- 期刊
公共衛生觀點的心理健康：以婦女的憂鬱症為例
Mental Health from the Perspective of Public Health: Using Women's Depression as an Example
摘要
心理健康是人權，也是公共衛生領域非常重要的議題，二十多年來，世界衛生組織十分重視心理健康，例如2001年以「心理健康」為世界健康日的主題與該年年報重點；2004年世界衛生組織在「心理健康促進報告」中進一步指出，沒有心理健康就不能算是健康，它與整體健康是不可分割，顯示心理健康是健康的基礎。然而台灣公共衛生界對心理健康議題關注有限，過去雖有大型精神疾病流行病學調查，但是除了少數研究外，對於心理健康議題仍較缺乏社會結構層次的分析。以性別為例，憂鬱症是婦女最常見的心理健康問題，過去對於女性憂鬱症，大多只從微觀、個人層次來分析壓力經驗，或是認為與男女的生理性或荷爾蒙不同有關，較少關照到社會結構與社會性別的社會關係對婦女心理健康的影響。本文嘗試探討心理健康公共衛生論點落實的可行性，先由心理健康的公共衛生觀點談起，再以婦女的主要心理健康問題－憂鬱症為例，由婦女的實際生活經驗和社會處境來討論社會環境結構對其心理健康的影響，最後以80年代Holland在英國倫敦某一個多元文化社區的十年計畫為例，探究社區介入，藉此創造一個支持與促進婦女心理健康環境的可行性。心理健康問題，除了關心個人健康行為，更應該關注個人和環境社會力的互動關係，注意社會政治經濟結構中權力、資源分配等議題對人們心理健康的影響，期待藉由本文能使台灣公共衛生界更重視心理健康議題，瞭解社會環境結構如何透過性別、階級或是種族等建構，對人們心理健康產生影響，進一步能以社區集體行動力量，創造支持心理健康的社會環境。
並列摘要
Mental health is a human right and a critical topic in the realm of public health. In the last 20 years, the World Health Organization has been emphasizing mental health. For example, in 2001, they used mental health as the topic for World Health Day and as the focus of their annual report of that year. In 2004, they further stated in the ＂Mental Health Promotion＂ report that without mental health, a person cannot be considered as healthy and that mental health is inseparable from overall health. However, Taiwan's public health domain gives only limited attention to mental health topics. Although the field of public health has conducted large-scale epidemiological survey of mental health, it lacks analysis on mental health topics in the level of social structure except for few studies. Take gender as an example. Depression is the most common mental health problem in women. In the past, depression in women was mostly analyzed based on their stress experiences at a microscope, personal level. In addition, depression was considered to be associated with the biological hormone differences between men and women. Few past studies discussed the impact of social structure and social gender-related social relationship on women's mental health. The objective of this article is to explore the feasibility of implementing public health topics related to mental health. This article started with the public health perspective regarding mental health. Next, women's main mental health problem (i.e., depression) was used as an example. By using women's actual life experiences and social situations, this study discussed how social environmental structure affected their mental health. Finally, this article used a 10-year project in the 1980s conducted by Holland in a multicultural community in London, United Kingdom, as an example to scrutinize the effectiveness of community intervention, thereby exploring the feasibility of creating a supportive environment that promotes women's mental health. When it comes to mental health problems, attention must be paid to personal health behaviors, the interactions between a person and the environment and society, and how topics such as power and resource allocation in a social, political, and economic structure influence people's mental health. Through this article, we aim to increase the attention Taiwan's public health domain pays to mental health topics, helping them understand how social environmental structure affects people's mental health through the construction of gender, social class, or race. Eventually, through communities' collective action power, they may create a social environment that supports mental health.