研究生: |
黃俊智 Huang, Jiunn-Jyh |
---|---|
論文名稱: |
臺灣心理衛生社工的現況、困境與因應 The current situation, difficulties and coping of mental health social workers in Taiwan |
指導教授: |
李思賢
Lee, Szu-Hsien |
口試委員: |
李思賢
Lee, Szu-Hsien 李俊宏 Lee, Chun-Hung 黃名琪 Huang, Ming-Chyi |
口試日期: | 2024/06/01 |
學位類別: |
碩士 Master |
系所名稱: |
成癮防制碩士在職學位學程 Continuing Education Master's Program of Addiction Prevention |
論文出版年: | 2024 |
畢業學年度: | 112 |
語文別: | 中文 |
論文頁數: | 53 |
中文關鍵詞: | 心衛社工 、減少傷害 |
英文關鍵詞: | mental health social worker, harm reduction |
研究方法: | 主題分析 、 半結構式訪談法 |
DOI URL: | http://doi.org/10.6345/NTNU202400941 |
論文種類: | 代替論文:專業實務報告(專業實務類) |
相關次數: | 點閱:80 下載:15 |
分享至: |
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報 |
臺灣藉由強化社會安全網計畫,提出心理衛生社工(以下稱心衛社工)的設置。本文希望能探索臺灣心衛社工的實務工作現況,促進社區及網絡單位對心衛社工們的認知與支持,同時也呈現實務上心衛社工面臨的困境,提出改進的建議,以期待能協助心衛社工能常駐久任。
本文採用質性研究個別深度訪談,於臺灣北部都會地區邀請了5位心衛社工接受訪談,訪談內容轉謄為逐字稿,再以主題分析方法進行歸納與分析。本文發現透過心衛社工的工作,保護性案件中相對人服務的重要性首次被看到。心衛社工藉由減少傷害的工作方法,提供個案、家庭以及社區一個安全、不被評價且感受到支持的正向經驗,進而促使家庭與社區發生改變。心衛社工自身也轉變為更具包容力以及彈性的助人工作者。然而心衛社工遭遇了長時間、高負荷的困境,使得人力不斷地流失。有待建立完善的制度,達到去機構化的目標,使個案能獲得有尊嚴的自立生活。
最後本文提出3點建議:1. 持續落實減少傷害,讓選擇減少傷害的方式成為生活態度的一種;2. 以減少傷害為核心,建置相關服務標準指引,並提供更多專業訓練課程;3. 持續推動社區內心理健康識能及減害概念,從認識精神疾病及生活賦能做起,推廣友善社區。
Taiwan has established Mental Health Social Workers (referred to as MH social workers) through the Improving Social Safety Nets Program. This article aims to explore the current situation of MH social workers, promote understanding with community and network units, and also present the practical difficulties faced by MH social workers, offering suggestions for improvement with the hope of assisting MH social workers in achieving long-term and stable positions.
The article utilizes a qualitative research method with individual in-depth interviews, inviting five mental health social workers in the metropolitan area of northern Taiwan for interviews. The interview content was transcribed verbatim, followed by thematic analysis for induction and analysis. This article reported the importance of serving the respondent in protective cases was first recognized through the work of MH social workers. By employing harm reduction, MH social workers provide a positive experience of safety, non-judgmental support, and encouragement to client, families, and communities. This leads to transformative changes within families and communities. Additionally, MH social workers themselves transform into empathetic and flexible worker. However, MH social workers face prolonged periods of high workload. There is still a need to establish comprehensive systems and achieve the goal of deinstitutionalization, allowing individuals to lead dignified, independent lives.
The article concludes with three recommendations:
1. Continue to promote harm reduction, and make it a part of one’s lifestyle attitude.
2. Develop service standard guidelines with Harm Reduction, and provide a professional training.
3. Consistently advance mental health awareness and harm reduction, for a friendly community.
王婉諭(2022年3月24日)。6大重點看懂我們為什麼要修精神衛生法?。多多益善(Right Plus)王婉諭專欄。https://rightplus.org/2022/03/24/amendment/
王金永、盧惠芳、黃韻如(2024)。精神科社工人員臨床團體工作實務現況與能力研究。中華心理衛生學刊,37(1),19-51。https://doi.org/10.30074/FJMH.202403_37(1).0002
白鎮福、李宗憲、吳思穎、黃韻儒、李思賢(2022)。施用影響精神藥物者之以全人為導向的復元與社會復歸架構:社區服務機構之文本分析。中華心理衛生學刊,35(2),181-213。doi: 10.30074/FJMH.202206_35(2).0004
任依島(2020年1月30日)。【投書】是誰讓社區關懷的工作失焦?一位社區關懷訪視員的心聲。獨立評論@天下。https://opinion.cw.com.tw/blog/profile/52/article/9002
李思賢(2008)。減少傷害緣起與思維:以美沙冬療法做為防制愛滋感染、減少犯罪與海洛因戒治之策略。刑事政策與犯罪研究論文集,11,89-109。法務部。
李思賢(2022)。施用成癮藥物者的復元與復歸社會的挑戰。中華心理衛生學刊,35(2),111-116。doi: 10.30074/FJMH.202206_35(2).0001
李思賢(2024年1月19-20日)。減少傷害宣言﹝連署書發表﹞。2024亞太減少傷害國際專家論壇與研討會,臺北市,臺灣。
何建民(2009)。臺灣精神衛生法制之研究〔未出版之碩士論文〕。國立臺灣師範大學政治學研究所在職進修碩士班。https://hdl.handle.net/11296/md4tgd
吳孟潔(2022)。探討公共衛生護理師家庭訪視與社區精神病人緊急護送就醫之關係〔未出版之碩士論文〕。國立臺灣師範大學健康促進與衛生教育學系健康促進與衛生教育碩士在職專班。https://hdl.handle.net/11296/njcvte
吳慧菁(2022)。臺灣心理衛生社工的現況與未來。醫療品質雜誌,16(1),30-35。https://doi.org/10.53106/199457952022011601005
呂靜淑(2013)。破繭而出?!少年服務中心社工人員的角色期待、角色壓力與調適歷程之研究〔未出版之碩士論文〕。東吳大學社會工作學系。https://hdl.handle.net/11296/3n28v8
杜瑛秋(2004)。婚暴社工員陪同出庭過程的專業角色與功能之探討〔未出版之碩士論文〕。輔仁大學社會工作研究所。https://hdl.handle.net/11296/54xyfv
林子軒、蕭至邦(2021)。鑑往知來-精神醫療社工之歷史緣起與本土化挑戰。社區發展季刊,173,287-302。https://cdj.sfaa.gov.tw/Journal/Content?gno=11648
林憲(2007)。精神醫學的贈物:從臺灣到日本(王珮瑩譯)。心靈工坊。(原著出版於2004 年)。
林靜蘭、溫偉鈞、姜喬慧、薛競秀(2010)。出院精神病患重返社區所面臨之阻礙。弘光學報,61,26-39。https://doi.org/10.6615/har.201012.61.02
林靜蘭、黃秀梨(2011)。衛生所之社區精神衛生工作的挑戰與機會。護理雜誌,58(3),80-86。http://dx.doi.org/10.6224/JN.58.3.80
唐宜楨、吳慧菁(2008)。精神疾患汙名化與去汙名化之初探。身心障礙研究季刊,6(3),175-196。https://doi.org/10.30072/JDR.200809.0002
張如杏(2006)。台灣精神醫療社會工作專業發展與危機。臺灣社會工作學刊,6,119-145。https://doi.org/10.29814/TSW.200901.0004
陳佳慧(2020年4月14日)。慢性精神疾病復發機率高 醫呼籲:疫情期間也務必持續治療。健康醫療網。https://www.healthnews.com.tw/article/45800
陳雨鑫(2020年7月18日)。心衛社工「短命」 平均9個月就離職。聯合報元氣網。 https://health.udn.com/health/story/5999/4712639
楊聰財、魏兆玟(2008)。新版精神衛生法與強制就醫新制。源遠護理,2(2),11-17。http://dx.doi.org/10.6530/YYN.2008.2(2).02
劉竹瑄、鄭惠心、侯建州(2017)。社區關懷訪視員工作動機與角色之初探。社區發展季刊,157,372-386。https://cdj.sfaa.gov.tw/Journal/FileLoad?no=171794
劉運康(1984)。慢性精神科個案之社會復歸-談“去機構化”與“現代精神醫院之社區化”。職能治療學會雜誌,2,1-6。https://doi.org/10.6594/JTOTA.1984.02.01
衛生福利部(2018)。強化社會安全網計畫(核定本)。社會安全網,https://topics.mohw.gov.tw/SS/lp-4515-204.html
衛生福利部(2020)。強化社會安全網計畫─策略三辦理現況與未來展望。https://www.mohw.gov.tw/dl-67684-e1623c9d-13db-4536-822d-cccc1bb0427a.html
衛生福利部(2021)。社區關懷訪視及個案管理人員安全手冊。https://dep.mohw.gov.tw/DOMHAOH/lp-4505-107.html
蕭淑貞、黃宣宜、林靜蘭(2005)。社區精神衛生持續性護理的現況及展望。護理雜誌,52(1),11-17。https://doi.org/10.6224/jn.52.1.11
Armijo, J., Méndez, E., Morales, R., Schilling, S., Castro, A., Alvarado, R., & Rojas, G. (2013). Efficacy of community treatments for schizophrenia and other psychotic disorders: a literature review. Frontiers in Psychiatry, 4, 116. doi: 10.3389/fpsyt.2013.00116
Halcomb, E. J., McInnes, S., Patterson, C., & Moxham, L. (2019). Nurse-delivered interventions for mental health in primary care: a systematic review of randomized controlled trials. Family Practice, 36(1), 64-71. doi: 10.1093/fampra/cmy101
Huang, X. Y., Ma, M. F., Shih, H. H., & Li, H. F. (2008). Roles and functions of community mental health nurses caring for people with schizophrenia in Taiwan. Journal of Clinical Nursing, 17(22), 3030-3040. doi: 10.1111/j.1365-2702.2008.02426.x
Kennedy, C. W., Polivka, B. J., & Chaudry, R. (1997). Public health nurses' role in the care of adults with mental disabilities. Psychiatric Services, 48(4). 514-517. doi: 10.1176/ps.48.4.514
Lee, T. S.-H. (2011). Efficacy of drug counseling intervention among injecting drug users at opiate substitution treatment (NSC 100-2628-H-003-002-MY3) [Grant].
Lien, Y. J., & Kao, Y. C. (2019). Public beliefs and attitudes toward schizophrenia and depression in Taiwan: A nationwide survey. Psychiatry research, 273, 435-442. doi: 10.1016/j.psychres.2019.01.062
May, S. Y., Clara, N., Khin, O. K., Mar, W. W., Han, A. N., & Maw, S. S. (2021). Challenges faced by community health nurses to achieve universal health coverage in Myanmar: a mixed methods study. International Journal of Nursing Sciences, 8(3). 271-278. doi: 10.1016/j.ijnss.2021.05.003
McInerney, S. J., Finnerty, S., Walsh, E., Spelman, L., Edgar, N. E., & Hallahan, B. (2018). Quality of life and social functioning of former long-stay psychiatric patients transferred into the community: a 10 year follow up study. Social Psychiatry and Psychiatric Epidemiology, 53(8), 795–801. doi: 10.1007/s00127-018-1520-3
Spohn, E., & Warinner, A. (1951). The public health nurse in preventive and therapeutic psychiatry. American Journal of Orthopsychiatry, 21(2). 285-291. doi: 10.1111/j.1939-0025.1951.tb06102.x
Substance Abuse and Mental Health Services Administration (US). (2011). SAMHSA’s working definition of recovery. https://www.naadac.org/assets/2416/samhsa_working-definition_of_recovery.pdf
Svensson, B., & Bjorkman, T. (1999) . The role of the nurse in community psychiatry. Medical Archives, 53(3), 153-157. PMID: 10546450.
Wu, M. C., Hung, C. C., Fang, S. C., & Lee, T. S.-H. (2023). Change of home visit frequency by public health nurses predicts emergency escorts for psychiatric patients living in the community: A retrospective medical record review. Frontiers in Public Health, 11. doi: 10.3389/fpubh.2023.1066908.