社區心理衛生中心的歷史沿革

Community Mental Health Centers

楊聰財(Tsung-Tsair Yang) ； 李明濱(Ming-Been Lee) ； 吳英璋(Yin-Chang Wu) ； 魯中興(Chung-Hsing Lu) ； 陳韺(Ying Chen) ； 吳文正(Wen-Cheng Wu)

《北市醫學雜誌》 1卷4期 (2004/10) Pp. 393-411

https://doi.org/10.6200/TCMJ.2004.1.4.03

摘要

社區心理衛生在二次世界大戰後開始受到重視，在各國的發展歷程各有特色，尤以美國最為蓬勃。我國社區心理衛生在演進和制度上，有很多向美國學習的地方，但卻少有文獻深入探討兩者在歷史發展、文化背景與體制結構等方面的異同。美國各州心理衛生制度差異甚大，故以美國舊金山的社區心理衛生中心為例，摘要性提出我國與美國的文獻分析比較結果，期望從中獲得有利經驗和值得學習之處。從歷史沿革來看，我國心理衛生的發展較美國遲了至少二十年（以心理衛生協會之成立來看）；在社會文化方面，我國民眾對於精神疾病仍多偏見歧視，自願就醫或求助的個案仍是少數；在組織架構方面，我國也未如美國一般有最高行政層級的重視及統籌，例如美國公共衛生部門會規劃心理衛生、精神醫療預算分配和規定相關機構問的台作模式。因此有鑑於美國社區心理衛生的蓬勃發展，可見到我國尚有民智未開、制度不健全、經費及專業人力不足、資源連結不易等問題。

關鍵字

心理衛生 ； 社區心理衛生中心 ； 歷史沿革

並列摘要

Community mental health has been a priority since World War II. Different countries developed programs in a variety of ways and each have their own specific characteristics. Among these, the performance in the US based centers was found to be the best in the world. System development and application of our community mental health centers (CMHC) in Taiwan were based on the American model. A brief review will compare and contrast the history, culture, and structure of CMHCs between America and our country. The data was collected from Taiwan’s Community Mental Health Center (CMHC) and was compared to literature from other counties[kgiol] on their CMHC experience. Because of the variability between states in America regarding the system of CMHCs , we chose the San Francisco model to describe analytical variables, to compare available literature of America and Taiwan on CMHC, and to determine the experience and merit worthy of learning. The development of mental health programs in Taiwan occurred later than those in America by approximately twenty years (upon the time established by the Association of Mental Health). From the viewpoint of the social culture, people in Taiwan continue to harbor prejudice on those with mental disorders which leads to fewer people seeking voluntary treatment. Within the institution, Taiwanese administration does not bestow a high regard for mental health services as seen in the US. For example, the Department of Public Health in America manages the budget of both mental health & psychiatric medicine, and regulates the cooperation between associated agencies. According to the performance of community mental health centers in America, we could identify a number of problems including, immaturity of people’s psychological mind, lack of resources at the institution level, lack of finance and professional staff, and hard to connect with other resources in Taiwan.[kgio2j (Full text in Chinese)

並列關鍵字

mental health ； community mental health ； historic development