心栖空间：澳大利亚青少年心理健康整合式照护模式

沈光银; 陈廼茜; 胡佳浪

心栖空间：澳大利亚青少年心理健康整合式照护模式

1.
华南师范大学教育科学学院，广东广州 510631
2.
剑桥大学教育学院，英国剑桥 CB2 8PQ

基金项目:

2023年度国家社会科学基金“十四五”规划教育学一般课题“盲生与明眼生数感特征的对比及干预研究” BBA230110

详细信息

作者简介:
沈光银，江苏南京人，华南师范大学教育科学学院教授

陈廼茜，江苏南京人，剑桥大学教育学院硕士研究生

胡佳浪，广东梅州人，华南师范大学教育科学学院硕士研究生

中图分类号: G459
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出版历程
- 收稿日期: 2026-06-10
- 网络出版日期: 2026-08-07
- 刊出日期: 2026-08-01

Headspace: An Integrated Care Model for Adolescent Mental Health in Australia

1.
School of Education, South China Normal University, Guangzhou, 510631, China
2.
Faculty of Education, University of Cambridge, Cambridge, CB2 8PQ, United Kingdom

摘要

摘要: 全球超过四分之一的人口年龄分布在10~24岁之间，心理健康问题和精神障碍是该年龄组人群致残的首要原因。澳大利亚心栖空间模式的建构，开启了全球青少年心理健康整合式照护的创新实践。该照护模式以心理健康素养理论、临床分期理论、整合式照护理论和青少年友好服务理论为基础，围绕“服务可及性”“服务覆盖广度”“服务深度与适应性”和“复杂需求响应”四个核心发展方向，构建了一个“分权制衡、标准统一、人本导向、多元协同”的现代公共服务治理范式，形成了一套能够提供高可及性、青少年友好型、一站式服务的心理健康照护体系，破解了传统精神卫生系统年龄分割、医疗化壁垒和碎片化服务的困境。随着《心栖空间国家青少年心理健康基金会战略计划（2025—2028年）》的推进，心栖空间将通过青少年家庭参与与行业引领、早期预防与干预、循证与整合式照护、人才队伍培养及原住民文化建设，迭代完善整合式照护系统，持续守护每一位青少年的心理健康和身心福祉。
- 澳大利亚 /
- 心栖空间 /
- 青少年心理健康 /
- 整合式照护 /
- 原住民文化建设 /
- 公共服务治理
Abstract: Individuals aged 10 to 24 account for more than a quarter of the global population, and mental health conditions represent the leading cause of disability within this age group. Australia's headspace model has spearheaded global innovations in integrated adolescent mental health care. Informed by theories of mental health literacy, clinical staging, integrated care and adolescent-friendly health services, the model centres on four core priorities: accessibility, coverage, depth and adaptability of services, and response to complex clinical and social needs. Embracing power decentralization, unified standards, human-centred principles and multi-stakeholder cooperation, this governance paradigm delivers a highly accessible, youth-oriented one-stop care model, overcoming age segregation, over-medicalization and service fragmentation inherent to traditional mental health services. Guided by the headspace National Youth Mental Health Foundation Strategic Plan (2025–2028), the programme will continue to enhance its integrated care system through family involvement, sector leadership, early preventive interventions, evidence-based care, professional workforce development and Indigenous cultural advancement, to sustainably preserve adolescents' overall physical and mental well-being.
- Australia /
- headspace /
- adolescent mental health /
- integrated care /
- indigenous cultural development /
- public service governance

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图 1 澳大利亚心栖空间治理体系

资料来源：KPMG, Social Policy Research Centre & batyr. Evaluation of the National headspace Program – Final Report. Australian Government Department of Health and Aged Care.（2022-10-17）[2026-06-01] https://www.health.gov.au/resources/publications/evaluation-of-the-national-headspace-program.

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表 1 澳大利亚心栖空间的实施框架

要素类型	具体要素	核心内容与功能
服务性要素	青少年参与	确保青少年在服务设计、运营和评估的全过程拥有知情权和决策权
	亲友参与	积极邀请青少年的家庭及亲友参与服务过程并提供支持
	社区意识	提高社区对青少年心理健康的认识，减少污名化，促进早期识别
	增强可及性	通过降低地理、时间、经济和社会障碍，确保服务易于获取
	早期干预	针对早期症状和问题提供及时的评估与支持，防止问题恶化
	适宜性护理	根据青少年的具体需求和问题的严重程度，提供匹配的、基于证据的护理
	循证实践	基于最新的研究证据和最佳实践指南提供照护服务
	四大核心服务	提供心理健康、生理与性健康、酒精及其他药物滥用、工作与学习支持的整合服务
	服务整合	打破不同服务部门和提供者之间的壁垒，提供连贯、协调的服务体验
	支持性转介	为青少年在不同服务阶段、教育或生活环境之间的转介提供支持
支持性要素	全国网络	建立覆盖全国的实体服务中心网络，确保广泛覆盖
	牵头机构治理	由指定的牵头机构负责服务的总体协调、质量监督和资源管理
	联盟组织	与地方卫生、教育、社区等组织建立合作联盟，共同提供服务
	多学科工作团队	由精神科医生、心理学家、社会工作者、护士等组成的多学科团队提供整合服务
	混合式资金支持	采用政府、保险、自筹等多种资金来源相结合的模式，保障可持续性
	监测与评估	建立常规数据收集系统，持续监测服务的过程与结果，开展质量评估与改进

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表 2 澳大利亚心栖空间阶梯式干预路径

干预级别	干预路径	适用阶段	核心干预措施	目标
一级	社会心理干预	疾病早期，存在轻中度抑郁、焦虑、行为问题或物质滥用风险	心理教育、体育活动干预、认知行为疗法和物质滥用干预	缓解痛苦、恢复社会、学习或家庭功能，阻止症状发展为确诊疾病
二级	温和辅助治疗	一级干预效果有限，症状轻度持续、加强保护并降低进展风险	Omega-3脂肪酸补充治疗	不作为单独主力治疗，用于增效、巩固和预防
三级	药物治疗	社会心理干预无效，症状严重且痛苦显著，存在自伤、伤人或明显安全风险	氟西汀、小剂量非典型抗精神病药	低剂量起步，短期使用，严密监测，不优先、不首选、不长期维持

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