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

摘要： 背景　精神卫生属于国家重大公共卫生问题。在积极推进精神卫生事业发展，保障公民健康权益的基础上，对于北京市严重精神障碍发病报告制度的运行实施进行相关研究。目的　了解北京市严重精神障碍发病报告制度的实施状况及存在的问题，以期提供对于该制度的完善建议。方法　2018年11月—2019年3月采用分层随机抽样法选取了北京市朝阳区、西城区、大兴区、房山区四区辖区社区卫生服务中心从事精神病防治管理的医生（简称精防医生）进行严重精神障碍发病报告制度相关问题问卷调查，回收有效问卷214份，采用SPSS 25.0统计软件进行多重响应分析及χ2拟合优度检验。采取文献研究法，梳理有关该制度的最新规定及其他学者对于相关问题的研究理论。结果　接受问卷调查的精防医生中有54.7%（117/214）认为严重精神障碍发病报告制度非常重要，35.1%（75/214）认为比较重要，认为该制度重要的占比高达89.8%（192/214）。精防医生对于该制度的风险预警、疾病监测、社区管理的主要作用认知所占比例比较，差异无统计学意义（χ2=0.073，P=0.964）。15.9%（34/214）的精防医生认为该制度实施的效果非常好，50.9%（109/214）认为效果比较好，24.8%（53/214）认为一般，合计84.1%（180/214）的精防医生认为该制度并不完善，还有改进之处。精防医生对于该制度存在的问题所占比例比较，差异有统计学意义（χ2=88.338，P<0.001），其中选择“涉及到患者隐私，患者不愿被知道自己有精神疾病”的最多，占比高达83.2%（178/214）。精防医生对于该制度完善建议选择比例比较，差异有统计学意义（χ2=13.579，P=0.019），其中选择“规范信息收集、登记、更正、汇总制度”最多，占比高达76.6%（164/214），选择“规范信息共享及对患者隐私保护的制度”次之，占比达67.3%（144/214）。结论　严重精神障碍发病报告制度涉及对于患者隐私权的限制，尚存在不完善之处。以《民法典》立法精神为基础，通过修改《精神卫生法》对该制度进行明确详细的规定，完善报告条件、相关信息收集程序及纠错更新机制，保护精神障碍患者的基本权利。

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