ABOUT THE SPEAKER
Vikram Patel - Mental health care advocate
Vikram Patel helps bring better mental health care to low-resource communities -- by teaching ordinary people to deliver basic psychiatric services.

Why you should listen

In towns and villages that have few clinics, doctors and nurses, one particular need often gets overlooked: mental health. When there is no psychiatrist, how do people get care when they need it? Vikram Patel studies how to treat conditions like depression and schizophrenia in low-resource communities, and he's come up with a powerful model: training the community to help.

Based in Goa for much of the year, Patel is part of a policy group that's developing India's first national mental health policy; he's the co-founder of Sangath, a local NGO dedicated to mental health and family wellbeing. In London, he co-directs the Centre for Global Mental Health at the London School of Hygiene & Tropical Medicine. And he led the efforts to set up the Movement for Global Mental Health, a network that supports mental health care as a basic human right.

From Sangath's mission statement: "At the heart of our vision lies the ‘treatment gap’ for mental disorders; the gap between the number of people with a mental disorder and the number who receive care for their mental disorders."

More profile about the speaker
Vikram Patel | Speaker | TED.com
TEDGlobal 2012

Vikram Patel: Mental health for all by involving all

Vikram Patel:通过公众参与来实现所有人的精神健康

Filmed:
1,103,181 views

世界上有接近4亿5千人被精神疾病所困扰。在发达国家,只有一半的患者接受了适当的治疗,在发展中国家,由于精神疾病医生的严重短缺,有接近90%的患者不能接受治疗。Vikram Patel 向我们指出了一个十分有前景的道路——培养社区成员,使得他们可以进行精神健康干预,这一举措也激励着普通人之间的相互关爱。
- Mental health care advocate
Vikram Patel helps bring better mental health care to low-resource communities -- by teaching ordinary people to deliver basic psychiatric services. Full bio

Double-click the English transcript below to play the video.

00:16
I want you to imagine想像 this for a moment时刻.
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让我们一起来想象一下,
00:19
Two men男人, Rahul拉胡尔 and Rajiv拉吉夫,
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有两个人,拉胡和拉吉,
00:21
living活的 in the same相同 neighborhood邻里,
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住在一个小区,
00:23
from the same相同 educational教育性 background背景, similar类似 occupation占用,
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教育程度相同,工作也差不多。
00:27
and they both turn up at their local本地 accident事故 emergency
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他俩都去当地的急诊室,
00:29
complaining抱怨的 of acute急性 chest胸部 pain疼痛.
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说他们有严重的胸部疼痛
00:32
Rahul拉胡尔 is offered提供 a cardiac心脏的 procedure程序,
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急诊室给拉胡做了心脏检查,
00:35
but Rajiv拉吉夫 is sent发送 home.
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却让拉吉回家。
00:38
What might威力 explain说明 the difference区别 in the experience经验
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是什么原因让这两个几乎一样的人
00:41
of these two nearly几乎 identical相同 men男人?
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有着不同的遭遇?
00:44
Rajiv拉吉夫 suffers患有 from a mental心理 illness疾病.
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因为拉吉患有精神疾病。
00:47
The difference区别 in the quality质量 of medical care关心
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得不到同等质量的医疗服务,
00:51
received收到 by people with mental心理 illness疾病 is one of the reasons原因
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是导致精神疾病患者寿命
00:53
why they live生活 shorter lives生活
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短于不罹患精神疾病的人
00:55
than people without mental心理 illness疾病.
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的原因之一。
00:57
Even in the best-resourced资源最丰富的 countries国家 in the world世界,
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即使是在世界上资源最为丰富的国家,
01:00
this life expectancy期待 gap间隙 is as much as 20 years年份.
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这一寿命差距也有20年之多。
01:04
In the developing发展 countries国家 of the world世界, this gap间隙
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而在发展中国家,
01:06
is even larger.
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两者的寿命差距更大。
01:09
But of course课程, mental心理 illnesses疾病 can kill in more direct直接 ways方法
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然而,精神疾病当然也可以更直接地导致死亡。
01:12
as well. The most obvious明显 example is suicide自杀.
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最常见的例子就是自杀。
01:15
It might威力 surprise some of you here, as it did me,
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也许在座的一些朋友会感到吃惊,我那时也是,
01:18
when I discovered发现 that suicide自杀 is at the top最佳 of the list名单
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因为我发现,自杀在引起青年死亡的主要原因中
01:21
of the leading领导 causes原因 of death死亡 in young年轻 people
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排在第一位。
01:23
in all countries国家 in the world世界,
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在每一个国家都是如此,
01:25
including包含 the poorest最穷 countries国家 of the world世界.
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包括世界上最贫穷的国家。
01:28
But beyond the impact碰撞 of a health健康 condition条件
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不过,除去健康状况对寿命的影响,
01:31
on life expectancy期待, we're also concerned关心
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我们还关心
01:33
about the quality质量 of life lived生活.
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生活质量。
01:36
Now, in order订购 for us to examine检查 the overall总体 impact碰撞
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现在,为了让我们准确的知道
01:38
of a health健康 condition条件 both on life expectancy期待
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健康对寿命和生活质量的全面影响
01:41
as well as on the quality质量 of life lived生活, we need to use
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我们需要用到
01:44
a metric called the DALYDALY,
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一个叫做DALY的度量单位,
01:45
which哪一个 stands站立 for a Disability-Adjusted伤残调整 Life Year.
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DALY是伤残调整生命年的缩写(Disability-Adjusted Life Year)。
01:50
Now when we do that, we discover发现 some startling触目惊心 things
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当我们这么做时,我们发现了精神疾病的一些令人震惊的事实,
01:52
about mental心理 illness疾病 from a global全球 perspective透视.
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而这些事实是世界各国普遍存在的。
01:55
We discover发现 that, for example, mental心理 illnesses疾病 are
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例如,我们发现了精神疾病是
01:58
amongst其中包括 the leading领导 causes原因 of disability失能 around the world世界.
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引起生活不能自理的主要原因。
02:03
Depression萧条, for example, is the third-leading第三号 cause原因
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比如,抑郁正是第三大原因,
02:06
of disability失能, alongside并肩 conditions条件 such这样 as
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除此之外,还有
02:09
diarrhea腹泻 and pneumonia肺炎 in children孩子.
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腹泻和儿童肺炎。
02:12
When you put all the mental心理 illnesses疾病 together一起,
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当把所有精神疾病看成一个整体,
02:14
they account帐户 for roughly大致 15 percent百分
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全球15%的疾病负担
02:16
of the total global全球 burden负担 of disease疾病.
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是由他们造成的。
02:19
Indeed确实, mental心理 illnesses疾病 are also very damaging有害
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事实上,精神疾病对人们的身体将抗具有很大的破坏性,
02:24
to people's人们 lives生活, but beyond just the burden负担 of disease疾病,
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除了疾病负担,
02:29
let us consider考虑 the absolute绝对 numbers数字.
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让我们全面的了解一下精神疾病的破坏性。
02:32
The World世界 Health健康 Organization组织 estimates估计
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世界卫生组织统计到
02:34
that there are nearly几乎 four to five hundred million百万 people
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全世界有
02:37
living活的 on our tiny planet行星
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接近四亿到五亿的人
02:39
who are affected受影响 by a mental心理 illness疾病.
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受到精神疾病的影响。
02:41
Now some of you here
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你们中有一些人
02:43
look a bit astonished惊讶 by that number,
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对这个数字赶到震惊,
02:45
but consider考虑 for a moment时刻 the incredible难以置信 diversity多样
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但是,仔细想一下,精神疾病有数以万计的种类,
02:48
of mental心理 illnesses疾病, from autism自闭症 and intellectual知识分子 disability失能
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从儿童时的自闭症、智障
02:51
in childhood童年, through通过 to depression萧条 and anxiety焦虑,
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到成年的抑郁、焦虑、
02:54
substance物质 misuse滥用 and psychosis精神病 in adulthood成年,
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滥用药物和精神病,
02:56
all the way through通过 to dementia痴呆 in old age年龄,
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再到老年的痴呆,
02:58
and I'm pretty漂亮 sure that each and every一切 one us
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我敢肯定的说,今天在座的每一个人
03:01
present当下 here today今天 can think of at least最小 one person,
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都能想到至少一个人,
03:04
at least最小 one person, who's谁是 affected受影响 by mental心理 illness疾病
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在我们最熟悉的人中,至少有一个人
03:07
in our most intimate亲密 social社会 networks网络.
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受到精神疾病的影响。
03:12
I see some nodding点头 heads there.
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我看到一些人在点头。
03:15
But beyond the staggering踉跄 numbers数字,
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除了这些令人震惊的数字,
03:18
what's truly important重要 from a global全球 health健康 point of view视图,
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从全球健康的角度来看,
03:21
what's truly worrying令人担忧 from a global全球 health健康 point of view视图,
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真正重要和真正令人担忧的是,
03:23
is that the vast广大 majority多数 of these affected受影响 individuals个人
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在受影响的这些人中有很大一部分
03:27
do not receive接收 the care关心
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没有接受治疗
03:29
that we know can transform转变 their lives生活, and remember记得,
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然而,这些治疗确实可以改变他们的生活,请注意,
03:31
we do have robust强大的 evidence证据 that a range范围 of interventions干预措施,
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我们有充分的证据表明,
03:34
medicines药品, psychological心理 interventions干预措施,
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一些干预、药物治疗、心理辅导和社会干预
03:37
and social社会 interventions干预措施, can make a vast广大 difference区别.
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确实对精神疾病的治疗有很大的作用。
03:40
And yet然而, even in the best-resourced资源最丰富的 countries国家,
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但是,即使在资源丰富的国家
03:42
for example here in Europe欧洲, roughly大致 50 percent百分
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例如欧洲也有大约50%的人
03:45
of affected受影响 people don't receive接收 these interventions干预措施.
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不能接受治疗。
03:48
In the sorts排序 of countries国家 I work in,
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在我工作的一些国家,
03:51
that so-called所谓 treatment治疗 gap间隙
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甚至有90%的人
03:53
approaches方法 an astonishing惊人 90 percent百分.
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不能接受治疗。
03:58
It isn't surprising奇怪, then, that if you should speak说话
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因此,当你与
04:01
to anyone任何人 affected受影响 by a mental心理 illness疾病,
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患有精神疾病的人交谈时,
04:03
the chances机会 are that you will hear stories故事
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你一般总是能听到他们说起
04:06
of hidden suffering痛苦, shame耻辱 and discrimination区别
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几乎在他们所有的生活领域,
04:10
in nearly几乎 every一切 sector扇形 of their lives生活.
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他们都会有隐藏的痛苦、羞耻和被歧视的感觉。
04:13
But perhaps也许 most heartbreaking令人心碎 of all
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但是,或许在他们的描述中,
04:16
are the stories故事 of the abuse滥用
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最令人痛心的就是
04:19
of even the most basic基本 human人的 rights权利,
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对最基本的人权的践踏,
04:21
such这样 as the young年轻 woman女人 shown显示 in this image图片 here
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就像这张照片中的女子
04:24
that are played发挥 out every一切 day,
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这样的事情每天都会发生,
04:26
sadly可悲的是, even in the very institutions机构 that were built内置 to care关心
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悲哀的是,即使是在本应该治疗人们精神疾病的
04:30
for people with mental心理 illnesses疾病, the mental心理 hospitals医院.
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医院中也存在这种现象。
04:34
It's this injustice不公正 that has really driven驱动 my mission任务
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这是这一点让我感觉到我应该
04:37
to try to do a little bit to transform转变 the lives生活
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试着做一点努力来改变
04:39
of people affected受影响 by mental心理 illness疾病, and a particularly尤其
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遭受精神疾病折磨的人们的生活,
04:42
critical危急 action行动 that I focused重点 on is to bridge the gulf海湾
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我做的一个主要的工作就是在
04:46
between之间 the knowledge知识 we have that can transform转变 lives生活,
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我们所拥有的改变生活、有效治疗的知识与
04:49
the knowledge知识 of effective有效 treatments治疗, and how we actually其实
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把知识运用到日常生活中之间
04:51
use that knowledge知识 in the everyday每天 world世界.
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搭建一所桥梁。
04:55
And an especially特别 important重要 challenge挑战 that I've had to face面对
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我所要面对的一个重要挑战就是
04:58
is the great shortage短缺 of mental心理 health健康 professionals专业人士,
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极度缺乏像精神病专家和心理学专家这类的
05:01
such这样 as psychiatrists精神科医生 and psychologists心理学家,
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精神健康专家,
05:02
particularly尤其 in the developing发展 world世界.
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而这一现在在发展中国家尤为严重。
05:05
Now I trained熟练 in medicine医学 in India印度, and after that
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现在,我在印度学习了医学,
05:08
I chose选择 psychiatry精神病学 as my specialty专业, much to the dismay沮丧
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我选择了精神病治疗作为的专业,
05:11
of my mother母亲 and all my family家庭 members会员 who
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这让我妈妈和我的亲戚觉得很失望,
05:13
kind of thought neurosurgery神经外科 would be
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因为在她们严重神经外科医生才
05:15
a more respectable可敬 option选项 for their brilliant辉煌 son儿子.
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配得上他们聪明的儿子。
05:18
Any case案件, I went on, I soldiered当过兵 on with psychiatry精神病学,
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我始终坚持着做精神病治疗不论遇到什么病例,
05:21
and found发现 myself training训练 in Britain英国 in some of
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并且我让自己在英国一些最好的医院得到了锻炼。
05:23
the best最好 hospitals医院 in this country国家. I was very privileged特权.
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我十分的幸运。
05:26
I worked工作 in a team球队 of incredibly令人难以置信 talented天才, compassionate富于同情心的,
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我与一些十分有天赋、有工作热情的人一起工作,
05:29
but most importantly重要的, highly高度 trained熟练, specialized专门
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但是最重要的是,他们也是接受了严格训练的、
05:32
mental心理 health健康 professionals专业人士.
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专业的精神疾病专家。
05:35
Soon不久 after my training训练, I found发现 myself working加工
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在我学习完不久,我首先在津巴布韦工作,
05:37
first in Zimbabwe津巴布韦 and then in India印度, and I was confronted面对
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之后到了印度,
05:39
by an altogether new reality现实.
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我又需要面对一个新的事实。
05:42
This was a reality现实 of a world世界 in which哪一个 there were almost几乎 no
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我需要面对的是,有一些地方
05:45
mental心理 health健康 professionals专业人士 at all.
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根本就没有精神病专家。
05:48
In Zimbabwe津巴布韦, for example, there were just about
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例如,在津巴布韦,只有大约十来个精神病医生,
05:50
a dozen psychiatrists精神科医生, most of whom lived生活 and worked工作
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并且他们中的大部分居住在哈拉雷(津巴布韦首都),
05:53
in Harare哈拉雷 city, leaving离开 only a couple一对
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使得只有几个精神病医生
05:55
to address地址 the mental心理 health健康 care关心 needs需求
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负责生活在乡下的9百万人的
05:57
of nine million百万 people living活的 in the countryside农村.
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精神健康。
06:01
In India印度, I found发现 the situation情况 was not a lot better.
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印度的情况不比津巴布韦好到哪里去。
06:05
To give you a perspective透视, if I had to translate翻译
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具体地说,如果我把
06:07
the proportion比例 of psychiatrists精神科医生 in the population人口
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英国精神病医生的人口比例
06:09
that one might威力 see in Britain英国 to India印度,
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应用到印度
06:12
one might威力 expect期望 roughly大致 150,000 psychiatrists精神科医生 in India印度.
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印度大约需要15万精神病医生。
06:17
In reality现实, take a guess猜测.
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然而事实又是怎样呢?
06:20
The actual实际 number is about 3,000,
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实际上,印度只有3千精神病医生,
06:23
about two percent百分 of that number.
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只是15万的百分之2。
06:25
It became成为 quickly很快 apparent明显的 to me that I couldn't不能 follow跟随
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我很快的意识到,在像印度或津巴布韦这些国家,我不能
06:28
the sorts排序 of mental心理 health健康 care关心 models楷模 that I had been trained熟练 in,
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我不能再遵循我所学的那种精神病治疗模式了,
06:31
one that relied heavily严重 on specialized专门, expensive昂贵
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因为那种模式的精神病治疗,
06:34
mental心理 health健康 professionals专业人士 to provide提供 mental心理 health健康 care关心
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只能在一个人有能力获得专业的、昂贵的精神病专家的治疗
06:36
in countries国家 like India印度 and Zimbabwe津巴布韦.
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的情况下才能成功。
06:39
I had to think out of the box about some other model模型
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我必须打破思维定势,
06:41
of care关心.
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寻找其他方式。
06:43
It was then that I came来了 across横过 these books图书,
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那时,我接触了这些书,
06:46
and in these books图书 I discovered发现 the idea理念 of task任务 shifting
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在这些书中我发现了
06:49
in global全球 health健康.
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全球健康任务转变这一观点。
06:51
The idea理念 is actually其实 quite相当 simple简单. The idea理念 is,
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这一想法十分的简单。就是,
06:54
when you're short of specialized专门 health健康 care关心 professionals专业人士,
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当你缺少专业的健康专家时,
06:57
use whoever is available可得到 in the community社区,
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可以找社区中有空闲时间的人
07:00
train培养 them to provide提供 a range范围 of health健康 care关心 interventions干预措施,
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教给他们一些保健干预的知识,
07:03
and in these books图书 I read inspiring鼓舞人心 examples例子,
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这些书中就有一些鼓舞我的例子。
07:06
for example of how ordinary普通 people had been trained熟练
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例如,书中有写到怎样使普通人学会
07:09
to deliver交付 babies婴儿,
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接生、诊断并治疗早期肺炎,
07:10
diagnose诊断 and treat对待 early pneumonia肺炎, to great effect影响.
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这些都十分的有效。
07:13
And it struck来袭 me that if you could train培养 ordinary普通 people
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于是,我想到,如果我们可以训练普通人去
07:16
to deliver交付 such这样 complex复杂 health健康 care关心 interventions干预措施,
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完成这些复杂的保健干预,
07:18
then perhaps也许 they could also do the same相同
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或许他们也能进行
07:21
with mental心理 health健康 care关心.
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精神疾病治疗。
07:23
Well today今天, I'm very pleased满意 to report报告 to you
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今天,我十分高兴的告诉你们
07:25
that there have been many许多 experiments实验 in task任务 shifting
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在过去十年,发展中国家有许多
07:29
in mental心理 health健康 care关心 across横过 the developing发展 world世界
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精神疾病治疗任务转移的实验,
07:31
over the past过去 decade, and I want to share分享 with you
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我想和你们分享3个特殊的实验
07:33
the findings发现 of three particular特定 such这样 experiments实验,
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的成果,
07:36
all three of which哪一个 focused重点 on depression萧条,
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这三个实验都是关于最普遍
07:38
the most common共同 of all mental心理 illnesses疾病.
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的精神疾病——抑郁症。
07:41
In rural乡村 Uganda乌干达, Paul保罗 Bolton博尔顿 and his colleagues同事,
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在乌干达的郊区,Paul Bolton 和他的同事
07:44
using运用 villagers村民, demonstrated证明 that they could deliver交付
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对该村村民进行实验,发现他们可以
07:48
interpersonal人际交往 psychotherapy心理治疗 for depression萧条
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进行抑郁症的人际关系精神疗法,
07:50
and, using运用 a randomized随机 control控制 design设计,
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Paul 和他的同事进行了一些随机控制实验,
07:53
showed显示 that 90 percent百分 of the people receiving接收
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他们发现接受这种干预的90%的人恢复健康,
07:55
this intervention介入 recovered恢复 as compared相比
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而与之相比在对照组,只有
07:57
to roughly大致 40 percent百分 in the comparison对照 villages村庄.
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大约40%的人恢复了健康。
08:01
Similarly同样, using运用 a randomized随机 control控制 trial审讯 in rural乡村 Pakistan巴基斯坦,
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类似的,Atif Rahman和他的同时在
08:05
Atif与Atif Rahman拉赫曼 and his colleagues同事 showed显示
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巴基斯坦的郊区也进行了随机控制实验,
08:07
that lady淑女 health健康 visitors游客, who are community社区 maternal母系
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该实验表明在巴基斯坦保健系统
08:10
health健康 workers工人 in Pakistan's巴基斯坦 health健康 care关心 system系统,
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的社区女工作者
08:13
could deliver交付 cognitive认知 behavior行为 therapy治疗 for mothers母亲
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在对患有抑郁的母亲进行认知行为治疗时
08:15
who were depressed郁闷, again showing展示 dramatic戏剧性 differences分歧
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也同样在康复比例上取得了显著的提高。
08:17
in the recovery复苏 rates利率. Roughly大致 75 percent百分 of mothers母亲
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大约75%的母亲获得了康复,而
08:20
recovered恢复 as compared相比 to about 45 percent百分
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对照组中只有45%
08:23
in the comparison对照 villages村庄.
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恢复了健康。
08:25
And in my own拥有 trial审讯 in Goa果阿, in India印度, we again showed显示
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我在印度果阿的实验再一次证明
08:28
that lay铺设 counselors心理咨询师 drawn from local本地 communities社区
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从当地社区中寻找的普通人
08:31
could be trained熟练 to deliver交付 psychosocial心理 interventions干预措施
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在经过培训后可以对抑郁、焦虑进行心理干涉,
08:33
for depression萧条, anxiety焦虑, leading领导 to 70 percent百分
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这些健康顾问可以让70%的人恢复健康,
08:36
recovery复苏 rates利率 as compared相比 to 50 percent百分
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而即使在主要的健康中心,
08:38
in the comparison对照 primary health健康 centers中心.
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这一数据也只能达到50%。
08:41
Now, if I had to draw together一起 all these different不同
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现在,总观这些关于任务转换的不同实验,
08:43
experiments实验 in task任务 shifting, and there have of course课程
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当然还有其他的实验,
08:46
been many许多 other examples例子, and try and identify鉴定
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当我试着寻找
08:48
what are the key lessons教训 we can learn学习 that makes品牌
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成功的任务转换的
08:50
for a successful成功 task任务 shifting operation手术,
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关键所在时,
08:53
I have coined创造 this particular特定 acronym缩写, SUNDARSUNDAR.
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我将其总结为这样一个缩略语:SUNDAR。
08:57
What SUNDARSUNDAR stands站立 for, in Hindi印地语, is "attractive有吸引力."
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SUNDAR是什么意思呢?在印度语中是“诱人的意思”。
09:01
It seems似乎 to me that there are five key lessons教训
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在我看来,对于一个有效的任务转换,
09:03
that I've shown显示 on this slide滑动 that are critically危重 important重要
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有五个关键之处,
09:06
for effective有效 task任务 shifting.
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请看幻灯片。
09:08
The first is that we need to simplify简化 the message信息
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第一,我们需要简化信息,
09:11
that we're using运用, stripping剥离 away all the jargon行话
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将医学中的专业术语
09:14
that medicine医学 has invented发明 around itself本身.
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剔除。
09:17
We need to unpack解压 complex复杂 health健康 care关心 interventions干预措施
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我们需要将复杂的,未经加工的保健干预
09:20
into smaller components组件 that can be more easily容易
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变成短小的内容,只有这样我们才能简单的将其
09:22
transferred转入 to less-trained少训练 individuals个人.
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教授给缺乏专业训练的人员。
09:25
We need to deliver交付 health健康 care关心, not in large institutions机构,
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我们提供的健康治疗,并不是在一些大型的机构中提供,
09:27
but close to people's人们 homes家园, and we need to deliver交付
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而是在人们家附近提供,并且
09:30
health健康 care关心 using运用 whoever is available可得到 and affordable实惠
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我们用的是当地社区有空闲时间且有能力
09:32
in our local本地 communities社区.
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的人。
09:35
And importantly重要的, we need to reallocate重新分配 the few少数 specialists专家
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重要的是,我们要将有时间的仅有的几个专家
09:38
who are available可得到 to perform演出 roles角色
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也重新划定角色,
09:40
such这样 as capacity-building能力建设 and supervision监督.
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例如,让他们做一些能力培养和监督的工作。
09:43
Now for me, task任务 shifting is an idea理念
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对我来说,任务转换是一个
09:45
with truly global全球 significance意义,
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在全球都有重要性的想法,
09:48
because even though虽然 it has arisen兴起 out of the
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即使,这一想法是在发展中国家
09:51
situation情况 of the lack缺乏 of resources资源 that you find
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这些缺乏资源的条件下产生的,
09:54
in developing发展 countries国家, I think it has a lot of significance意义
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它对资源充足的国家同样有
09:57
for better-resourced资源较充足 countries国家 as well. Why is that?
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许多重要意义。为什么是这样呢?
10:00
Well, in part部分, because health健康 care关心 in the developed发达 world世界,
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一部分的原因是发达国家和发展中国家
10:04
the health健康 care关心 costs成本 in the [developed发达] world世界,
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疾病治疗的费用差距
10:06
are rapidly急速 spiraling螺旋式上升 out of control控制, and a huge巨大 chunk
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正在呈现螺旋式的发展,而这一趋势已经控制不了了,
10:09
of those costs成本 are human人的 resource资源 costs成本.
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其中,人力资源的耗费占很大一部分。
10:12
But equally一样 important重要 is because health健康 care关心 has become成为
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还有一个同样重要的原因就是,随着健康治疗
10:15
so incredibly令人难以置信 professionalized专业化 that it's become成为 very remote远程
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变得越来越专业,
10:19
and removed去除 from local本地 communities社区.
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它与当地社区的距离也就越来越远。
10:21
For me, what's truly sundar孙大信 about the idea理念 of task任务 shifting,
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对我来说,任务转变这一思想真正吸引人的地方
10:25
though虽然, isn't that it simply只是 makes品牌 health健康 care关心
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不是它可以使更多的人接受
10:27
more accessible无障碍 and affordable实惠 but that
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健康治疗,而是
10:30
it is also fundamentally从根本上 empowering授权.
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它的最基本的激励作用。
10:32
It empowers如虎添翼 ordinary普通 people to be more effective有效
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它激励普通人在治疗
10:36
in caring爱心 for the health健康 of others其他 in their community社区,
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本社区患者时变得更加有效,
10:39
and in doing so, to become成为 better guardians监护人
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同时,他们也成了患者们更好的
10:40
of their own拥有 health健康. Indeed确实, for me, task任务 shifting
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健康卫士。事实上,对我来说,任务转变是
10:44
is the ultimate最终 example of the democratization民主化
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医疗知识民主化的最终范例,
10:46
of medical knowledge知识, and therefore因此, medical power功率.
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因此他也是医学力量民主化的最终范例。
10:52
Just over 30 years年份 ago, the nations国家 of the world世界 assembled组装
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仅在30年前,世界各国聚集在
10:55
at Alma-Ata阿拉木图 and made制作 this iconic标志性的 declaration宣言.
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阿拉木图发表了如图这个图标式宣言。
10:58
Well, I think all of you can guess猜测
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我认为,你们都能想到
11:00
that 12 years年份 on, we're still nowhere无处 near that goal目标.
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12年后,我们离那个目标还是很遥远。
11:03
Still, today今天, armed武装 with that knowledge知识
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然而,今天,我们有条件
11:06
that ordinary普通 people in the community社区
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在充足的监督和支持下,
11:09
can be trained熟练 and, with sufficient足够 supervision监督 and support支持,
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使得社区中的普通人通过接受训练
11:12
can deliver交付 a range范围 of health健康 care关心 interventions干预措施 effectively有效,
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可以进行一系列有效的健康干预,
11:15
perhaps也许 that promise诺言 is within reach达到 now.
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或许那个承诺已在我们的能力范围之内。
11:19
Indeed确实, to implement实行 the slogan口号 of Health健康 for All,
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事实上,为了贯彻实现所有人健康这一口号,
11:23
we will need to involve涉及 all
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我们需要所有人
11:24
in that particular特定 journey旅程,
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对此的参与,
11:26
and in the case案件 of mental心理 health健康, in particular特定 we would
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在精神健康方面,我们格外
11:29
need to involve涉及 people who are affected受影响 by mental心理 illness疾病
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需要患有精神疾病的患者和
11:32
and their caregivers护理人员.
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他们的护理者的参与。
11:33
It is for this reason原因 that, some years年份 ago,
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几年前,正是因为这个原因,
11:36
the Movement运动 for Global全球 Mental心理 Health健康 was founded成立
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全球精神卫生运动成立了,
11:38
as a sort分类 of a virtual虚拟 platform平台 upon which哪一个 professionals专业人士
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作为一个虚拟平台,
11:42
like myself and people affected受影响 by mental心理 illness疾病
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许多像我一样的专家和被精神疾病困扰着的人们
11:45
could stand together一起, shoulder-to-shoulder肩到肩,
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团结起来,肩并着肩,
11:47
and advocate主张 for the rights权利 of people with mental心理 illness疾病
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倡导精神疾病患者获得
11:50
to receive接收 the care关心 that we know can transform转变 their lives生活,
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可以改变他们生活的治疗的权利,
11:53
and to live生活 a life with dignity尊严.
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让他们活的有尊严。
11:56
And in closing关闭, when you have a moment时刻 of peace和平 or quiet安静
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最后,我希望当你们空闲时或
12:00
in these very busy few少数 days or perhaps也许 afterwards之后,
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在这不忙的几天或者以后的任何时候,
12:02
spare备用 a thought for that person you thought about
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你们可以替你们认识的
12:05
who has a mental心理 illness疾病, or persons that you thought about
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患有精神疾病的
12:08
who have mental心理 illness疾病,
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人或人们想想,
12:09
and dare to care关心 for them. Thank you. (Applause掌声)
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并尽可能的照顾他们。谢谢。(鼓掌)
12:13
(Applause掌声)
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(鼓掌)
Translated by Ma Yao
Reviewed by Yuguo Zhang

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ABOUT THE SPEAKER
Vikram Patel - Mental health care advocate
Vikram Patel helps bring better mental health care to low-resource communities -- by teaching ordinary people to deliver basic psychiatric services.

Why you should listen

In towns and villages that have few clinics, doctors and nurses, one particular need often gets overlooked: mental health. When there is no psychiatrist, how do people get care when they need it? Vikram Patel studies how to treat conditions like depression and schizophrenia in low-resource communities, and he's come up with a powerful model: training the community to help.

Based in Goa for much of the year, Patel is part of a policy group that's developing India's first national mental health policy; he's the co-founder of Sangath, a local NGO dedicated to mental health and family wellbeing. In London, he co-directs the Centre for Global Mental Health at the London School of Hygiene & Tropical Medicine. And he led the efforts to set up the Movement for Global Mental Health, a network that supports mental health care as a basic human right.

From Sangath's mission statement: "At the heart of our vision lies the ‘treatment gap’ for mental disorders; the gap between the number of people with a mental disorder and the number who receive care for their mental disorders."

More profile about the speaker
Vikram Patel | Speaker | TED.com