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Article(id=1241675636230640222, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241675628051755031, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202403499, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1711468800000, receivedDateStr=2024-03-27, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773968140895, onlineDateStr=2026-03-20, pubDate=1732464000000, pubDateStr=2024-11-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773968140895, onlineIssueDateStr=2026-03-20, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773968140895, creator=13701087609, updateTime=1773968140895, updator=13701087609, issue=Issue{id=1241675628051755031, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='22', pageStart='4033', pageEnd='4224', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773968138945, creator=13701087609, updateTime=1773968595676, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241677543783322543, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241675628051755031, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241677543783322544, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241675628051755031, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=4127, endPage=4132, ext={EN=ArticleExt(id=1241675636561990260, articleId=1241675636230640222, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Currentstatus of psychological treatment/counseling services in mental health medical institutions in mainland China in 2020, columnId=1228016572892119056, journalTitle=Modern Preventive Medicine, columnName=Primary Health Services, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand the current status of psychological therapy and counseling services in mental health institutions in mainland China so as to provide reference basis for developing subsequent relevant policies.

Methods

From May to June 2021, the National Mental Health Project Office conducted a survey using a self-designed questionnaire on 3 833 institutions providing psychological therapy and counseling services in 31 provinces in mainland China. The data was collected by the mental health project offices at all levels and submitted to the National Mental Health Project Office.

Results

2 214(57.76%) institutions provided psychological therapy or counseling services to both outpatient and inpatient patients. In 2020, we served over 21.86 million people, with outpatient patients slightly higher than inpatients. 2 685(70.05%) institutions charge fees, of which 1 206(44.92%) reported that their psychological therapy services are included in medical insurance. The fee standards for psychological therapy and counseling services vary greatly among different institutions, with psychological therapy services ranging from 5 yuan RMB to 3 000 yuan RMB per session and psychological counseling services ranging from 5 yuan RMB to 2 400 yuan RMB per session.

Conclusion

Residents have low utilization of psychological therapy or counseling services within medical institutions. The prices of psychological therapy or counseling services vary greatly, and the medical security needs to be deeply implemented.

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目的

了解中国内地精神卫生医疗机构中心理治疗及心理咨询服务情况，为后续制定相关政策提供参考依据。

方法

2021年5—6月，国家精神卫生项目办公室采用自编调查表对中国内地31个省（自治区、直辖市）所有提供心理治疗/咨询服务的3 833家机构进行资源调查；由各级精神卫生项目办公室收集汇总数据，上报国家精神卫生项目办公室。

结果

2 214（57.76%）家机构对门诊和住院患者均提供心理治疗/咨询服务；2020年服务2 186万余人次，门诊患者略高于住院患者；2 685（70.05%）家机构收费，其中1 206（44.92%）家报告其心理治疗服务纳入医保，不同机构的心理治疗/咨询服务收费标准差异较大，心理治疗在5元～3 000元/次，心理咨询在5元～2 400元/次。

结论

居民对医疗机构内心理治疗/咨询服务利用不高；心理治疗/咨询服务价格参差不齐，医疗保障需要贯彻落实。

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马宁，E-mail:
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陈润滋（1989—），女，硕士，助理研究员，研究方向：公共卫精神卫生、精神卫生政策

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陈润滋（1989—），女，硕士，助理研究员，研究方向：公共卫精神卫生、精神卫生政策

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陈润滋（1989—），女，硕士，助理研究员，研究方向：公共卫精神卫生、精神卫生政策

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Progress in mental health literacy［J］. Journal of Neuroscience and Mental Health, 2013, 13(1): 98-101. (In Chinese), articleTitle=Progress in mental health literacy, refAbstract=null), Reference(id=1241826544168014588, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, doi=null, pmid=null, pmcid=null, year=2018, volume=32, issue=2, pageStart=95, pageEnd=100, url=null, language=null, rfNumber=［13］, rfOrder=21, authorNames=王琰, 李小平, 范鑫, journalName=中国心理卫生杂志, refType=null, unstructuredReference=王琰，李小平，范鑫，等．上海市心理卫生机构开展心理健康服务的发展现状［J］．中国心理卫生杂志, 2018, 32(2): 95-100., articleTitle=上海市心理卫生机构开展心理健康服务的发展现状, refAbstract=null), Reference(id=1241826544331592450, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, doi=null, pmid=null, pmcid=null, year=2018, volume=32, issue=2, pageStart=95, pageEnd=100, url=null, language=null, rfNumber=［13］, rfOrder=22, authorNames=Wang Y, Li XP, Fan X, journalName=Chinese Mental Health Journal, refType=null, unstructuredReference=Wang Y, Li XP, Fan X, et al. Development of mental health service agencies in Shanghai［J］. Chinese Mental Health Journal, 2018, 32(2): 95-100. (In Chinese), articleTitle=Development of mental health service agencies in Shanghai, refAbstract=null), Reference(id=1241826544532919053, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, doi=null, pmid=null, pmcid=null, year=2022, volume=55, issue=6, pageStart=459, pageEnd=468, url=null, language=null, rfNumber=［14］, rfOrder=23, authorNames=马宁, 陈润滋, 张五芳, journalName=中华精神科杂志, refType=null, unstructuredReference=马宁，陈润滋，张五芳，等．2020年中国精神卫生资源状况分析［J］．中华精神科杂志, 2022, 55(6): 459-468., articleTitle=2020年中国精神卫生资源状况分析, refAbstract=null), Reference(id=1241826544742634262, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, doi=null, pmid=null, pmcid=null, year=2022, volume=55, issue=6, pageStart=459, pageEnd=468, url=null, language=null, rfNumber=［14］, rfOrder=24, authorNames=Ma N, Chen RZ, Zhang WF, journalName=Chinese Journal of Psychiatry, refType=null, unstructuredReference=Ma N, Chen RZ, Zhang WF, et al.The mental health resources in Chinese mainland by 2020［J］. 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(In Chinese), articleTitle=The mental health resources in Chinese mainland by 2020, refAbstract=null), Reference(id=1241826544885240611, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, doi=null, pmid=null, pmcid=null, year=2023, volume=54, issue=5, pageStart=985, pageEnd=993, url=null, language=null, rfNumber=［15］, rfOrder=25, authorNames=钟怀昌, 熊海, 周亚希, journalName=四川大学学报：医学版, refType=null, unstructuredReference=钟怀昌，熊海，周亚希，等．西藏地区城乡居民卫生服务利用影响因素对比分析［J］．四川大学学报：医学版, 2023, 54(5): 985-993., articleTitle=西藏地区城乡居民卫生服务利用影响因素对比分析, refAbstract=null), Reference(id=1241826545027846953, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, doi=null, pmid=null, pmcid=null, year=2023, volume=54, issue=5, pageStart=985, pageEnd=993, url=null, language=null, rfNumber=［15］, rfOrder=26, authorNames=Zhong HC, Xiong H, Zhou YX, journalName=Journal of Sichuan University: Medical Sciences, refType=null, unstructuredReference=Zhong HC, Xiong H, Zhou YX, et al. Comparative analysis of influencing factors of health service utilization among urban and rural residents in Tibet［J］. Journal of Sichuan University: Medical Sciences, 2023, 54(5): 985-993. 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Investigation and analysis of the working status and development situation of psychotherapy inpsychiatric hospitals［J］. Journal of Shanghai Jiaotong University: Medical Science, 2017, 37(12): 1682-1686. (In Chinese), articleTitle=Investigation and analysis of the working status and development situation of psychotherapy inpsychiatric hospitals, refAbstract=null), Reference(id=1241826546839786300, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, doi=null, pmid=null, pmcid=null, year=2022, volume=5, issue=1, pageStart=58, pageEnd=65, url=null, language=null, rfNumber=［17］, rfOrder=29, authorNames=景梦欣, 赵文清, 乔颖, journalName=心理学通讯, refType=null, unstructuredReference=景梦欣，赵文清，乔颖，等．中国社会心理咨询服务:基于需求和服务的现状分析［J］．心理学通讯, 2022, 5(1): 58-65., articleTitle=中国社会心理咨询服务:基于需求和服务的现状分析, refAbstract=null), Reference(id=1241826546957226819, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, doi=null, pmid=null, pmcid=null, year=2022, volume=5, issue=1, pageStart=58, pageEnd=65, url=null, language=null, rfNumber=［17］, rfOrder=30, authorNames=Jing MX, Zhao WQ, Qiao Y, journalName=Psychological Communications, refType=null, unstructuredReference=Jing MX, Zhao WQ, Qiao Y, et al. Social psychological counseling services in China:a current situation analysis based on demand and services［J］. Psychological Communications, 2022, 5(1): 58-65. (In Chinese), articleTitle=Social psychological counseling services in China:a current situation analysis based on demand and services, refAbstract=null), Reference(id=1241826547074667338, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, doi=null, pmid=null, pmcid=null, year=2009, volume=25, issue=5, pageStart=600, pageEnd=601, url=null, language=null, rfNumber=［18］, rfOrder=31, authorNames=曹伟燕, 王培承, 蔡伟芹, journalName=中国公共卫生, refType=null, unstructuredReference=曹伟燕，王培承，蔡伟芹，等．居民住院卫生服务利用影响因素决策树分析［J］．中国公共卫生, 2009, 25(5): 600-601., articleTitle=居民住院卫生服务利用影响因素决策树分析, refAbstract=null), Reference(id=1241826547225662287, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, doi=null, pmid=null, pmcid=null, year=2009, volume=25, issue=5, pageStart=600, pageEnd=601, url=null, language=null, rfNumber=［18］, rfOrder=32, authorNames=Cao WY, Wang PC, Cai WQ, journalName=Chinese Journal of Public Health, refType=null, unstructuredReference=Cao WY, Wang PC, Cai WQ, et al. Use of hospitalization services among residents of Weifang and its influencing factor［J］. Chinese Journal of Public Health, 2009, 25(5): 600-601. (In Chinese), articleTitle=Use of hospitalization services among residents of Weifang and its influencing factor, refAbstract=null), Reference(id=1241826547355685717, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, doi=null, pmid=null, pmcid=null, year=2023, volume=40, issue=12, pageStart=1, pageEnd=6, 10, url=null, language=null, rfNumber=［19］, rfOrder=33, authorNames=朱坤, 施文凯, 张璐莹, journalName=卫生经济研究, refType=null, unstructuredReference=朱坤，施文凯，张璐莹，等．高质量发展视角下的我国医疗保障制度分析［J］．卫生经济研究, 2023, 40(12): 1-6, 10., articleTitle=高质量发展视角下的我国医疗保障制度分析, refAbstract=null), Reference(id=1241826547468931932, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, doi=null, pmid=null, pmcid=null, year=2023, volume=40, issue=12, pageStart=1, pageEnd=6, 10, url=null, language=null, rfNumber=［19］, rfOrder=34, authorNames=Zhu K, Shi WK, Zhang LY, journalName=Health Economics Research, refType=null, unstructuredReference=Zhu K, Shi WK, Zhang LY, et al. Analysis of China’s medical security system from the perspective of high-quality development［J］. Health Economics Research, 2023, 40(12): 1-6, 10. (In Chinese), articleTitle=Analysis of China’s medical security system from the perspective of high-quality development, refAbstract=null), Reference(id=1241826547582178146, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［20］, rfOrder=35, authorNames=郑晋鸣, 曲一琳, journalName=光明日报, refType=null, unstructuredReference=郑晋鸣，曲一琳．专家呼吁心理咨询治疗应纳入医保［N］．光明日报，2007-05-12．, articleTitle=专家呼吁心理咨询治疗应纳入医保, refAbstract=null), Reference(id=1241826547724784485, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［20］, rfOrder=36, authorNames=Zheng JM, Qu YL, journalName=null, refType=null, unstructuredReference=Zheng JM, Qu YL. Experts call for psychological counseling treatment to be included in medical care［N］, 2007-05-12. (In Chinese), articleTitle=Experts call for psychological counseling treatment to be included in medical care, refAbstract=null), Reference(id=1241826547892556653, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［21］, rfOrder=37, authorNames=朱玥颖, journalName=健康时报, refType=null, unstructuredReference=朱玥颖．心理治疗纳入医保期待全国推广［N］．健康时报，2021-08-24（001）．, articleTitle=心理治疗纳入医保期待全国推广, refAbstract=null), Reference(id=1241826548005802867, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, doi=null, pmid=null, pmcid=null, year=null, volume=null, issue=null, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=［21］, rfOrder=38, authorNames=Zhu YY, journalName=Health Times, refType=null, unstructuredReference=Zhu YY. The inclusion of psychotherapy in medical insurance is expected to be promoted nationwide［N］. Health Times, 2021-08-24(001). (In Chinese), articleTitle=The inclusion of psychotherapy in medical insurance is expected to be promoted nationwide, refAbstract=null)], funds=[Fund(id=1241826539604611629, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, awardId=null, language=CN, fundingSource=国家卫生健康委员会疾病预防控制局委托项目, fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241826530733658198, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, xref=1., ext=[AuthorCompanyExt(id=1241826530737852503, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, companyId=1241826530733658198, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China), AuthorCompanyExt(id=1241826530746241112, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, companyId=1241826530733658198, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.北京大学第六医院　北京大学精神卫生研究所　国家卫生健康委员会精神卫生学重点实验室（北京大学）　国家精神心理疾病临床医学研究中心（北京大学第六医院），北京　100191)]), AuthorCompany(id=1241826530821738592, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, xref=2., ext=[AuthorCompanyExt(id=1241826530830127201, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, companyId=1241826530821738592, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.宁波市康宁医院)]), AuthorCompany(id=1241826530981122150, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, xref=3., ext=[AuthorCompanyExt(id=1241826530985316455, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, companyId=1241826530981122150, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=3.电子科技大学附属四川省人民医院心身医学中心　四川省精神医学中心)]), AuthorCompany(id=1241826531119534189, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, xref=4., ext=[AuthorCompanyExt(id=1241826531127922799, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, companyId=1241826531119534189, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=4.内蒙古自治区精神卫生中心　内蒙古自治区第三医院)])], figs=[ArticleFig(id=1241826538283405770, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, language=EN, label=Table 1, caption=

The volume of psychotherapy /counseling services provided by mental health medical institutions in mainland China in 2020

, figureFileSmall=null, figureFileBig=null, tableContent=
分类依据项目门诊患者住院患者合计
N总=21 860 688		构成比
（%）b
服务量（人次）
N门诊=11 305 804		构成比
（%）		服务量（人次）
N住院=10 554 884		构成比
（%）a
机构类别精神专科医院4 399 79031.709 480 45068.3013 880 24063.49
综合医院精神（心理）科6 552 35688.5884 471111.427 397 06733.84
独立精神（心理）诊所16 375100.0000.0016 3750.07
综合门诊部34 879100.0000.0034 8790.16
精神康复机构48 41543.0064 17657.00112 5910.52
基层医疗卫生机构253 98960.54165 54739.46419 5361.92
主管单位卫生健康9 576 59357.387 112 26842.6216 688 86176.34
其他政府部门515 11120.571 988 64079.432 503 75111.45
企业116 42073.1642 72026.841591400.73
民营1 097 68043.751 411 25656.252 508 93611.48
行政级别省级及以上2 734 79163.561 568 13536.444 302 92622.42
地市级4 538 24949.074 711 00650.939 249 25548.19
区县级2 818 66449.972 821 76750.035 640 43129.39
), ArticleFig(id=1241826538400846294, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, language=CN, label=表1, caption=

2020年中国内地精神卫生医疗机构心理治疗/咨询服务量

, figureFileSmall=null, figureFileBig=null, tableContent=
分类依据项目门诊患者住院患者合计
N总=21 860 688		构成比
（%）b
服务量（人次）
N门诊=11 305 804		构成比
（%）		服务量（人次）
N住院=10 554 884		构成比
（%）a
机构类别精神专科医院4 399 79031.709 480 45068.3013 880 24063.49
综合医院精神（心理）科6 552 35688.5884 471111.427 397 06733.84
独立精神（心理）诊所16 375100.0000.0016 3750.07
综合门诊部34 879100.0000.0034 8790.16
精神康复机构48 41543.0064 17657.00112 5910.52
基层医疗卫生机构253 98960.54165 54739.46419 5361.92
主管单位卫生健康9 576 59357.387 112 26842.6216 688 86176.34
其他政府部门515 11120.571 988 64079.432 503 75111.45
企业116 42073.1642 72026.841591400.73
民营1 097 68043.751 411 25656.252 508 93611.48
行政级别省级及以上2 734 79163.561 568 13536.444 302 92622.42
地市级4 538 24949.074 711 00650.939 249 25548.19
区县级2 818 66449.972 821 76750.035 640 43129.39
), ArticleFig(id=1241826538505703905, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, language=EN, label=Table 2, caption=

Psychotherapy /counseling services in the Eastern, Central, and Western regions in 2020

, figureFileSmall=null, figureFileBig=null, tableContent=
区域服务人次数每10万人口服务利用次数c
住院人次百分比a门诊人次百分比合计百分比b
东部4 440 94738.197 186 28061.8111 627 22753.191 685.15
中部1 644 07149.301 690 47750.703 334 54815.25792.77
西部4 469 86664.792 429 04735.216 898 91331.562 305.96
合计10 554 88448.2811 305 80451.7221 860 688100.001 550.65
), ArticleFig(id=1241826538618950123, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, language=CN, label=表2, caption=

2020年东中西部地区心理治疗/咨询服务情况

, figureFileSmall=null, figureFileBig=null, tableContent=
区域服务人次数每10万人口服务利用次数c
住院人次百分比a门诊人次百分比合计百分比b
东部4 440 94738.197 186 28061.8111 627 22753.191 685.15
中部1 644 07149.301 690 47750.703 334 54815.25792.77
西部4 469 86664.792 429 04735.216 898 91331.562 305.96
合计10 554 88448.2811 305 80451.7221 860 688100.001 550.65
), ArticleFig(id=1241826538761556475, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, language=EN, label=Table 3, caption=

Fees forpsychotherapy /counseling services in mental health medical institutions in mainland China in 2020

, figureFileSmall=null, figureFileBig=null, tableContent=
分类依据项目收费机构数不收费机构数合计
总数（家）占比（%）a总数（家）占比（%）
机构类别精神专科医院1 03575.4433724.561 372
综合医院精神（心理）科1 48571.1260328.882088
独立精神（心理）诊所1773.91626.0923
综合门诊部1758.621241.3829
精神康复机构2156.761643.2437
基层医疗卫生机构11038.7317461.27284
合计2 68570.051 14829.953 833
主管单位类别卫生健康1 83769.7979530.212 632
民政7776.242423.76101
公安250.00250.004
其他政府部门7588.241011.7685
企业5269.332330.6775
民营64268.5929431.41936
合计2 68570.051 14829.953 833
行政等级省级及以上25192.96197.04270
地市级65891.14648.86722
区县级1 08259.1374840.871 830
合计1 99170.5583129.452 822
), ArticleFig(id=1241826538912551429, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, language=CN, label=表3, caption=

2020年中国内地精神卫生医疗机构心理治疗/咨询服务收费情况

, figureFileSmall=null, figureFileBig=null, tableContent=
分类依据项目收费机构数不收费机构数合计
总数（家）占比（%）a总数（家）占比（%）
机构类别精神专科医院1 03575.4433724.561 372
综合医院精神（心理）科1 48571.1260328.882088
独立精神（心理）诊所1773.91626.0923
综合门诊部1758.621241.3829
精神康复机构2156.761643.2437
基层医疗卫生机构11038.7317461.27284
合计2 68570.051 14829.953 833
主管单位类别卫生健康1 83769.7979530.212 632
民政7776.242423.76101
公安250.00250.004
其他政府部门7588.241011.7685
企业5269.332330.6775
民营64268.5929431.41936
合计2 68570.051 14829.953 833
行政等级省级及以上25192.96197.04270
地市级65891.14648.86722
区县级1 08259.1374840.871 830
合计1 99170.5583129.452 822
), ArticleFig(id=1241826539046769164, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, language=EN, label=Table 4, caption=

Number of institutions withpsychotherapy services included in medical insurance in each province in 2020

, figureFileSmall=null, figureFileBig=null, tableContent=
省份未纳入医保已纳入医保/部分项目纳入医保总计纳保比例
（%）
北京市11687986.08
天津市9132259.09
河北省649015458.44
山西省38508856.82
内蒙古自治区24396361.90
辽宁省495210151.49
吉林省18325064.00
黑龙江省28295750.88
上海市19476671.21
江苏省11551204.17
浙江省14771544.55
安徽省40509055.56
福建省693724.17
江西省62107213.89
山东省12511223747.26
河南省5111917070.00
湖北省188910783.18
湖南省5586312.70
广东省1434618924.34
广西区42569857.14
海南省14163053.33
重庆市34346850.00
四川省829517753.67
贵州省3574216.67
云南省60107014.29
西藏区11250.00
陕西省67239025.56
甘肃省28315952.54
青海省25771.43
宁夏区13112445.83
新疆区18466471.88
总计1 4811 2042 68544.84
), ArticleFig(id=1241826539176792595, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241675636230640222, language=CN, label=表4, caption=

2020年各省心理治疗服务纳入医保的机构数量

, figureFileSmall=null, figureFileBig=null, tableContent=
省份未纳入医保已纳入医保/部分项目纳入医保总计纳保比例
（%）
北京市11687986.08
天津市9132259.09
河北省649015458.44
山西省38508856.82
内蒙古自治区24396361.90
辽宁省495210151.49
吉林省18325064.00
黑龙江省28295750.88
上海市19476671.21
江苏省11551204.17
浙江省14771544.55
安徽省40509055.56
福建省693724.17
江西省62107213.89
山东省12511223747.26
河南省5111917070.00
湖北省188910783.18
湖南省5586312.70
广东省1434618924.34
广西区42569857.14
海南省14163053.33
重庆市34346850.00
四川省829517753.67
贵州省3574216.67
云南省60107014.29
西藏区11250.00
陕西省67239025.56
甘肃省28315952.54
青海省25771.43
宁夏区13112445.83
新疆区18466471.88
总计1 4811 2042 68544.84
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2020年中国内地精神卫生医疗机构心理治疗/咨询服务现状
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陈润滋 1 , 马宁 1 , 王云锋 2 , 白羽 1 , 苏荣成 3 , 李紫聿 4 , 吴霞民 1 , 陆林 1
现代预防医学 | 基层卫生服务 2024,51(22): 4127-4132
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现代预防医学 | 基层卫生服务 2024, 51(22): 4127-4132
2020年中国内地精神卫生医疗机构心理治疗/咨询服务现状
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陈润滋1, 马宁1 , 王云锋2, 白羽1, 苏荣成3, 李紫聿4, 吴霞民1, 陆林1
作者信息
  • 1.北京大学第六医院　北京大学精神卫生研究所　国家卫生健康委员会精神卫生学重点实验室（北京大学）　国家精神心理疾病临床医学研究中心（北京大学第六医院），北京　100191
  • 2.宁波市康宁医院
  • 3.电子科技大学附属四川省人民医院心身医学中心　四川省精神医学中心
  • 4.内蒙古自治区精神卫生中心　内蒙古自治区第三医院

    • 陈润滋（1989—），女，硕士，助理研究员，研究方向：公共卫精神卫生、精神卫生政策

通讯作者:

马宁，E-mail:
Currentstatus of psychological treatment/counseling services in mental health medical institutions in mainland China in 2020
Run-zi CHEN1, Ning MA1 , Yun-feng WANG2, Yu BAI1, Rong-cheng SU3, Zi-yu LI4, Xia-min WU1, Lin LU1
Affiliations
  • Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
出版时间: 2024-11-25 doi: 10.20043/j.cnki.MPM.202403499
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摘要
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目的

了解中国内地精神卫生医疗机构中心理治疗及心理咨询服务情况，为后续制定相关政策提供参考依据。

方法

2021年5—6月，国家精神卫生项目办公室采用自编调查表对中国内地31个省（自治区、直辖市）所有提供心理治疗/咨询服务的3 833家机构进行资源调查；由各级精神卫生项目办公室收集汇总数据，上报国家精神卫生项目办公室。

结果

2 214（57.76%）家机构对门诊和住院患者均提供心理治疗/咨询服务；2020年服务2 186万余人次，门诊患者略高于住院患者；2 685（70.05%）家机构收费，其中1 206（44.92%）家报告其心理治疗服务纳入医保，不同机构的心理治疗/咨询服务收费标准差异较大，心理治疗在5元～3 000元/次，心理咨询在5元～2 400元/次。

结论

居民对医疗机构内心理治疗/咨询服务利用不高；心理治疗/咨询服务价格参差不齐，医疗保障需要贯彻落实。

精神卫生医疗机构  /  心理治疗  /  心理咨询  /  横断面调查
Objective

To understand the current status of psychological therapy and counseling services in mental health institutions in mainland China so as to provide reference basis for developing subsequent relevant policies.

Methods

From May to June 2021, the National Mental Health Project Office conducted a survey using a self-designed questionnaire on 3 833 institutions providing psychological therapy and counseling services in 31 provinces in mainland China. The data was collected by the mental health project offices at all levels and submitted to the National Mental Health Project Office.

Results

2 214(57.76%) institutions provided psychological therapy or counseling services to both outpatient and inpatient patients. In 2020, we served over 21.86 million people, with outpatient patients slightly higher than inpatients. 2 685(70.05%) institutions charge fees, of which 1 206(44.92%) reported that their psychological therapy services are included in medical insurance. The fee standards for psychological therapy and counseling services vary greatly among different institutions, with psychological therapy services ranging from 5 yuan RMB to 3 000 yuan RMB per session and psychological counseling services ranging from 5 yuan RMB to 2 400 yuan RMB per session.

Conclusion

Residents have low utilization of psychological therapy or counseling services within medical institutions. The prices of psychological therapy or counseling services vary greatly, and the medical security needs to be deeply implemented.

Mental health institutions  /  Psychotherapy  /  Psychological counseling  /  Cross-sectional survey
陈润滋, 马宁, 王云锋, 白羽, 苏荣成, 李紫聿, 吴霞民, 陆林. 2020年中国内地精神卫生医疗机构心理治疗/咨询服务现状. 现代预防医学, 2024 , 51 (22) : 4127 -4132 . DOI: 10.20043/j.cnki.MPM.202403499
Run-zi CHEN, Ning MA, Yun-feng WANG, Yu BAI, Rong-cheng SU, Zi-yu LI, Xia-min WU, Lin LU. Currentstatus of psychological treatment/counseling services in mental health medical institutions in mainland China in 2020[J]. Modern Preventive Medicine, 2024 , 51 (22) : 4127 -4132 . DOI: 10.20043/j.cnki.MPM.202403499
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近年来，心理健康工作越来越受到重视，2019年，健康中国行动推进委员会正式发布《健康中国行动（2019—2030年）》，将心理健康促进行动列为15项专项行动之一，明确要求精神卫生医疗机构要普及心理咨询和治疗技术在临床诊疗中的应用[1]。心理治疗与心理咨询作为心理健康服务的主要方式之一，有助于减轻疾病负担，促进家庭和谐，改善公众心理健康水平，构建良好的社会氛围[2]。心理治疗在医疗机构中开展，心理咨询主要在医疗机构、学校和社会机构中发展[3]。精神卫生医疗机构是心理治疗/咨询服务提供主体，目前对精神卫生医疗机构内心理治疗/咨询服务利用的相关研究较少，为全面掌握其开展情况，为制定相关政策提供数据基础和循证依据，2021年5—6月，国家精神卫生项目办公室开展了专项调查。
1　对象和方法
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1.1　对象
截至2020年底全国31个省（自治区、直辖市）所有提供精神障碍诊断治疗、心理治疗/咨询或精神康复服务的医疗卫生机构。
1.2　方法
国家精神卫生项目办公室编制调查表，内容包括：提供心理治疗/咨询服务类型，2020年服务量，收费及医保情况。
对所有调查人员进行培训。各级精神卫生项目办公室（以下简称项目办）协调辖区内相关医疗卫生机构填写调查表，录入数据库后逐级报送至上级项目办。各省级项目办负责将本省（自治区、直辖市）原始调查表、epidata数据库提交至国家项目办，最终汇总形成全国数据库。国家项目办对数据进行二次录入与逻辑校验等质控工作。
各省人口学数据来源于第七次人口普查数据[4]。东、中、西部地区的划分依据2021年中国卫生健康统计年鉴[5]。
1.3　统计分析
采用Excel 2010软件对精神卫生医疗机构内心理治疗/咨询服务利用情况（包括服务对象及服务量、收费及医保情况）进行描述性统计分析，对定量资料采用中位数和四分位数间距，对定性资料采用例数、人次数和构成比进行描述。
2　结果
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2.1　全国精神卫生医疗机构心理治疗/咨询服务利用情况
2020年，中国内地精神卫生医疗机构中有3 833家机构提供心理治疗/咨询服务，服务量为21 860 688人次，其中住院患者10 554 884人次（48.28%）；门诊患者11 305 804人次（51.72%）。按照就诊机构类型分，精神专科医院服务量为13 880 240人次，占比63.49%，其中住院患者9 480 450人次（68.30%）；综合医院服务量为7 397 067人次，占比33.84%，其中门诊患者6 552 356人次（88.58%）。按照主管单位类别分，卫生健康主管的精神卫生医疗机构提供的心理治疗/咨询服务量为16 688 861人次，占比76.34%。按照机构主管单位级别分，政府主管的提供心理治疗/咨询的机构中，地市级机构服务量最多，占比48.19%。详见表1。
2.2　东中西部精神卫生医疗机构心理治疗/咨询服务利用情况
从地域上看，东部省份精神卫生医疗机构的心理治疗/咨询服务总人次要远高于中部和西部地区，是中部地区的3.5倍，是西部地区的1.7倍，西部地区是中部地区的2.1倍。在服务住院和门诊患者方面，东中西部各有特点，东部地区门诊人次要远高于住院人次，中部地区二者相近，西部地区住院人次远高于门诊人次。每10万人口对心理治疗/咨询的利用情况为中部最低，西部最高。详见表2。
2.3　心理治疗/咨询服务收费情况
2 685家（70.05%）的机构心理治疗/咨询服务收费。综合门诊部、精神康复机构和基层医疗卫生机构中心理治疗/咨询不收费的机构比例均超过40%，其中，基层医疗卫生机构超过60%。企业主管的和民营精神卫生医疗机构中心理治疗/咨询不收费的机构占比均超过30%。县级机构中，不收费的机构占比为40.87%。详见表3。
调查数据显示，心理咨询收费标准最高2 400元/次，最低5元/次，中位收费标准为45元/次，四分位数间距为48；心理治疗收费标准最高3 000元/次，最低5元/次，中位收费标准为57.6元/次，四分位数间距为55。
2.4　心理治疗服务纳入医保情况
2 685家心理治疗/咨询服务收费的精神卫生医疗机构中，已将心理治疗或部分心理治疗项目纳入医保的有1 204家，占比44.84%。分省来看，北京、湖北纳入医保的机构比例均超过80%；福建、江苏和浙江纳入医保的机构比例不到10%；重庆、山东、广东有机构报告心理咨询已纳入医保报销。详见表4。
3　讨论与建议
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心理治疗可有效改善精神障碍患者的精神症状和心理状态，提高患者治疗满意度，对其生活质量产生积极影响[6-8]。临床上心理治疗最常见的对象是神经症等轻度精神障碍患者，也包括药物治疗同时需要配合心理治疗的严重精神障碍患者[3]。心理咨询对精神障碍的预防有重要作用，通过接受心理咨询，使存在心理问题或困扰的人获得专业帮助，防止心理问题演变为精神障碍[3]。心理咨询与心理治疗在理论基础、工作形式等方面有诸多重叠，因此有时并不区分。本次调查对心理治疗/咨询服务利用量的统计未将二者严格区分。
2022年世界精神卫生报告指出，全世界约有1/8的人患有精神障碍，在新冠疫情大流行的第1年，精神障碍患者中焦虑和抑郁发生率增加了25%以上[9]。2013年中国精神障碍流行病学调查显示，18岁以上人群精神障碍终生患病率为16.6%，其中焦虑障碍和心境障碍的终生患病率高居前两位[10]。据此估计，我国约有2亿人可能需要得到精神心理相关的治疗或支持。而2020年医疗机构内心理治疗/咨询服务量仅为2 000多万人次，按照平均每人接受10次治疗计算，约有200万人接受了医疗机构内的心理治疗/咨询。美国国家精神卫生研究所数据显示，2022年18岁及以上的人群中，患有任何一种精神疾病的约有5 940万，其中50.6%的人寻求了专业治疗[11]，其居民对精神卫生服务利用优于我国。我国尚有大量有潜在需求的人未到医疗机构就诊/咨询的主要原因一是部分有需求的人求助于社会上的心理服务机构，二是部分学生求助于学校的心理健康服务部门或人员，三是由于心理健康素养水平有限，影响了患者/求助者去专业机构寻求帮助[12]。
东、中、西部地区心理治疗/咨询服务量由高到低依次是东部地区、西部地区、中部地区。东部地区资源丰富，人口众多，人口密度大，服务可及性强，公众的就诊意识强，因此服务量最高。此外，东部地区门诊服务量是住院服务量的1.6倍，说明东部地区有更多有需要的人能主动去专业门诊寻求帮助，这也与既往研究一致[13]。而西部地区的服务量和每10万人口对心理治疗/咨询服务的利用要高于中部地区，这与既往的研究结果不同。西部地区资源薄弱、医疗服务可及性差[14]，公众就诊意识相对不高[15]、精神疾病污名和患者病耻感强，其对心理治疗/咨询服务的利用应低于中部地区。分析服务人员类型，西部地区心理治疗/咨询服务主要为住院患者提供，可能与医务人员可以根据病情需要及时提供服务有关。
此次调查显示，中国内地精神卫生医疗机构内心理治疗/咨询服务收费标准参差不齐，且中位收费标准远低于赵文清等人调查获得的心理治疗/咨询从业者的心理预期[16]。单次心理治疗/咨询过程通常需要50分钟，耗时久，而心理治疗/咨询师培养成本较高，职业支出较大[17]。过低的收费或不收费无法充分体现其劳动价值，导致其不愿从事该行业，或是一些优秀的心理治疗师/咨询师到社会机构中提供收费高昂的服务，不利于行业健康发展。基层医疗卫生机构、综合门诊部、企业或民营机构、县级机构中心理治疗/咨询服务不收费比例较高，可能由于能力有限，同等收费下公众更倾向更高级别的医疗机构，这类机构为吸引患者更多提供免费服务。长此以往，此类机构心理服务发展受限，影响质量和口碑，形成恶性循环。
医疗保障是卫生服务利用的直接影响因素[18]。医疗保障制度的有效实施能够增加居民的卫生服务利用。医保支付方式也能发挥规范医疗服务价格与医疗服务行为的杠杆作用[19]。目前全国心理治疗/咨询收费标准不统一，心理治疗单个疗程通常需要8~12次[17]，过高收费会导致一些患者中断治疗，不利于恢复。此次调查显示， 31省均将心理治疗纳入医保目录，但执行情况不同。近年来，多位专家呼吁将心理咨询纳入医保[20-21]，此前北京、深圳有一些探索，本次调查发现重庆、山东也有地区将心理咨询纳入医保，这将为心理咨询全面纳入医保做出有力探索。
针对本研究发现的问题，提出以下建议：一是加强精神心理知识宣传，尤其中西部地区，降低精神疾病污名，提升居民心理健康素养；二是建议利用医联体扩大心理治疗/咨询服务范围，可通过定点支援、在线心理服务平台等方式促进优质医疗服务下沉，增强服务可及性；三是借助互联网技术，通过在线培训、在线督导等形式提升基层能力水平，进而提高服务质量；四是相关部门应加强沟通，制定合理的收费标准，在充分体现心理治疗/咨询服务人员劳动价值的同时，提供居民可负担的服务；五是加大心理治疗保障力度，探索心理咨询的保障措施，降低费用负担。
本研究存在一定局限性，一是数据由各级精神卫生项目办收集，个别机构因行政管理要求未报告相关数据；二是在调查服务利用时未将心理咨询与心理治疗做区分。后续应进一步探讨。
基金
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  • 国家卫生健康委员会疾病预防控制局委托项目
文献
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2024年第51卷第22期
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doi: 10.20043/j.cnki.MPM.202403499
  • 接收时间：2024-03-27
  • 首发时间：2026-03-20
  • 出版时间：2024-11-25
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  • 收稿日期：2024-03-27
基金
国家卫生健康委员会疾病预防控制局委托项目
作者信息
    1.北京大学第六医院　北京大学精神卫生研究所　国家卫生健康委员会精神卫生学重点实验室（北京大学）　国家精神心理疾病临床医学研究中心（北京大学第六医院），北京　100191
    2.宁波市康宁医院
    3.电子科技大学附属四川省人民医院心身医学中心　四川省精神医学中心
    4.内蒙古自治区精神卫生中心　内蒙古自治区第三医院

通讯作者:

马宁，E-mail:
参考文献
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https://castjournals.cast.org.cn/joweb/xdyfyx/CN/10.20043/j.cnki.MPM.202403499
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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