以前就开始了。）

This will include teachers in every school being offered mental health first-aid training, and better support in the workplace.
这种转变包括每所学校的老师接受心理健康问题的急救训练以及在工作岗位上得到更好的支持。

According to the Centre for Mental Health, a think-tank, the consequences of mental illness cost the British economy more than ￡100bn ($120bn) a year in health care and lost economic output from sickness or unemployment.
据心理健康中心的一个智囊团分析，心理疾病产生的后果就是给英国的经济带来每年超过1000亿欧元（相当于1200亿美元）的损失，那就是在心理保健以及因为疾病或失业导致的经济损失方面。

But the system is structured badly, with physical and mental care run and funded separately.
但是，整个系统的结构设置极其地不合理——生理和心理保健分开运营以及资助。

This means treatment is not integrated and money wasted.
这意味着治疗不完整还会导致资金浪费。

Funding is a problem, too.
资金也是一个问题。

Though mental illness represents 28% of the national disease burden in Britain, it accounts for only 13% of spending by the National Health Service (NHS).
虽然心理疾病占了英国国家疾病负担的28%，它只占了国家健康服务支出（简称NHS）的13%。

In 2011-12, for the first time in a decade, funding for mental health fell, says the King’s Fund, another think-tank.
在2011年到2012年间，十年里面首次，国家给心理健康的资金投入降低了，另外一个智囊团———国王基金说到。

Even though the NHS mandated that such funding should increase in 2015-16 alongside increases for acute care, about 40% of mental-health trusts continue to experience year-on-year cuts to their budgets.
即使NHS批准了心理健康资金投入在2015年到2016年和急诊的治疗资金一样应该提升，但还是有将近40%的心理疾病基金持续经历每年预算的裁剪。

Since government money for mental illness is not ring-fenced, it is often used to plug gaps in funding for emergency hospital care or other areas.
由于政府财政对心理疾病的支出存在漏洞，这部分资金在过去就常常用来填补医院急诊或其他领域的空缺。

Mrs May spoke of the need for better accountability.
梅女士提到了对更多支出比例的需要。

But “investment in mental health has been difficult to maintain when pressures on acute hospital care are so great,” says Helen Gilburt of the King’s Fund.
但是国王基金的海伦吉尔伯特说到，当医院急诊的压力巨大时国家对心理健康医疗的投资一直以来都很难保持。

Those pressures have become even more evident in recent days.
那些压力在最近尤为明显。

On January 7th the Red Cross claimed there was a “humanitarian crisis” in Britain’s hospitals.
在1月7号，红十字会称在英国的医院里面有一种人道主义危机。

The NHS’s medical director for acute care denied this but admitted that staff were under “a level of pressure we haven’t seen before”.
NHS的急救药物主管否认此事但是承认了员工正承受着“前所未有”的压力。

According to leaked documents seen by the BBC, nearly a quarter of patients waited longer than four hours in accident and emergency (A&E) rooms in the first week of this year.
根据BBC目睹的泄露文件，将近四分之一的病人今年第一周在紧急意外室等候超过4小时。

One in five patients admitted for further treatment endured a long wait on a trolley or in a hospital corridor—twice the rate normally seen.
5个病人中就有一个接受进一步治疗的需要在医院的手推车或走廊上忍受一段很长时间的等待，而这是平常的速度的两倍。

With not enough mental-health care provided in the community, recent research has found that the number of people with mental illness coming to A&E doubled between 2011-12 and 2015-16.
由于在社区没有提供足够的心理治疗，最近的调查显示有心理疾病来急诊的数量比2011－2012年到2015-2016年间翻了一倍。

The fact that the prime minister herself has chosen to highlight the issue marks an important step, says Graham Thornicroft of King’s College London.
首相自己选择强调这一问题是向前迈出了重要的一步，伦敦皇家学院的格兰汉史鲁尼科洛福特说到。

Talking about mental health used to be seen as a vote loser.
谈到心理疾病在过去会被视为竞选的失败者。

Now, he says, not only are more celebrities unafraid to talk openly about their mental illness, but it appears to have entered the mainstream as a political issue.
而现在，他说，不仅越来越多的名人不再害怕公开谈论自己的心里疾病，而且这也成了主要的政治问题之一。

“We now need to see if this policy priority is backed up by substantial extra resources to make sure these aspirations become reality,” he adds.
“我们现在需要确保这种政治优势是否有足够的额外资源的支撑来保证这些愿望成为现实。”他补充到。

On that front, Mrs May is implementing a pledge made last year by her predecessor, David Cameron, to spend ￡1bn on adult mental health and ￡1.4bn on youth mental health during this parliament.
在这方面，现任首相政府也正在实现上任首相卡梅伦政府的相关承诺，即在成人心理健康方面投入10亿英镑并在青少年心理健康方面投入14亿英镑。

That money is being spent on both acute mental health care, such as specialists at every A&E unit, and on community care.
这些钱正被用在心理急救门诊，例如每个意外急救门诊的专家以及社区医疗上面。

New rules limit how long a patient with acute mental illness should wait, just like the four-hour limits for physical maladies in A&E.
新的规定限制每个心理疾病患者急诊需要等待的时长，正如在意外急诊部门的外伤4小时限制。

But this week’s announcements added up to additional funding of only ￡15m for community care, and ￡67m for digital services like online therapy—small beer considering the scale of the problems and of the prime minister’s avowed ambitions.
但是这周的通告增加了1500万欧元社区医疗的额外资金以及6700万的电子服务例如在线治疗—考虑到问题的规模以及首相公开宣布的目标。

Demand is growing.
需求正在增长。

The NHS found that the proportion of people with anxiety and depression receiving treatment increased from 24% in 2007 to 37% in 2014.
NHS发现从2007年到2014年间，接受治疗的焦虑症以及抑郁症患者的比例由24%增至37%。

This may show that people are feeling confident enough to seek help as the stigma of mental illness decreases, says Mr Thornicroft.
史鲁尼科洛福特先生说这表明了随着对心理疾病的羞耻感不断减少人们越来越有自信去寻找帮助。

But the NHS also found that the proportion of the population reporting self-harm trebled between 2000 and 2014, to 6%, including one in five 16- to 24-year-old women.
但是NHS同时发现从2000年到2014年间自残的比例翻了三倍至6%，其中的五分之一是16-24岁女性。

With such a tide, money to match the great promises for mental health cannot come soon enough.
按照这样的趋势，应对这样巨大的承诺所要的资金很难马上到位。