Aile Hekimliginde Sosyal Psikiyatri ve Toplum Ruh Sagligi Uygulamalari

.: PREFACE
Ön Söz
Preface
Doç. Dr. Derya İREN AKBIYIK
Sağlık Bilimleri Üniversitesi Ankara Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Aile Hekimliği ABD,
Ankara
Article Language: TR
Aile Hekimlerine Davet

Onsekizinci yüzyılın sonlarına doğru Fransız Dr. Pinel'n öne sürdüğü, psikiyatri hastalarının hastanede yatarak tedavileri yerine, toplum içinde uyumla yaşayacak koşullar oluşturulmasını hedefleyen düşünce ve onu destekleyen çalışmalar, sosyal psikiyatrinin tüm dünyadaki ilk adımları sayılmaktadır.

Psikiyatri önceleri, ruhsal hastalığı olanların daha çok hastanelerde ayaktan ya da yatarak tedavi ve izlemlerini çağrıştıran bir tıp disipliniydi. Ama ruhsal hastalıkların çevresel faktörler ve diğer kişilerle iletişimden doğrudan etkileniyor olması, konusunda yeni fikirlerin ortaya atılmasıyla psikiyatrik hizmetler, hastanede devam eden medikal tedavilerden sosyal alanlara, farklı disiplinlere doğru genişlemeye başlamıştır.

Bu süreç psikiyatriye sadece tıp alanında bir genişleme, yayılma sağlamakla kalmamış, toplumbilimciler, politikacılar, antropologlar gibi profesyonellerle de yakın işbirliğini zorunlu kılmıştır. Bir başka deyişle psikiyatri hastalarının 'iyilik' hâlinin sağlanması, tıp ve psikiyatrinin dışında farklı bilim alanlarını da daha çok ilgilendirir olmuştur. Yani ruh sağlığının sosyal ve toplumsal yanının, yine sosyal ve toplumsal mekanizmalarla güçlendirilmesi artarak önem kazanmaya başlamıştır.

Ancak toplum yönelimli çalışmayı ve hastalarına biyopsikososyal kapsamda hizmet vermeyi ilke edinmiş olmasına rağmen aile hekimliği tıp disiplini, maalesef toplum ruh sağlığı çalışmalarının dünyada ve farklı bilim alanlarında yayılmasına aynı hızda eşlik edememiştir. Psikiyatri hastalarının birinci basamakta alacağı hizmetin toplum ruh sağlığı açısından ne kadar önemli olduğu, hem Dünya Sağlık Örgütü hem de diğer sağlık otoriteleri tarafından defalarca tekrarlanmıştır. Buna rağmen pek çok ülkede olduğu gibi Türkiye'de de aile hekimlerinin bu konuları ve bakış açısını öncelikli tutarak sahiplendiklerini, günlük pratiklerine ya da akademik çalışmalarına yeterince taşıdıklarını söylemek zordur.

Bu kitap, sadece aile hekimleri ve birinci basamak sağlık hizmetleri çalışanlarına sosyal psikiyatri ve toplum ruh sağlığı uygulamaları konusundaki farkındalıklarını artırmayı, günlük pratiklerine taşımaları yolunda heveslendirmeyi amaçlayan ilk ve somut bir hedef değil, aynı zamanda bu alanda daha çok emek vermeleri yolunda bir davettir.

Şüphesiz ki çok sayıda değerli bilim insanı bu alanda emek vermektedir. Ama bu kitabın çıkmasında sosyal psikiyatri ve toplum ruh sağlığı çalışmalarının dünya liderlerinden olan Prof. Dr. Stefan Priebe ve ülkemizde bu disiplinin yolunu açmış olan Prof. Dr. Işık Sayıl'ın kazandırdığı bakış açısı çok etkili olmuştur. Her ikisi ile de yolum kesiştiği için hem kendimi, hem de bu politikalardan çok fayda gören hastalarımızı şanslı buluyor ve kendilerine teşekkür ediyorum.

Umarım bu yazılar ülkemizde ruh sağlığı alanında yepyeni ve güçlü politikaların gündeme gelmesine fırsat sağlar.

Doç. Dr. Derya İREN AKBIYIK
Editör
Invitation for Family Physicians

Towards the end of the eighteenth century, the thoughts by Dr. Pinel from France, aiming to create conditions that psychiatric patients will live in harmony in the society rather than being under inpatient treatment and the studies supporting him are considered as the first steps of social psychiatry all over the world.

Psychiatry was primarily a medical discipline that evoked an outpatient or inpatient treatment and follow-up of patients with mental illnesses at the hospitals. However, with the emergence of new ideas about the fact that mental illnesses are directly affected by environmental factors and communication with other people, psychiatric services have begun to expand from medical treatments in the hospital to social areas and different disciplines.

This process not only provided an expansion and spread in the field of medicine, but also required close cooperation with professionals such as sociologists, politicians and anthropologists. In other words, the provision of 'wellbeing' of psychiatric patients has become more relevant to different fields of science besides medicine and psychiatry. In other words, the social and community aspects of mental health are strengthened by social and community mechanisms.

However, despite its the principle of providing community-oriented work and providing biopsychosocial services to patients, family medicine discipline, unfortunately, could not accompany the spread of community mental health studies in the world and in different scientific areas. The importance of mental health services for psychiatric patients in primary care has been repeatedly reiterated by both the World Health Organization and other health authorities. Despite this, it is hard to say that the family physicians in Turkey, as in many countries, are holding the primary ownership of these issues and carry them to their daily practice or academic studies.

This book is not only a first and tangible goal for family physicians and primary health care workers to raise awareness of social psychiatry and community mental health practices and to encourage them to carry out their daily practice, but also an invitation for them to spend more effort in this field.

Undoubtedly, many valuable scientists are working in this field. But in the publication of this book, the perspectives imparted by Prof. Dr. Stefan Priebe who is one of the world leaders in social psychiatry and community mental health and Prof. Dr. Işık SAYIL, who paved the way for this discipline in our country, have been very effective. I feel lucky myself because I have crossed paths with them and our patients who have benefited a lot from these policies. I am cordially thankful to both of them.

I hope that these articles provide an opportunity to come up new and powerful policies in the field of mental health in our country.

Doç. Dr. Derya İREN AKBIYIK
Editor

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