online ML Comm SPECIAL ISSUE 2030 정신건강의학과의미래보고서 J Korean Neuropsychiatr Assoc 2014;53(2):75-86 ISSN 1015-4817 www.knpa.or.kr 가톨릭대학교의과대학의정부성모병원정신건강의학교실, 1 경기북부병무지청, 2 경희대학교의과대학정신건강의학교실, 3 인제대학교의과대학일산백병원정신건강의학교실, 4 가천대학교의학전문대학원정신건강의학교실, 5 순천향대학교의과대학부천병원정신건강의학교실 6 이해국 1 최원석 2 백종우 3 이강준 4 나경세 5 정한용 6 The Future Report for the Innovative Advance of Korean Psychiatry in 2030 Hae Kook Lee, MD, PhD 1, Won Seok Choi, MD 2, Jong Woo Paik, MD, PhD 3, Kang Joon Lee, MD, PhD 4, Kyoung Sae Na, MD 5, and Han Yong Jung, MD, PhD 6 1 Department of Psychiatry, Uijeongbu St. Mary s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea 2 Department of Psychiatry, Military Manpower Administration, Uijeongbu, Korea 3 Department of Psychiatry, Kyung Hee University College of Medicine, Seoul, Korea 4 Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea 5 Department of Psychiatry, Gachon University College of Medicine, Incheon, Korea 6 Department of Psychiatry, College of Medicine, Soonchunhyang University, Bucheon Hospital, Bucheon, Korea Received December 21, 2013 Revised January 13, 2014 Accepted February 19, 2014 Address for correspondence Han Yong Jung, MD, PhD Department of Psychiatry, College of Medicine, Soonchunhyang University, Bucheon Hospital, 170 Jomaru-ro, Wonmi-gu, Bucheon 420-767, Korea Tel +82-32-621-5232 Fax +82-32-621-5018 E-mail hanyjung@schmc.ac.kr Futurology is an interdisciplinary field, studying yesterday s and today s changes, and aggregating and analyzing both lay and professional strategies and opinions with respect to tomorrow. Therefore, the purpose of this article is to provide the future direction and strategy for the advancement of Korean psychiatry based on the author s subjective opinion as well as the objective consideration of future changes in the environmental factors affecting psychiatry. First, we attempted to analyze the pros and cons of our status, according to the SWOT analysis. There are several positive factors in the outer environment, such as the increase of personal income, healthy aging people, interest in mental health, and development of a national mental health plan. Meanwhile, the negative factors affecting our future originated from the excessive control by national health insurance as well as our short capacity for social or general mental health needs. Second, we estimated the needs from future changes that might affect modern psychiatry. The future changes force us to prepare ourselves to be more competent in fulfillment of customer oriented positive mental health needs. Further, greater competency is needed in application of neurobehavioral knowledge to the clinical field. In addition, development of dedicated leadership and partnership for accomplishment of social and community based projects is also needed. In conclusion, the Korean Neuropsychiatric Association, for organizational integration of the profession, must develop a strategic plan for achievement of the ideal goal. In the first step, from 2014 to 2019, we need to develop the vision, mission, strategy and framework of our organization. And, the mission should be carried out by several task forces. Consecutively, achievements of the task force should be applied to the organizational performance. In the second step, from 2020 to 2029, full time employment of a psychiatrist for the function of executive secretary should be established. In the third step, from 2029, we need to formally participate in the national project and community program by establishment of a full time organization for the major strategic area. The suggestions could be realized by the communication and commitment of the psychiatric organization. J Korean Neuropsychiatr Assoc 2014;53(2):75-86 KEY WORDSZZ Future Korean Neuropsychiatric Association Communication Commitment. 서 론 Copyright 2014 Korean Neuropsychiatric Association 75
J Korean Neuropsychiatr Assoc 2014;53(2):75-86 본론 정신건강의학과의환경변화 미래변화의예측고령화시대에따른정신보건서비스변화의필요성 76
정신건강의학과의미래 HK Lee, et al. - 정보통신기술의발달로인한가상의정신보건사회도래 - - 세계보건기구의종합적정신보건행동계획 2013~2020 16) www.knpa.or.kr 77
J Korean Neuropsychiatr Assoc 2014;53(2):75-86 Lancet의 global mental health - 국내외타학회벤치마킹 Disease or injury DALYs millions) Percent of total DALYs 1. Lower respiratory infections 94.5 6.2 2. Diarrhoeal diseases 72.8 4.8 3. Unipolar depressive disorders 65.5 4.3 4. Ischaemic heart disease 62.6 4.1 5. HIV/AIDS 58.5 3.8 6. Cerebrovascular disease 46.6 3.1 7. Prematurity and low birth weight 44.3 2.9 8. Birth asphyxia and birth trauma 41.7 2.7 9. Roadtraffic accidents 41.2 2.7 10. Neonatal infections and other 40.4 2.7 11. Tuberculosis 34.2 2.2 12. Malaria 34.0 2.2 13. COPD 30.2 2.0 14. Refractive errors 27.7 1.8 15. Hearing loss, adult onset 27.4 1.8 16. Congenital anomalies 25.3 1.7 17. Alcohol use disorders 23.7 1.6 18. Violence 21.7 1.4 19. Diabetes mellitus 19.7 1.3 20. Self-inflicted injuries 19.6 1.3 Fig. 1. Leading causes of burden of disease (DALYs). 23,24) This picture was received a citation permission from the author. The original picture was in the 2011 epidemiological survey of mental disorders in Korea and Global burden of disease 2004. 78
정신건강의학과의미래 HK Lee, et al. - 대한응급의학회 26) 2004 Disease or injury Lower respiratory infrctions AS % of total DALYs 6.2 Rank 1 Rank 1 As % of total DALYs 6.2 2030 Disease or injury Unipolar depressive disorders Diarrhoeal diseases 4.8 2 2 5.5 Ischaemic heart disease Unipolar depressive disorders 4.3 3 3 4.9 Road traffic accidents Ischaemic heart disease 4.1 4 4 4.3 Cerebrovascular disease HIV/AIDS 3.8 5 5 3.8 COPD Cerebrovascular disease 3.1 6 6 3.2 Lower respiratory infections Prematurity and low birth weight 2.9 7 7 2.9 Hearing loss, adult onset Birth asphyxia and birth trauma Road traffic accidents Neonatal infections and other COPD Refractive errors Hearing loss, adult onset Diabetes mellitus 2.7 2.7 2.7 2.0 1.8 1.8 1.3 8 9 10 13 14 15 19 8 9 10 11 12 15 18 2.7 2.5 2.3 1.9 1.9 1.9 1.6 Refractived errors HIV/AIDS Diabetes mellitus Neonatal infections and other Prematurity and low birth weight Birth asphyxia and birth trauma Diarrhoeal diseases Fig. 2. Changes in the leading cause of DALYs globally from 2004 to 2030. 23,24) This picture was received a citation permission from the author. The original picture was in the 2011 epidemiological survey of mental disorders in Korea and Global burden of disease 2004. www.knpa.or.kr 79
J Korean Neuropsychiatr Assoc 2014;53(2):75-86 - 대한의학회 27) 미국정신과학회 (American Psychiatry Association, APA) 80
정신건강의학과의미래 HK Lee, et al. www.knpa.or.kr 81 - -
J Korean Neuropsychiatr Assoc 2014;53(2):75-86 - 미국신경과학회 (American Academy of Neurology, AAN) Table 1. The role and function of APF and APIRE APF APIRE stigma Performance-in-Practice PIP DSM-5: Diagnostic and Statistical Manual of Mental Disorders-5 Judges Leadership Initiatives APF : American Psychiatric Foundation, APIRE : American Psychiatric Institute for Research and Education 82
정신건강의학과의미래 HK Lee, et al. 호주뉴질랜드정신의학회 (The Royal Australian & New Zealand College of Psychiatrist, RANZCP) - 결론 www.knpa.or.kr 83
J Korean Neuropsychiatr Assoc 2014;53(2):75-86 - 성숙 성숙과발전 2029 도전 미래준비선언 2014 도전성과의확인 2019 국가정책참여확대 집단적연구과제참여확대 정신건강증진서비스세팅정착과확대 사무국상근조직구축 전략사업일상수행조직구축운영 국가정책공식파트너 국책연구과제연구개발의조직적수행 다양한임상서비스체계유지지원 지역사회리더로서정체성구축및확대 각영역별특화, 분화된일상조직구축 비전, 미션, 전략수립 범정신과합의 범사회적검증 전략사업의시행조직의시험적운영 성과관리와평가및조정 Fig. 3. The roadmap to the successful future of the psychiatric professional. 84
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