離開了心理健康就不能稱之為健康，心理健康司宜專責且獨立

No Health without Mental Health: An Independent Department of Mental Health Should be Established

張珏(Chueh Chang) ； 王長偉(Chang Wei Wang) ； 顏采如(Cai Ru Gan) ； 溫桂君(Gui Jun Wen)

《台灣公共衛生雜誌》 34卷3期 (2015/06) Pp. 240-253

https://doi.org/10.6288/TJPH201534103072

摘要

有鑑於2013年7月衛生福利部正式成立前，在所謂朝野協商下立法院堅持將「口腔健康」併入規劃多時的「心理健康司」，作者質疑公共衛生組織架構處置的適當性，衛生署究竟對心理健康的重視程度為何？因此回顧我國從2005開始組織再造心理衛生單位的變遷，2012－2014立院公報中各立委與政府單位對話紀實的摘錄整理，並比較國際組織WHO，和美國、泰國、英國等國家衛生組織架構中，心理健康單位的位階與工作內涵。結果發現早在2005年政府組織再造的規劃藍圖已經確認了在中央層級應設立心理健康的專責單位，2005年至2012年衛福部的規劃至少經歷四個行政院核定版本，皆維持心理健康為獨立的「司」級單位（2005年「健康促進與心理衛生司」、2009年「心理健康與物質濫用防制司」、2010、2012年「心理健康司」）。目前成立「心理及口腔健康司」從立院公報可以看到是政治力及利益團體的介入，既不符合《中央行政機關組織基準法》第22條機關設立的原則，也與WHO和幾個國家組織變遷的不符合，更反應出立法委員與衛生署首長，不了解何謂全民心理健康。口腔健康加入心理健康司，非但沒有增加心理健康的人力與經費，反而出現排斥現象，也誤導對心理健康的意義。因此提出結論與建議：由各國家組織架構瞭解，口腔加入心理健康司是屬不成行政體統。衛生福利部成立已屆一年半，建議應檢討並調整，恢復「心理健康」組織的獨立和其高階組織的定位，並須將公共心理健康普及化。

關鍵字

組織再造 ； 心理健康司

並列摘要

According to the negotiating meeting of different parties in Legislation Yuan, there was a decision to integrate Oral Health with the Department of Mental Health (DMH) for the newly organization reformed as Ministry of Health and Welfare (MHW) in July 2013. The authors questioned the appropriation for the organization structure as well as the negligence of mental health of the MHW from Public Health perspective. Using archive document review for the development of establishing the DMH since 2005, debates records published by Legislation Yuan, as well as reference to the organization structure of WHO, USA, British and Thailand. Results show that although the DMH has undergone four or five amendment, mental health duties have still remained to be an independent department. The establishment of the ＂Department of Mental and Oral Health＂ is a clear mistake made by the legislators and governors. This decision was made without understanding the true meaning of mental health and putting no attention on the public health organization structures. Both legislation and government distinctly act against the legal requirement of Article 22 ＂Basic Code Governing Central Administrative Agencies Organizations＂ and are clearly moving towards the opposite direction of the international trends. Furthermore, the competition between the oral and mental health will diminish and confuse the work of mental health for everyone. Legislative consultation claims to review after one year of implementation, and it is strongly recommended to put in real reconsideration that Mental Health unit should remain its independence in highest position; the effects of neglecting public mental health needs can be just as detrimental. Final conclusion and suggestions that it is a bias decision to integrate oral health into Mental Health Department. More efforts need to be made to understand the meaning of 'no health without mental health' as well as the meaning of mental health promotion for all and the definition of mental health /mental ill health in order to return back the appropriate structure of MHW.

並列關鍵字

Organizational reform ； Department of Mental Health

參考文獻

立法院：委員會紀錄。立法院公報 2011；100：213-87。The Legislative Yuan, R.O.C. (Taiwan). Committee meeting recordings. The Legislative Yuan Gazette 2011;100:213-87.

立法院：院會紀錄。立法院公報 2013；102：792-7。The Legislative Yuan, R.O.C. (Taiwan). Meeting recordings. The Legislative Yuan Gazette 2013;102:792-7.

立法院：黨團協商紀錄。立法院公報 2013；102：1408-13。The Legislative Yuan, R.O.C. (Taiwan). The meeting recordings of consult among political parties. The Legislative Yuan Gazette 2013;102:1408-13.

立法院：委員會紀錄。立法院公報 2013；102：2384。The Legislative Yuan, R.O.C. (Taiwan). Committee meeting recordings. The Legislative Yuan Gazette 2013;102:2384.

立法院：院會紀錄。立法院公報 2013；102：386-8。The Legislative Yuan, R.O.C. (Taiwan). Meeting recordings. The Legislative Yuan Gazette 2013;102:386-8.