每日英語跟讀 Ep.975: England’s Mental Health Experiment: Free Talk Therapy英格蘭的免費談話治療實驗 大減心理治療污名

England is in the midst of a unique national experiment, the world’s most ambitious effort to treat depression, anxiety and other common mental illnesses.

The rapidly growing initiative, which has gotten little publicity outside the country, offers virtually open-ended talk therapy free of charge at clinics throughout the country: in remote farming villages, industrial suburbs, isolated immigrant communities and high-end enclaves. The goal is to eventually create a system of primary care for mental health not just for England but for all of Britain.

英格蘭正進行獨特的全境實驗，一項為治療憂鬱症、焦慮和其他常見精神疾病而展開的舉世最具雄心壯舉。

這項計畫正快速開展，但在英格蘭以外卻鮮為人知，該計畫在全境各地的診所提供幾乎無時間限制的免費談話治療，涵蓋了偏遠農村、工業郊區、孤立移民社區及高檔社區。最終目標是不僅為英格蘭，同時也為全英國建立一套精神健康的初級保健制度。

At a time when many nations are debating large-scale reforms to mental health care, researchers and policymakers are looking hard at England’s experience, sizing up both its popularity and its limitations. Mental health care systems vary widely across the Western world, but none have gone nearly so far to provide open-ended access to talk therapies backed by hard evidence. Experts say the English program is the first broad real-world test of treatments that have been studied mostly in carefully controlled lab conditions.

The demand in the first several years has been so strong it has strained the program’s resources. According to the latest figures, the program now screens nearly 1 million people a year, and the number of adults in England who have recently received some mental health treatment has jumped to 1 in 3 from 1 in 4 and is expected to continue to grow. Mental health professionals also say the program has gone a long way to shrink the stigma of psychotherapy in a nation culturally steeped in stoicism.

當前許多國家正就大舉改革精神健康照護進行辯論，研究人員和決策人士也緊盯著英格蘭的經驗，分析其普及性和侷限。西方各國精神健康照護制度彼此差別很大，但迄今沒有哪個國家能提供獲確切證據所支持的無時間限制談話治療。專家表示，英格蘭這項計畫是第一個廣泛的現實世界治療試驗，而這些治療法大多是在實驗室精心控制的條件下研究過的。

由於起初幾年需求相當強勁，以致該計畫資源吃緊。最新數據顯示，該計畫每年篩檢近一百萬人，且最近接受過精神健康治療的英格蘭成年人數比例，已從四分之一跳增至三分之一，且料將繼續成長。精神健康專業人士並表示，該計畫已使心理治療在這個文化上充滿堅忍主義的國度汙名大減。

“You now actually hear young people say, ‘I might go and get some therapy for this,'” said Dr. Tim Kendall, clinical director for mental health for the National Health Service. “You’d never, ever hear people in this country say that out in public before.”

A recent widely shared video of three popular royals — Prince William, Prince Harry and Kate, Duchess of Cambridge — discussing the importance of mental health care and the princes’ struggles after their mother’s death is another sign of the country’s growing openness about treatment.

英國國民保健署精神健康臨床主任提姆．肯達爾博士說：「你現在真的會聽見年輕人說『我可能會去接受些治療』。以前你在這個國家絕不會聽見人們當眾這麼說。」

最近三位皇室人氣成員（威廉王子、哈利王子及劍橋公爵夫人凱特）的一個影片被廣泛分享，其中探討了精神健康照護的重要性，以及兩位王子在母親死後的心理掙扎，這是這個國家對治療日益開放的另一跡象。

The enormous amount of data collected through the program has shown the importance of a quick response after a person’s initial call and of a triage-like screening system in deciding a course of treatment. It will potentially help researchers and policymakers around the world to determine which reforms can work — and which most likely will not.

透過該計畫收集的極大量數據顯示，在某人初次呼求後迅速回應，以及以分類篩選系統決定治療過程的重要性。這可能會幫助世界各地的研究人員與決策人士確定哪些改革會有用，哪些又極可能沒用。

Source article: https://paper.udn.com/udnpaper/POH0067/316894/web/