美國鄉下的危機
The hidden crisis in rural American----Youtube
Cochise County is a rural stretch of land in Southeastern Arizona on the Mexican border. Its population of more than 123,000 people
is scattered almost 4 million acres.
Yet the county has only two private practice psychiatrists and not a single health facility.
Many rural counties in the US are having a hard time attracting doctors and mental professionals.
Cities and suburban areas can offer higher salaries.
The demand for psychiatritic services,since I arrived here has gone up,at least geographically,and I don't have any explanation for that.
(Doctor James Reed,psychiatrist,經神科醫師詹姆士)
I am seeing far more difficult cases than I used to see when I first started here in 1993.
My receptionist told me that she turned down eight people for requesting new appointments to come and see me.
I could,I guess, accept patients and say,"Come and see me in three or four months."
It's just too much to do. I probably have well over 350 patients in my casefiles.
Once I did the math,and talking with Doctor Sullivan,who's the other psychiatrist here,and between us,
We cover an area about the size of the state of Israel.
Despite our best efforts,we havn't been able to arrtact psychiatrists here.
There are many jobs being offered at USD200,000 to 300,000 a year working for a larger institution and that's certainly
more attractive to young doctors.
There is just an overall increasing demand for mental health services across the board and we can't keep up,just the two of us here.
911 calls in this area often involve people with mental health issues.
In June 2019,the local hospital hired a psychiatrist for patient in acute mental health crisis. But without access to long-term care,
many mentally ill residents end up in jail.
(Mark Dannels,Cochise County Sheriff,亞歷桑那州 柯奇鎮警長 馬克)
We got a little over 6,200 square miles of policing that we do here in the county. But overall ,it's a very vast county.
We did a snapshot here a few months back,of what it looks like when it come to mental house in my jail.
On that day,67% of the people in the jail ,which houses up to 300 people, were either pre-diagnoised or currently diagnoised,
with some kind of mental health disorder. I consider it an epicdemic in our county with lack of resources in rural counties.
(doctor James詹姆士醫生)
Our problem is funding,where do we get the funds to help the people that are out,and see that they get the bottom-up they need.
When decisions are made by congressional people or elected leaders or those that have decision-making power to change
mental health issues,it's all about urban America.
美國鄉下極度缺少精神科醫生,這是個很大的危機
上文敘述的是亞歷桑那州靠近墨西哥邊界的一個小鎮,該鎮123,000人口散居在很大一片土地上(地廣人稀),卻只有二位私人開業的精神科醫生
除此之外,沒有任何政府的醫療機構.光是一位精神科醫生就有高達350位病患,很多病人必須等三四個月才能排到看診,該鎮監獄裡的犯人
若以300人計算,高達67%的犯人都有經神上的問題,即便出獄後,社會對他們是不聞不問,放任他們自生自滅,沒人關心他們,有些人沒錢買保險,
舊病復發也無法去看醫生.有能力,能去想去看醫生的,要等上好幾個月才能排上.病患太多,遠遠超過這二位老醫生的負荷.雖然也曾經用盡所有努力,
希望能招募年輕的醫生來,但待遇和都市大型醫院相差太遠,根本招不到人
有些鎮民曾因經神病復發而撥打911求救,但因為鎮內沒有能力對病患施以長期照顧,這些鎮民最終只能死於獄中
這一切都是資金的問題,不單是亞歷桑那州的鄉下面臨這種危機,全美國各州的鄉下都一樣,只有冀望國會和有決策權的人能幫忙解決問題,
否則監獄只會愈蓋愈多
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