关键词: 严重精神障碍发病报告制度, 卫生政策, 精神障碍, 民法典, 隐私权

Abstract: Background　Mental health is a major national public health issue.To actively promote the development of mental health services to safeguard the health rights and interests of citizens，we studied the implementation of serious mental illness reporting system in Beijing. Objective　To explore the implementation of severe mental illness reporting system in Beijing，and identify and analyze the problems，providing suggestions for the improvement of the system.Methods　From November 2018 to March 2019，we conducted a questionnaire survey regarding the implementation of severe mental illness reporting system with psychiatrists （assuming duties of delivering mental illness prevention and management services） selected by stratified random sampling methodfrom community health centers in Beijing's Chaoyang，Xicheng，Daxing and Fangshan Districts. Multiple response analysis and Chi-square goodness-of-fit test were performed using SPSS 25.0. Literature review was performed to find the latest provisions of the system and other scholars' research theories on related issues.Results　In total，214 cases who returned responsive questionnaires were included for final analysis. Among the respondents，54.7%（117/214）thought the system was very important，and 35.1%（75/214） thought it was relatively important，the proportion was 89.8%（192/214）in total.The proportions of respondents knowing the role played by the system in mental illness risk warning，surveillance and community-based management were not statistically different（χ2=0.073，P=0.964）.The implementation effectiveness of the system was rated as excellent，relatively good，and fair by 15.9%（34/214），50.9%（109/214），and 24.8%（53/214） of the respondents，respectively. But 84.1%（180/214） of the respondents thought that the system was not very sound and needed improvements. The proportions of respondents choosing different problems existing in the implementation of the system were statistically different（χ2=88.338，P<0.001）.The proportion of respondents choosing “Considering personal privacy，the patient does not want to let his illness be known by others" was the most〔83.2%（178/214）〕. The proportions of respondents choosing different improvement recommendations for the system were statistically different（χ2=13.579，P=0.019）. The proportion of respondents choosing "Standardizing information collection，registration，correction and summary system" was the most〔76.6%（164/214）〕，and choosing "Standardizing information sharing and patient privacy protection system" was the second〔67.3%（144/214）〕.Conclusion　The implementation of the system involves the privacy of patients，and has imperfections.It is suggested to revise the system to a more detailed and clearer level via modifying the Mental Health Law of the People's Republic of China in accordance with the legislative spirit of the Civil Code of the People's Republic of China，and to improve the reporting criteria，relevant information collection procedures，and error correction updating mechanisms，thereby protecting the basic rights of mental illness patients.

Key words: Severe Mental Disorder Incidence Reporting System, Health policy, Mental disorders, Civil Code, Privacy