九二一震災心理衛生體系之因應

Responses of Mental Health Care Systems to 921 Earthquake

李明濱 ； 吳英璋 ； 陳純誠 ； 戴傳文 ； 陳喬琪 ； 陳快樂 ； 丘彥南 ； 張敏 ； 馬小萍 ； 陸汝斌 ； 蕭淑貞 ； 張玨

《中華公共衛生雜誌》 19卷3S期 (2000/06) Pp. 27-50

https://doi.org/10.6288/CJPH2000-19-3S-04

摘要

台灣的心理衛生體系主要包含下列四大部分：（1）衛生署主管的精神醫療系統、（2）大學部精神醫療人員的培育系統、（3）教育部主管的輔導與諮商人員培育系統與學校輔導老師，以及（4）社區中各類輔導與諮商機構。本文主要針對921震災心理衛生體系之反應，就災後3個月內針對下列各項主題提出實證資料及改善建議：一、心理衛生需求之系統評估；二、災難精神衛生與醫療特徵：災區民眾及協助者。三、特殊族群之接觸與照顧；及四、災難應變工作者之精神衛生。整體言之，本次震災救護與重建過程主要係以緊急醫療衛生為出發點，而後逐步加入各種心理衛生體系人員，從事精神心理問題之處置與重建。由於精神醫療網平常之運作已上軌道，加上精神醫療及心理衛生民間團體與志工之通力合作，因此，就本次震災之緊急醫療及重建過程經驗中，進行尚稱順利，但亟需改善者，為各相關機構、團體之縱向與橫向溝通不足，建議平時即應建立跨部會且具整合功能之中央級災難心理衛生委員會，強化各心理衛生體系有關災難醫療衛生相關之教育訓練與研究，以落實縱向與橫向之聯繫，使面臨重大災難時能提供更迅速之應變措施。

關鍵字

精神衛生體系 ； 災難精神醫學 ； 創傷後壓力症

並列摘要

The mental health service is provided by a team comprising psychiatrists, nurses, psychologists, social workers, occupational therapists and other allied professionals. In Taiwan the mental health care system comprises the following four parts: 1) psychiatric care systems, 2) educational systems for the training of mental health professionals, 3) school-based mental health workers, and 4) other community-based non-governmental organizations or private practice related to psychological counseling service. After the earthquake, the psychiatric team working as a part of whole medical team, immediately got involved to serve the victims in disaster areas. In a week, under the supervision of the Department of Health, a well-organized nation-wide psychiatric care system including major psychiatric units started to operate in the affected areas. Since the psychiatric network system of Taiwan area has been running well for a long time at a regular basis, the disaster psychiatric care was provided effectively and efficiently for the victims. Meanwhile, the school-based mental health workers also provided the counseling for the school children and teachers. The main issue at the administrative level was the lack of vertical and horizontal integration and collaboration between different working groups from diverse disciplines such as psychiatric care givers and the others from the different systems such as psychologists, university teachers, students, and non-professional volunteers. The present report discusses the available mental health care systems, psychological and mental problems of the victims and care givers, aspects of the specific population at high risks and finally the problems of the relief workers participating in the rescue work. Through the reflection of the experience in the past few months, the authors provide proper suggestions and comments in order to respond more quickly and effectively to the disasters in future.

並列關鍵字

mental health care system ； disaster mental health ； post-traumatic stress syndrome