新型冠狀病毒疫情持續，各地確診個案節節上升。抗疫潮當中包含的不確定性、與SARS 經歷的聯想、防疫裝備供應緊張等因素，容易引發市民焦慮、恐慌及其他精神困擾徵狀。
The new coronary virus epidemic continues, and there is a steady rise in the number of cases. Instability, association with SARS' experiences, stress on the supply of anti-epidemic equipment, etc., can easily lead to public anxiety, panic and other signs of mental distress.
國際及本地學者和精神科專家紛紛警告，疫情衍生的精神問題或比疫情本身傷害更大，對於醫護人員、確診者與其家屬尤甚。在處理疫情衍生的精神健康問題方面，基層醫療的角色舉足輕重。?
International and local scholars and psychiatrists warn that the epidemic has more mental problems than the epidemic itself, especially for medical practitioners, practitioners, and their families.
抗疫須兼顧精神健康? 循基層醫療有效介入
anti-epidemic and mental health? > >....................................................................................................................................................................................
國際醫學權威期刊《刺針》（The Lancet）於本月第一星期連續刊登三篇文章，均提倡新型冠狀病毒疫情與精神健康的關係，及制訂精神健康應對措施的重要性。文章指出，根據以往全球重大疫情的經驗，疫情衍生的精神問題相當普遍。文章引述的研究可見，高達55%的SARS確診者在康復後患上創傷後壓力症、39%患上抑鬱症；於SARS期間在高風險地點（如SARS病房、急診室、胸肺科）工作的醫護人員，出現創傷後壓力症徵狀的機會是其他醫護人員的兩倍。然而，目前國際針對受新型冠狀病毒影響的精神健康情況關注不足，不但未有相關精神健康測查及服務需求的公開統計數據，大多數前線醫務人員亦未有精神健康工作的培訓。
Three articles, published in the first week of this month in the International Journal of Medical Authority The Lancet, promote the relationship between the new coronary virus epidemic and mental health, and the importance of developing mental health responses. The article notes that, based on past experience of major global epidemics, mental health problems arising from the epidemic are widespread. The research cited shows that 55% of SARS patients are currently less aware of post-traumatic stress disorder and 39% of depression after recovery, and that medical staff working in high-risk locations (such as SARS wards, emergency rooms, pulmonary pulmonary units) during the SARS period have no training in mental health work.
當然，在面對重大疫情，首要措施是疾病防控。但世界衛生組織亦早有提醒，社會及政策制定者在此時容易忽視精神健康對策，全面應對措施不單包含疾病防控，還需充分意識到社會的精神健康需要。世衛建議，在抗疫的不同階段，由前期準備、面對爆發到疫情過後的恢復期間，政府與社區代表需要共建精神健康應對指引，而有效的介入需要融入並建基於基層醫療，運用社區支援以減低標籤或歧視的情況。
But the World Health Organization has long warned that social and policy makers are vulnerable to ignoring mental health concerns at a time when comprehensive responses not only include disease prevention, but also the need to be fully aware of the mental health needs of society. The World Health Organization suggests that, at different stages of the epidemic, government and community representatives need to work together to build mental health guidelines, and effective interventions need to integrate and build on foundation-based medical care, using community support to reduce stigma or discrimination.
中國國家衛生健康委疾控局於過去一個月向各省市應對新型冠狀病毒感染的領導小組、指揮部印發《新型冠狀病毒感染的肺炎疫情緊急心理危機干預指導原則》。指導原則明確要求將精神健康工作納入疫情防控整體部署，動員社區基層醫療人員至精神科專家，從社區至醫院組建隊伍，為確診患者、疫情防控一線的醫護（第一級人群）、居家隔離者、家屬、普通市民（第二、三、四類人群），分別提供相應精神健康服務。面對重大疫情，將精神健康對策融入並構建於基層醫療的重要性顯而易見。
In the past month, the National Health Board of China has published the Principles Governing the Critical Mental Risks of Pneumonia Infected by the new coronary virus to its leadership group and command in all provinces and cities. The guidelines clearly require that mental health work be integrated into the prevention and control of the epidemic as a whole, that community-based healers be deployed to mental health specialists, and that teams be set up from the community to the hospital to identify patients, first-level care for the prevention and control of the epidemic, home-stayers, families, and ordinary citizens (second, third, and fourth). In the face of a major epidemic, the importance of integrating mental health concerns and building them into basic health care is evident.
在香港，雖然一眾非政府機構、社區有心人士各自推出不同的精神健康防疫小貼士，然而未見港府公佈統一指引。醫管局前港島東聯網家庭醫學及基層醫療部門主管、家庭醫學專科醫生朱偉星指，香港精神健康服務於基層醫療層面一向缺乏統籌，過去基層醫療發展未有重視精神健康服務。儘管如此，面對有市民因肺炎疫情感到精神困擾，朱醫生認為，他作為基層醫療一份子、個人和家庭在社區的第一道健康防線，社區家庭醫生可為市民提供正確防疫資訊，識別精神困擾早期徵狀，並於社區內處理較輕微的個案，以減低公營醫院在疫情時期的負擔。
In Hong Kong, although a number of non-governmental organizations and interested members of the community have introduced different mental health services, they do not see the Hong Kong public guidelines. Despite this, Dr. Chu believes that, as the first health line in the community for patients, individuals and families in the basement, a community home doctor can provide citizens with correct information on the prevention of disease, understand early signs of mental distress, and deal with minor cases in the community to reduce the burden of public hospitals during the outbreak.
醫管局前港島東聯網家庭醫學及基層醫療部門主管、家庭醫學專科醫生朱偉星
精神服務有待進一步融入基層醫療
港府近年響應世衛對健康的定義，指「沒有精神健康就沒有健康」，同時透過基層醫療，對健康服務採納「重預防、治未病、早治療」的原則。然而，發展基層醫療健康服務的討論文件，未有將精神健康服務納入其中，檢討精神健康服務的報告亦甚少探討基層醫療的角色。 In recent years, the government has responded to the World Health Organization's definition of health, which means that there is no health without mental health, and has adopted the principles of "precautionary care, medical treatment, early treatment" for health services through the base level of medical care. However, discussion papers on the development of the base level of health services have not included mental health services, and reports of mental health services have rarely explored the role of the foundation level of health care. 這次新型冠狀病毒的來襲再次提醒我們，「沒有精神健康就沒有健康」不只是口號，更是抗疫整體部署及長遠地發展全面基層醫療健康服務的重要基礎。 This attack on the new coronary virus reminds us once again that "no health without mental health" is not just a slogan, but an essential foundation for the overall deployment of the epidemic and the long-term development of comprehensive health-care services at the ground level. ?
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