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Article(id=1311350509177496074, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311350193946194882, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202603373, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1774368000000, receivedDateStr=2026-03-25, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1790579925101, onlineDateStr=2026-09-28, pubDate=1786291200000, pubDateStr=2026-08-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1790579925101, onlineIssueDateStr=2026-09-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1790579925101, creator=13701087609, updateTime=1790579925101, updator=13701087609, issue=Issue{id=1311350193946194882, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='15', pageStart='2689', pageEnd='2880', issueExtLink='null', onlineDate='null', pubDate='1786291200000', pubDateStr='2026-08-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1790579849945, creator='13701087609', updateTime=1790588319569, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1311385718195315029, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311350193946194882, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1311385718195315030, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311350193946194882, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2820, endPage=2825, ext={EN=ArticleExt(id=1311350509395599883, articleId=1311350509177496074, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Evolutionary path of China’s mental health policies based on a three-stage independent latent dirichlet allocation approach, columnId=1228016567846367388, journalTitle=Modern Preventive Medicine, columnName=Health Policy and Management, runingTitle=null, highlight=null, articleAbstract=
Objective

To delineate the evolutionary trajectory of China’s mental health policies from 2001 to 2025 and to further explore the underlying driving forces behind this evolution.

Methods

Taking 298 policy documents as the research object, a “three-stage independent latent Dirichlet allocation (LDA) + cosine similarity + Sankey diagram” analytical framework was constructed to identify the key focus areas and evolutionary pathways of mental health work across three stages, combined with a literature review to analyze the driving factors of policy change.

Results

A total of 7, 6, and 4 latent topics were extracted from the three stages, respectively. The policies exhibited a transition from system exploration to legal standardization and then to psychological services. The driving forces behind policy changes primarily stemmed from multiple dimensions, including resource allocation, institutional changes, public events, and social demands.

Conclusion

Over the past 25 years, China’s mental health policy has undergone a paradigm shift from disease treatment to social psychological services. Resource allocation (e.g., the 686 Program, professional institution construction) directly gave rise to early policy themes. Major institutional events (the enactment of the Mental Health Law, the elevation of mental health to a national strategy)promoted the formation of legal standardization and social psychological service themes. Public events (SARS, the Wenchuan earthquake)catalyzed the transformation of service models. Changes in social demands (the shift from focusing on the management and control of severe mental disorders to the promotion of mental health for the entire population) constituted the most fundamental driving force.

, authors=Yu-wen WEI, Shu-ying MAO, Ze-wei CHEN, Lin YUE, Meng-rong ZHU, authorsList=Yu-wen WEI, Shu-ying MAO, Ze-wei CHEN, Lin YUE, Meng-rong ZHU, authorCompany=null, correspAuthors=Meng-rong ZHU, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1311350510628725268, articleId=1311350509177496074, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=基于三阶段独立潜在狄利克雷分配模型的中国精神卫生政策的演化路径研究, columnId=1228016568014139551, journalTitle=现代预防医学, columnName=卫生政策与管理, runingTitle=null, highlight=null, articleAbstract=
目的

分析2001—2025年我国精神卫生政策的演化路径，并进一步揭示其变迁背后的深层驱动力。

方法

以298份政策文本为研究对象，构建“三阶段独立潜在狄利克雷分配（latent Dirichlet allocation,LDA）模型+余弦相似度+桑基图”的研究框架，分析三个阶段精神卫生工作的关注重点及演化路径，并结合文献研究法分析政策变迁的驱动因素。

结果

三个阶段分别挖掘出7、6和4个潜在主题，政策呈现从体系探索到法治规范再到心理服务的演化路径。政策变迁的驱动力主要来自资源配置、制度变迁、公共事件与社会需求等多个维度。

结论

过去二十五年，我国精神卫生政策经历了从疾病治疗到社会心理服务的范式转移。资源配置（如686项目、专业机构建设）直接催生了早期政策主题；重大制度事件（《精神卫生法》出台、心理健康上升为国家战略）推动了法治规范、社会心理服务主题的形成；公共事件（非典、汶川地震）催化了服务模式转型；社会需求变化（从重性精神疾病管控转向全民心理健康促进）构成最根本的牵引力量。

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魏玉文（1999—），女，硕士在读，研究方向：卫生政策与管理

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朱梦蓉，E-mail:
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魏玉文（1999—），女，硕士在读，研究方向：卫生政策与管理

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The historical evolution of China's current mental health system[J]. China Market, 2011, (24): 57-60.(In Chinese), articleTitle=The historical evolution of China's current mental health system, refAbstract=null)], funds=[Fund(id=1311350517155062345, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, awardId=2023WJW-YL01, language=CN, fundingSource=四川省卫健委项目“四川精神卫生地方立法项目研究”(2023WJW-YL01), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1311350512331612693, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, xref=null, ext=[AuthorCompanyExt(id=1311350512340001302, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, companyId=1311350512331612693, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=West China School of Public Health / West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1311350512348389911, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, companyId=1311350512331612693, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=四川大学华西公共卫生学院/华西第四医院，四川 成都 610041)])], figs=[ArticleFig(id=1311350514470707771, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, language=EN, label=Figure 1, caption= Perplexity curve, figureFileSmall=uw0YgpOw8pzOH3ZjZoDuDg==, figureFileBig=BON9rm2GHZOl5YK9pE3CYg==, tableContent=null), ArticleFig(id=1311350514533622332, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, language=CN, label=图1, caption=困惑度曲线, figureFileSmall=uw0YgpOw8pzOH3ZjZoDuDg==, figureFileBig=BON9rm2GHZOl5YK9pE3CYg==, tableContent=null), ArticleFig(id=1311350514726560317, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, language=EN, label=Figure 2, caption=pyLDAvis visualization, figureFileSmall=i/gv3/NAXW9Op25eopXLAA==, figureFileBig=vpDGAVxg8M0O+e5pF8H3dQ==, tableContent=null), ArticleFig(id=1311350514806252094, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, language=CN, label=图2, caption=pyLDAvis可视化, figureFileSmall=i/gv3/NAXW9Op25eopXLAA==, figureFileBig=vpDGAVxg8M0O+e5pF8H3dQ==, tableContent=null), ArticleFig(id=1311350514873360959, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, language=EN, label=Figure 3, caption=Evolutionary trajectory of mental health policy, figureFileSmall=qA5YLZLEZrWnLkOUnSp05g==, figureFileBig=A8Gfp8Uefabp6ftFcGPFPA==, tableContent=null), ArticleFig(id=1311350514940469824, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, language=CN, label=图3, caption=精神卫生政策演化路径, figureFileSmall=qA5YLZLEZrWnLkOUnSp05g==, figureFileBig=A8Gfp8Uefabp6ftFcGPFPA==, tableContent=null), ArticleFig(id=1311350515007578689, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, language=EN, label=Table 1, caption=

Policy stage division (2001—2025)

, figureFileSmall=null, figureFileBig=null, tableContent=
阶段划分依据政策数量（份）
第一阶段：体系建设与法治化准备阶段（2001—2011年）以首次全国性的专项规划《中国精神卫生工作规划（2002—2010年）》出台为起点，以上海、北京、宁波、杭州、武汉等地方立法探索为特征，奠定了体系建设与法治准备的基础。106
第二阶段：法律奠基阶段（2012—2015年）以《中华人民共和国精神卫生法》颁布为标志，实现从政策推动向法治引领的历史性跃升，政策重心转向法律实施与制度规范。74
第三阶段：政策转型阶段（2016—2025年）以心理健康上升为国家战略为标志，政策导向从疾病视角转向健康视角，服务对象从重点人群拓展至全人群。118
), ArticleFig(id=1311350515070493250, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, language=CN, label=表1, caption=

政策阶段划分（2001—2025年）

, figureFileSmall=null, figureFileBig=null, tableContent=
阶段划分依据政策数量（份）
第一阶段：体系建设与法治化准备阶段（2001—2011年）以首次全国性的专项规划《中国精神卫生工作规划（2002—2010年）》出台为起点，以上海、北京、宁波、杭州、武汉等地方立法探索为特征，奠定了体系建设与法治准备的基础。106
第二阶段：法律奠基阶段（2012—2015年）以《中华人民共和国精神卫生法》颁布为标志，实现从政策推动向法治引领的历史性跃升，政策重心转向法律实施与制度规范。74
第三阶段：政策转型阶段（2016—2025年）以心理健康上升为国家战略为标志，政策导向从疾病视角转向健康视角，服务对象从重点人群拓展至全人群。118
), ArticleFig(id=1311350515141796419, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, language=EN, label=Table 2, caption=

Policy theme set

, figureFileSmall=null, figureFileBig=null, tableContent=
阶段主题特征词
体系建设与法治化准备阶段精神卫生信息系统建设与管理系统|信息|业务|管理员|数据|报告|规范|行政部门|国家|应急
重性精神疾病管理治疗项目|示范区|培训|免费|药物|评估|病人|社区|行政部门|经费
高校心理教育心理|学生|教育|辅导|学校|咨询|心理健康|发展|教师|能力
精神卫生工作体系建设心理|发展|服务|救助|网络|心理健康|生活|培训|政府|能力
精神卫生宣传教育宣传|活动|主题|心理|儿童|区县|社区|心理健康|疾病|时间
精神卫生调查评估调查|心理|方法|家庭|职业|精神分裂症|疾病|医生|原因|生活
精神卫生基础设施建设项目|投资|专科|中央|发展|精神科|医疗机构|设备|资金|规划
法律奠基阶段精神卫生宣传教育与公众倡导主题|老年人|心理|精神疾病|区县|形式|职工|计生委|时间|咨询
精神卫生法落实监督监督|检查|市级|计生|年度|区县|精防|计生委|报告|法律法规
重性精神疾病管理项目|考核|报告|信息|评估|辖区|自治区|文件|网络|督导
精神卫生服务规范心理咨询|执业|监护人|医学|民政|计生|医师|精神科|精神病|合法权益
精神卫生工作发展规划心理|救助|建设|医疗|计生|机制|政府|政策|精神科|能力
中小学心理教育制度|学生|学校|心理|教育|教师|设置|护理|建设|管理制度
政策转型阶段精神卫生服务能力提升医疗卫生|精防|专科|门诊|项目|儿童|社会福利|专科医院|考核|督导
精神疾病诊疗规范与医保支付保障检查|药物|病情|疫情|精神病|精神疾病|防控|监护人|住院|项目
精神障碍社区康复对象|残疾人|残联|融合|平台|资源|监护人|民政|社会工作者|民政部门
社会心理服务体系建设学生|救助|儿童|计生|教育|学校|残联|医疗卫生|心理援助|心理危机干预
), ArticleFig(id=1311350516744020548, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, language=CN, label=表2, caption=

政策主题集

, figureFileSmall=null, figureFileBig=null, tableContent=
阶段主题特征词
体系建设与法治化准备阶段精神卫生信息系统建设与管理系统|信息|业务|管理员|数据|报告|规范|行政部门|国家|应急
重性精神疾病管理治疗项目|示范区|培训|免费|药物|评估|病人|社区|行政部门|经费
高校心理教育心理|学生|教育|辅导|学校|咨询|心理健康|发展|教师|能力
精神卫生工作体系建设心理|发展|服务|救助|网络|心理健康|生活|培训|政府|能力
精神卫生宣传教育宣传|活动|主题|心理|儿童|区县|社区|心理健康|疾病|时间
精神卫生调查评估调查|心理|方法|家庭|职业|精神分裂症|疾病|医生|原因|生活
精神卫生基础设施建设项目|投资|专科|中央|发展|精神科|医疗机构|设备|资金|规划
法律奠基阶段精神卫生宣传教育与公众倡导主题|老年人|心理|精神疾病|区县|形式|职工|计生委|时间|咨询
精神卫生法落实监督监督|检查|市级|计生|年度|区县|精防|计生委|报告|法律法规
重性精神疾病管理项目|考核|报告|信息|评估|辖区|自治区|文件|网络|督导
精神卫生服务规范心理咨询|执业|监护人|医学|民政|计生|医师|精神科|精神病|合法权益
精神卫生工作发展规划心理|救助|建设|医疗|计生|机制|政府|政策|精神科|能力
中小学心理教育制度|学生|学校|心理|教育|教师|设置|护理|建设|管理制度
政策转型阶段精神卫生服务能力提升医疗卫生|精防|专科|门诊|项目|儿童|社会福利|专科医院|考核|督导
精神疾病诊疗规范与医保支付保障检查|药物|病情|疫情|精神病|精神疾病|防控|监护人|住院|项目
精神障碍社区康复对象|残疾人|残联|融合|平台|资源|监护人|民政|社会工作者|民政部门
社会心理服务体系建设学生|救助|儿童|计生|教育|学校|残联|医疗卫生|心理援助|心理危机干预
), ArticleFig(id=1311350516819518021, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, language=EN, label=Table 3, caption=

Stage 1-2 thematic similarity matrix

, figureFileSmall=null, figureFileBig=null, tableContent=
主题精神卫生宣传教育与公众倡导重性精神疾病管理精神卫生法落实监督精神卫生服务规范精神卫生工作发展规划中小学心理教育
精神卫生信息系统建设与管理0.0000.3070.0710.0330.0000.035
高校心理教育0.2470.0000.0650.0370.3600.529
精神卫生基础设施建设0.0000.2690.0120.0790.0930.036
重性精神疾病管理治疗0.0150.4390.0500.0600.0160.007
精神卫生工作体系建设0.1660.0360.0690.0180.5060.232
精神卫生调查评估0.0820.0000.0250.0400.1370.090
精神卫生宣传教育0.1920.0290.0310.0000.0770.057
), ArticleFig(id=1311350516895015494, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, language=CN, label=表3, caption=

阶段1～2主题相似度矩阵

, figureFileSmall=null, figureFileBig=null, tableContent=
主题精神卫生宣传教育与公众倡导重性精神疾病管理精神卫生法落实监督精神卫生服务规范精神卫生工作发展规划中小学心理教育
精神卫生信息系统建设与管理0.0000.3070.0710.0330.0000.035
高校心理教育0.2470.0000.0650.0370.3600.529
精神卫生基础设施建设0.0000.2690.0120.0790.0930.036
重性精神疾病管理治疗0.0150.4390.0500.0600.0160.007
精神卫生工作体系建设0.1660.0360.0690.0180.5060.232
精神卫生调查评估0.0820.0000.0250.0400.1370.090
精神卫生宣传教育0.1920.0290.0310.0000.0770.057
), ArticleFig(id=1311350516974707271, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, language=EN, label=Table 4, caption=

Stage 2-3 thematic similarity matrix

, figureFileSmall=null, figureFileBig=null, tableContent=
主题精神卫生服务能力提升精神疾病诊疗规范与医保支付保障精神障碍社区康复社会心理服务体系建设
精神卫生宣传教育与公众倡导0.0000.0530.0000.087
重性精神疾病管理0.2950.0680.0000.033
精神卫生法落实监督0.0330.4540.0000.110
精神卫生服务规范0.0890.0930.1040.209
精神卫生工作发展规划0.0720.0000.0620.317
中小学心理教育0.0000.0740.0000.258
), ArticleFig(id=1311350517054399048, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350509177496074, language=CN, label=表4, caption=

阶段2～3主题相似度矩阵

, figureFileSmall=null, figureFileBig=null, tableContent=
主题精神卫生服务能力提升精神疾病诊疗规范与医保支付保障精神障碍社区康复社会心理服务体系建设
精神卫生宣传教育与公众倡导0.0000.0530.0000.087
重性精神疾病管理0.2950.0680.0000.033
精神卫生法落实监督0.0330.4540.0000.110
精神卫生服务规范0.0890.0930.1040.209
精神卫生工作发展规划0.0720.0000.0620.317
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基于三阶段独立潜在狄利克雷分配模型的中国精神卫生政策的演化路径研究
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魏玉文 , 毛蜀莹 , 陈泽伟 , 岳琳 , 朱梦蓉
现代预防医学 | 卫生政策与管理 2026,53(15): 2820-2825
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现代预防医学 |卫生政策与管理 2026 , 53 (15) : 2820 -2825
基于三阶段独立潜在狄利克雷分配模型的中国精神卫生政策的演化路径研究
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魏玉文, 毛蜀莹, 陈泽伟, 岳琳, 朱梦蓉
作者信息
  • 四川大学华西公共卫生学院/华西第四医院，四川 成都 610041
通讯作者:
朱梦蓉，E-mail:
作者简介:

魏玉文（1999—），女，硕士在读，研究方向：卫生政策与管理

Evolutionary path of China’s mental health policies based on a three-stage independent latent dirichlet allocation approach
Yu-wen WEI, Shu-ying MAO, Ze-wei CHEN, Lin YUE, Meng-rong ZHU
Affiliations
  • West China School of Public Health / West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China
出版时间: 2026-08-10 doi: 10.20043/j.cnki.MPM.202603373
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摘要
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目的

分析2001—2025年我国精神卫生政策的演化路径，并进一步揭示其变迁背后的深层驱动力。

方法

以298份政策文本为研究对象，构建“三阶段独立潜在狄利克雷分配（latent Dirichlet allocation,LDA）模型+余弦相似度+桑基图”的研究框架，分析三个阶段精神卫生工作的关注重点及演化路径，并结合文献研究法分析政策变迁的驱动因素。

结果

三个阶段分别挖掘出7、6和4个潜在主题，政策呈现从体系探索到法治规范再到心理服务的演化路径。政策变迁的驱动力主要来自资源配置、制度变迁、公共事件与社会需求等多个维度。

结论

过去二十五年，我国精神卫生政策经历了从疾病治疗到社会心理服务的范式转移。资源配置（如686项目、专业机构建设）直接催生了早期政策主题；重大制度事件（《精神卫生法》出台、心理健康上升为国家战略）推动了法治规范、社会心理服务主题的形成；公共事件（非典、汶川地震）催化了服务模式转型；社会需求变化（从重性精神疾病管控转向全民心理健康促进）构成最根本的牵引力量。

精神卫生政策  /  LDA模型  /  主题相似度  /  主题演化  /  政策变迁
Objective

To delineate the evolutionary trajectory of China’s mental health policies from 2001 to 2025 and to further explore the underlying driving forces behind this evolution.

Methods

Taking 298 policy documents as the research object, a “three-stage independent latent Dirichlet allocation (LDA) + cosine similarity + Sankey diagram” analytical framework was constructed to identify the key focus areas and evolutionary pathways of mental health work across three stages, combined with a literature review to analyze the driving factors of policy change.

Results

A total of 7, 6, and 4 latent topics were extracted from the three stages, respectively. The policies exhibited a transition from system exploration to legal standardization and then to psychological services. The driving forces behind policy changes primarily stemmed from multiple dimensions, including resource allocation, institutional changes, public events, and social demands.

Conclusion

Over the past 25 years, China’s mental health policy has undergone a paradigm shift from disease treatment to social psychological services. Resource allocation (e.g., the 686 Program, professional institution construction) directly gave rise to early policy themes. Major institutional events (the enactment of the Mental Health Law, the elevation of mental health to a national strategy)promoted the formation of legal standardization and social psychological service themes. Public events (SARS, the Wenchuan earthquake)catalyzed the transformation of service models. Changes in social demands (the shift from focusing on the management and control of severe mental disorders to the promotion of mental health for the entire population) constituted the most fundamental driving force.

Mental health policy  /  LDA topic model  /  Topic similarity  /  Topic evolution  /  Policy change
魏玉文, 毛蜀莹, 陈泽伟, 岳琳, 朱梦蓉. 基于三阶段独立潜在狄利克雷分配模型的中国精神卫生政策的演化路径研究. 现代预防医学, 2026 , 53 (15) : 2820 -2825 . DOI: 10.20043/j.cnki.MPM.202603373
Yu-wen WEI, Shu-ying MAO, Ze-wei CHEN, Lin YUE, Meng-rong ZHU. Evolutionary path of China’s mental health policies based on a three-stage independent latent dirichlet allocation approach[J]. Modern Preventive Medicine, 2026 , 53 (15) : 2820 -2825 . DOI: 10.20043/j.cnki.MPM.202603373
正文
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精神卫生政策是精神卫生服务体系建设的制度基础，亦是卫生行政部门实现精神卫生目标的关键工具[1]。我国精神卫生政策经历了从疾病治疗到社会心理服务的范式转移，其演进脉络与内在驱动力亟待系统揭示。目前，精神卫生政策研究以定性方法为主，定量研究多采用政策工具分析、政策建模一致性（policy modeling consistency，PMC）指数模型及社会网络分析等，应用潜在狄利克雷分配（latent Dirichlet allocation,LDA）模型进行文本挖掘的研究相对有限。研究内容侧重于政策发展脉络梳理、外部特征揭示与政策评估等，对政策主题的量化提取、演化路径的动态刻画以及演进因素探讨相对不足。精神卫生政策文本具有高维特征，大量专业术语易影响聚类效果，需进行语义解析[2]。LDA模型具备降维能力，适用于长文本处理，可无监督提取潜在语义信息，且建模工具和流程相对成熟，是主题挖掘的重要方法[3]。然而，LDA无法直接识别主题间的关联，也难以动态追踪主题随时间的演变过程[3]。余弦相似度可弥补这一局限，通过计算相邻阶段主题相似度，判断主题继承、整合或新主题涌现。因此，本研究基于LDA模型挖掘2001—2025年间的政策主题，通过余弦相似度量化相邻阶段主题关联强度，并借助桑基图可视化演进路径。进而从资源配置、制度变迁、公共事件与社会需求四个维度剖析政策演变的深层驱动力，以期为理解我国精神卫生政策的演化逻辑提供新视角，并为政策优化提供参考依据。
1　资料与方法
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1.1　资料来源
本研究以“精神卫生”“精神疾病”“精神障碍”“心理健康”为关键词，在北大法宝、北大法意及政府门户网站中进行检索。政策文本的纳入标准如下：（1）发文主体为国家层面或省级层面（不含港澳台地区）；（2）政策文本公开发布且现行有效；（3）文本类型包括法律法规、规划、意见、办法、通知等规范性文件；（4）发布时间起止范围为2001—2025年。依据上述检索策略与纳入标准，共获得298份有效政策文本，其中国家层面政策69篇，省级层面政策229篇。
1.2　研究方法
1.2.1　窗口划分
通过对这一时期的政策脉络进行大致梳理，以重大事件、标志性政策出台及重大战略调整为关键节点并结合专业知识将研究期划分为三个阶段。
1.2.2　LDA模型
LDA模型由哥伦比亚大学教授David M.Blei[4]于2003年首次提出，是一种基于概率的三层贝叶斯模型（文档-主题-词汇），用于发现文本数据中的隐藏主题[5]。本研究基于LDA模型对三阶段政策文本分别进行主题聚类分析。具体步骤如下：第一步，基于Python中的Jieba库对政策文本进行分词和去停用词；第二步，通过词袋模型（bag-of-wordsmodel）方式构建词典，将分词后的文本转化为模型容易识别的向量模式；第三步，设定LDA模型的超参数α和β为经验值，并通过困惑度（perplexity）曲线与pyLDAvis可视化工具综合确定各阶段的最优主题数K。最后，利用Python的Scikit-learn库训练LDA模型，得到“文档-主题”概率分布和“主题-关键词”概率分布。
1.2.3　余弦相似度（cosine similarity）
余弦相似度通过测量两个向量在空间中的夹角余弦值来判断其相似性[6]。两个向量的方向越一致，夹角越小，余弦值越接近1，表示它们越相似；反之，夹角越大，余弦值越接近0，表示相似度越低[7]。其计算公式为：
式中，分子为两向量的内积，分母为各自的模长（也称欧几里得范数）[8]。余弦相似度具有计算效率高、对文本长度不敏感、结果可解释性强等优势[9]，已被广泛应用于主题演化分析。本研究运用Python3.12软件计算相邻阶段主题的余弦相似度，并基于构建的相似度矩阵绘制桑基图（将连线阈值设置为0.1，过滤弱连接），可视化政策演化路径。
2　结果
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2.1　政策阶段划分
2001—2025年我国精神卫生政策发展划分为三个阶段，各阶段的划分依据与政策文本数量见表1。
2.2　政策主题聚类分析
2.2.1　最优主题数确定
困惑度用于衡量模型的预测能力，困惑度越低，模型对样本的预测能力则越强[10]。以体系建设与法治化准备阶段为例，根据困惑度曲线可知，当主题数增加时，困惑度先急剧下降，后趋于平缓，见图1。依据折肘法判断[11]，主题数K=7时，模型困惑度出现拐点，且变化趋势趋于平缓，可初步确定最优主题数为7。再结合pyLDAvis可视化结果，当主题数为7时，各主题之间无交集，主题聚类效果好，因此确定最优主题数K=7，见图2。同理可得，法律奠基阶段的最优主题数K=6，政策转型阶段的最优主题数K=4。
2.2.2　主题提取与命名
对三个阶段的政策进行独立LDA建模分析，提取各主题下概率最高的10个特征词，结合特征词、政策分布及先验知识进行主题命名，结果见表2。
2.3　政策演化路径分析
2.3.1　主题相似度
不同主题之间的关联强度，可通过计算它们在相邻发展阶段上的余弦相似度来衡量。第一阶段与第二阶段的主题相似度矩阵见表3，第二阶段与第三阶段的主题相似度矩阵见表4。
2.3.2　政策演化路径
基于相似度矩阵，运用Python中的plotly库，将我国精神卫生政策演化路径绘制成桑基图，见图3，图中左侧节点代表第一阶段主题，中间节点代表第二阶段主题，右侧节点代表第三阶段主题，连线的粗细表示相似度大小，直观展示了主题的继承、分化与新生。
2.3.3　 演化路径解读
（1）第一阶段→第二阶段：从分散探索向法治规范演进 “精神卫生工作体系建设”与“精神卫生工作发展规划”呈现明显继承关系（相似度0.51），体现了两阶段政策导向的延续性；同时，前一阶段分散的三个主题（疾病管理、信息平台、硬件建设）整合为一个系统化主题（相似度0.44、0.31、0.27），体现了从多元探索向集约化管理的过渡；“精神卫生法落实监督”“精神卫生服务规范”两个全新主题（与前一阶段各主题相似度均低于0.1）的出现，标志着精神卫生工作从规划指导转向具体法治规范。上述特征共同反映了该时期政策从分散探索向法治规范的演进。
（2）第二阶段→第三阶段：从疾病治疗向社会心理服务转型 多个既有主题（发展规划、心理教育、服务规范）汇聚至社会心理服务体系建设主题（相似度0.32、0.26、0.21），表明政策导向从疾病防治转向全民心理健康促进；“重性精神疾病管理”与“精神卫生服务能力提升”高度关联（相似度0.30），说明严重精神障碍治疗已从重点攻坚任务融入常规服务提质增效；法律监督主题与诊疗保障主题关联显著（相似度0.45），反映法治建设推动了服务保障机制的完善；“精神障碍社区康复”的崛起，标志着服务模式从以医院为中心向以社区为中心转变。上述特征共同反映了该时期政策从疾病治疗向社会心理服务的范式转移。
3　讨论
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我国精神卫生政策经历了从分散探索到法治规范再到心理服务的演化路径。第一阶段（2001—2011年）以体系建设与初步探索为主，政策关键词集中于规划、机构、重性精神疾病与地方立法，体现从零散探索向系统规划、从地方实践向国家立法的转变；第二阶段（2012—2015年）以法治引领与制度奠基为核心，关键词涵盖法律、监督、规范与重精管理，实现从政策推动向法治引领的跃升；第三阶段（2016—2025年）进入政策转型期，关键词聚焦能力提升、社会心理、社区康复与诊疗保障，政策视角从疾病干预转向全民心理健康促进，服务对象由重点人群扩展至全人群。上述演化路径揭示了政策议题随社会需求与制度完善不断深化的内在逻辑。进一步分析发现，政策变迁的驱动力主要来自资源配置、制度变迁、公共事件与社会需求四个维度。
3.1　资源投入对早期政策主题的催生作用
2004年“重性精神疾病管理治疗项目”获批中央经费686万元；2008年国家首次大规模投资精神卫生专业机构硬件升级；2009年重性精神疾病管理被纳入九大类公共卫生服务项目，随访服务费用由政府支付[12]；2011年“国家重性精神疾病基本数据收集分析系统”正式上线，实现全国重性精神疾病病例的网络直报与数据集中管理[13]。上述资源投入共同塑造了第一阶段的政策主题框架，直接催生了“重精管理”“机构建设”“信息系统建设”等主题。基于此，未来应持续优化资源配置，巩固早期建设成果，继续推进精神卫生服务下沉，补齐县域短板，特别是农村和欠发达地区的基础设施与人才队伍建设。
3.2　重大制度事件的强制推动作用
（1）2012年10月，《中华人民共和国精神卫生法》正式颁布，标志着我国精神卫生工作结束了长期主要依靠政策和行政文件推动的历史，进入了有专门法律可依的新时代[14]。这一事件直接催生了“精神卫生法落实监督”“精神卫生服务规范”两个新主题（与第一阶段各主题相似度均低于0.1）。（2）2016年8月，习总书记在全国卫生与健康大会上对心理健康工作作出指示；同年10月，《“健康中国2030”规划纲要》将完善心理健康服务列为重点任务[13]。随后，原国家卫计委联合21部门印发《关于加强心理健康服务的指导意见》，将心理健康定位为重大公共卫生问题和社会问题[15]。2017年，十九大报告提出将社会心理服务纳入社会治理体系[15]。至此，心理健康上升为国家战略，推动第三阶段政策导向从疾病视角转向健康视角，形成“社会心理服务体系建设”这一主题。
3.3　重大公共事件的催化作用
（1）2003年非典疫情防治经验促使中央加强公共卫生建设，精神卫生借此获批“重性精神疾病管理治疗项目”（686项目），精神卫生工作正式进入国家公共卫生改革范畴[12]。686项目是我国精神卫生服务模式转型的关键起点，其核心在于推动服务向社区延伸[16]。该项目积累的实践经验为我国精神卫生政策的制定奠定了重要基础[17]。2017年，民政部等四部委印发《关于加快精神障碍社区康复服务发展的意见》；2022年，四部委再次发文，启动为期三年的“精康融合行动”，精神障碍社区康复体系基本成型[18]。因此，第三阶段“精神障碍社区康复”主题的崛起是以非典防控为契机，686项目为起点，历经长达二十余年实践积累的结果。（2）2008年汶川地震有力推动精神疾病从医学问题转向重大公共卫生与突出社会问题，使国民意识到精神心理健康的重要性，促进了灾害医疗救援、精神卫生及灾后重建社会工作的发展[19]。这一事件为后续我国精神卫生政策导向由疾病治疗向社会心理服务转型奠定了基础。未来应健全突发公共事件心理危机干预机制，细化分级响应预案与操作标准，加强心理援助队伍专业能力建设，并推动12355、12356等心理援助热线与应急热线的联动。
3.4　社会需求的驱动作用
1958年首次全国精神卫生工作会议召开以来，我国精神卫生工作长期以重性精神疾病患者的收治为主[20]。随着社会变革推进，心理问题逐渐凸显，尽管重性精神疾病管治任务依然繁重，但关注大众心理健康逐步成为新的社会需求[12]。在此背景下，2002年原卫生部等四部委印发《中国精神卫生工作规划（2002—2010年）》，确立了提高精神疾病知晓率与治疗率两条主线。但在2015年之前，政策重心仍在重精患者的治疗与管控，“肇事肇祸”“维护社会稳定”成为高频表述[15]。这也解释了前两阶段主题中均包含“重性精神疾病管理”与“宣传教育”，且两阶段宏观规划保持延续。进入21世纪，随着经济高速增长，严重精神障碍引发的恶性事件比重下降，常见精神障碍与一般心理行为问题带来的社会代价日益突出，政策导向逐步从精神疾病管理治疗转向心理健康服务与促进[15]。这也是第二阶段宏观工作规划出现断流的深层原因。当前政策导向已转向健康促进，未来应加大心理健康知识科普力度，提高公众对心理问题的识别能力和主动求助意愿，提升公众心理健康素养，推动被动治疗向主动促进转变。
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  • 四川省卫健委项目“四川精神卫生地方立法项目研究”(2023WJW-YL01)
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2026年第53卷第15期
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doi: 10.20043/j.cnki.MPM.202603373
  • 接收时间：2026-03-25
  • 首发时间：2026-09-28
  • 出版时间：2026-08-10
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  • 收稿日期：2026-03-25
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四川省卫健委项目“四川精神卫生地方立法项目研究”(2023WJW-YL01)
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    四川大学华西公共卫生学院/华西第四医院，四川 成都 610041

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2种不同金属材料的力学参数
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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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