精神醫療機構建構生態療癒(育)文化園區之研究—以臺北市立聯合醫院松德院區為例

摘要　　在臺灣的精神醫療體系規劃中，層次上可以看到有明顯的界分，除對「人」在醫學上的精神症狀分類外，精神衛生法也將精神病患生活空間環境定義界分為「社區」(community)與「機構」(psychiatric institution)。然而這兩類空間其實並非是絕對的對立面，反而更可能是息息相關。在去機構化(deinstitutionalization)的運動影響下，普遍希望能讓慢性精神病患經過再社會化(resocialization programme)的復健後可以「復歸社會」(social reintegration)，但因種種因素的影響下，執行上仍有一定的困難度。而精神醫療機構長期以來本就被認為是提供精神病患與社會隔絕的空間，故精神醫療機構常因受到「鄰避效應」(Not In My Back Yard，NIMBY)影響，只能選擇設置於較遠離都市的之邊陲區域(peripheral area)，但多也因此始基地內擁有許多自然生態資源。當現代人因社會快速變遷下，普遍工作壓力大更加上與自然生態接觸的匱乏，以致產生許多精神上的相關疾病，民眾除應有精神衛生的正確觀念外，更應有可以抒發心理壓力的療癒(育)環境，而這些都需要以跨領域(interdisciplinary)的方式來思考與規劃。本研究擬以臺北市立聯合醫院松德院區為主要基地，探討精神病患的治療空間與周邊生態環境狀況，更試圖從其他精神醫療機構與各種論述中探討可能的規劃方向。精神醫療機構本就屬於較為特殊的醫療產業，期望利用基地獨特自然生態資源為基礎，結合歷史、藝術及自然環境等來建構完整精神照護與生態療癒(育)園區，並可在建構後可協助重新塑造精神醫療機構的場所精神(spirit of place)、地域(local)定位與生態療癒觀念，並迎接新的地方認同(sense of place)，讓精神醫療機構社區化，擺脫過去令人恐懼的瘋人院污名及感受。

關鍵字

精神醫療體系；去機構化；復歸社會；鄰避效應；場所精神；地方認同

並列摘要

Abstract While it is evident that the psychiatric care system in Taiwan has classified mental disorders among psychiatric patients, the Mental Health Act also divides a psychiatric setting into a “community-based” environment and a “mental care facility.” These two environments are not opposites. Rather, they are actually interconnected in many ways. The deinstitutionalization movement has led the public to become aware of the importance of helping chronic psychiatric patients return to society after their resocialization therapy is completed, even though this has been hard to implement due to a broad range of factors. Since mental care facilities are often regarded as a secluded place to keep psychiatric patients away from the rest of society, such facilities are mostly built on the outskirts of a city and have an array of natural resources across the “bases” as a result of the Nimby (not in my back yard) effect. Modern people tend to suffer from work-related stress and mental disorders owing to less exposure to nature in the fast-changing world. To address these problems, the general public needs to develop mental health literacy and eco-therapy parks where they can rest, relax, and recover with the natural environment. All this needs to be taken into consideration and planning in cross-disciplinary ways. This study aims to use Taipei City Hospital, Songde Branch as a case study in order to explore the space of treatment and its overall eco-environment and to come up with workable plans based on the experiences of other mental care facilities or discourses. A mental care facility is an institution that provides healthcare services to patients with special needs, and it is our hope to employ the unique eco-resources in the “base,” in addition to the historic and artistic resources and natural environment, to create a well-rounded eco-therapy park in the above-mentioned hospital. This hospital is hoped to help to re-create a new spirit of place, a new definition of the locality, and a new concept known as “eco-therapy” in the healthcare facility, so as to embrace a sense of place and remove the stigma and ill feelings attached to a “lunatic asylum.”