精神障礙者老後生活的居住選擇-以臺中市為例

精神障礙者較於一般人在生活上遭遇較多的困難，同時也面臨更多的阻礙，因精神障礙者長久以來受到社會大眾對該疾病的汙名、刻板印象、偏見與歧視，媒體習以負面形象誇大精神障礙者的異常行為，難以被社會大眾所接納。然而，隨著精神障礙者老化，其健康照顧需求更顯複雜，高齡的精神障礙者面對照顧問題，其照顧的目標不只是個人精神疾病的治療，再加上精神障礙者老化速度加劇，精神障礙者因疾病慢性化可能導致功能退化，故所需的長期照護及服務需求，勢必日益殷切。身心障礙者權利公約影響全球身障者權利與保障，且牽引著精神障礙者服務的走向，其中第19條自立生活和融合社區明示：「身心障礙者有機會在與其他人平等的基礎上選擇居所，選擇於何處、與何人一起生活，不被強迫於特定之居住安排，應享有在社區中生活的平等權利以及與其他人同等的選擇」。研究者以質性研究深度訪談社區與住宿型精神復健機構的精神障礙者、社工及管理者，有關對精神障礙者未來步入老年生活的居住選擇，希望透過研究者的資料蒐集與分析，能夠提供給精神障礙者對老年居住能做一些選擇；並試著瞭解精神障礙者在社區精神復健機構接受服務的生活現況及精神障礙者目前的居住狀況。最後，研究者依其問題討論與研究結果，提供相關資訊予精神障礙者以及服務機構、政府在未來福利服務輸送之建議。

關鍵字

精神障礙者；老化理論；撤退理論；活躍老化；居住選擇

並列摘要

People with mental disorders encounter more difficulties in life than the average person, but also face more obstacles, because people with mental disorders have long been subjected to the stigma, stereotypes, prejudices and discrimination of the public for the disease, and the media is accustomed to exaggerating the abnormal behavior of mentally disabled people with negative images, which is difficult to be accepted by the public. However, as people with mental disorders age, their health care needs are more complex, and the elderly mentally disabled face care problems, and the goal of their care is not only the treatment of personal mental illness, coupled with the intensification of the aging rate of mental disorders, mental disorders may lead to functional degradation due to chronic diseases, so the long-term care and service needs required. It is bound to become more and more eager. Article 19 of the Convention on the Rights of Persons with Disabilities affects the rights and protection of persons with disabilities worldwide and drives the direction of services for persons with mental disabilities, with Article 19 of which states: "Persons with disabilities have the opportunity to choose their place of residence on an equal basis with others, where and with whom they live, not to be forced into specific living arrangements, and to enjoy equal rights to live in the community and the same choices as others". Researchers conduct in-depth interviews with mentally disabled people, social workers and managers of community-based and residential-type spiritual rehabilitation institutions, and hope to collect and analyze the researchers' data collection and analysis on the future living choices of people with mental disabilities in old age. It can provide people with mental disorders with some choices for old age living; and try to understand the current life situation of people with mental disabilities receiving services in community mental rehabilitation institutions and the current living conditions of people with severe disabilities. Finally, the researchers provide relevant information to the mentally handicapped people, as well as service agencies and the government's suggestions for future welfare service delivery based on their discussion of the issues and research results.