臺中與南投社區心理衛生中心運作型態之比較研究

Comparative Study of Operational Models in Two Mental Health Centers in Central Taiwan

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

《北市醫學雜誌》 1卷4期 (2004/10) Pp. 468-479

https://doi.org/10.6200/TCMJ.2004.1.4.12

摘要

目的：台中區、南投區兩家心理衛生服務中心自九二一震災後成立，是我國有史以來投注最多人力及經費的社區心理衛生機構，迄今已邁入第五年。本研究期望瞭解兩家中心五年來如何自災難心理衛生中心轉型為社區性的心衛中心，並比較分析其基本背景、業務內容、運作特色、成長與轉變，以提供政府規劃社區心理機構設置標準之參考。方法：採用多次專家焦點團體討論方式，並以 OPP 評估模式為資料收集工具，最後由專家學者進行實地訪察與紀錄。結果：兩中心皆以：「個案服務方案」、「自殺防治服務方案」、「資源網絡連結服務方案」、「社區宣導方案」、「教育訓練方案」作為工作主體架構。組織運作方面，台中區由縣衛生局長主任秘書擔任主持人，統籌規劃中心之成立，連結運用層級隸屬於地方政府、與衛生局同級之其他機關資源，並以衛生局之名義對民問機構資源進行協調整合；南投區中心主持人出身醫院，思考與問題診斷傾向醫療模式，對醫療資源的掌握甚為周全；與政府單位呈現下對上的互動。工作人力來源、個案處遇方式、分站服務，也因此呈現不同的特色。兩中心經過 CIPP 評估、專家建議之後，都進行了運作的改革。結論：1. 兩家中心原先設定時，其運作方式互不相同。經二年的發展過程，目前皆傾向配合衛生行政的運作模式；2. 兩中心皆發展相關方案以達到資源管理與專業能力的提昇；3. 本研究顯示出定期評量的重要性，能夠不斷協助機構加強資源運用與專業能力的進步。

關鍵字

社區心理衛生中心 ； CIPP 評估模式

並列摘要

Objectives: After the 921[kgiol] earthquake, Taichung Mental Health Services Center and Nan-tcu Mental Health Center were established to address the needs of the disastervictims. These centers commanded the highest level of both staff and budget ever seen before in Taiwan and have remained operational over the last five years. This goal of this study is to evaluate how these two centers changed their status from a disastrous mental health center to a community mental health center, and to analyze their basic context, work status, operational characteristics, growth and changes. Methods: The study was conducted using an experts focus group to examine the questions posed, collect data with the CIPP[kgio2] evaluation model, and perform field surveys and records[kgio3]. Results: Both centers used case service, suicide prevention, network connection of service resources, community publication, education training of staff as the mainframe of operation. In the organizational operation, Taichung Mental Health Services Center was presided over and established by the county public health department secretary to the president who organized and managed the operation of the center, coordinated and connected with other departmens resources at the same level within the public health department, and integrated resources of non-government -organizations (NGOs) in the name of the public health department for service and utilization Nan-tou Mental Health Center was presided over and operated by the hospital president and her staff, which promoted a philosophy more in line with a medical model, and then applied to the medically relevant psychiatric resources. The positions between the mental health center and the government departments were not on equal levels. Because of these different operational models, resources of staff manpower, styles of case management, and service patterns of the branches of the center presented different characteristics{kgio4]. Both centers processed the work reform after using the CIPP model to evaluate and accept the suggestions of experts. Conclusion: 1) The two centers tended to utilize administrative- oriented models; 2) They both developed programs to manage the community resources and improve their professional ability; 3) According to our research, we found the importance of regular evaluation[kgio5], since it can permit an agency to improve the ability of resource utilization and professional development. (Full text in Chinese)

並列關鍵字

community mental health center ； CIPP evaluation model