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  • 學位論文

台灣精神社工與社會工作系學生對精神疾患污名看法及接觸經驗之研究

Stigma Toward and Experience Working with People with Mental Illness Among Social Workers and Social Work Students

指導教授 : 唐宜楨

摘要


污名的存在不僅會影響個人福祉與機會的選擇,更會對個人的健康產生負面影響。受污名的族類甚多,精神疾患又屬當中最易被歧視的對象之一。而精神疾患在社會福利領域裡一直被視為是弱勢族群之一,值得幫助的對象。提供社會福利服務的社會工作者常有機會與精神疾患一同工作,當中又以「心理衛生」領域之精神社工為最主要的服務提供者。有鑑於社會工作是以人性尊嚴為核心價值的工作,身為精神社會工作專業助人者,以及正在接受專業訓練之社會工作系學生對於精神疾患的看法為何?是否能覺察到精神疾患之人權,並進行自我的反思? 本研究透過質性訪談方式,訪談11名精神社工與9名社會工作系學生。透過研究資料分析及歸納受訪者的經驗與看法後,研究發現大致能區分為以下三個部分: 一、接觸經驗:個人與精神疾患的接觸經驗確實能夠消除個人的污名看法,同時個人的生命經驗、親友是否為精神疾患、志工與實習參訪經驗,亦會對個人的精神疾患污名看法造成影響。然而,根據研究發現,亦有幾名受訪者在新自由主義價值充斥的社會工作場域裡,過長的工作時間、低薪資及績效壓力會影響精神社工的污名看法。 二、社會工作教育與自我反思:以目前的社會工作教育來看,「反歧視、反壓迫與自我反思」的概念通常僅出現於性別或族群(原住民、新移民)相關的課程中,在精神疾患相關課程上的運用僅著重於知識方面的講授而已。自我反思能力的養成能夠提升個人敏感度以及尊重案主自決,同時這樣的能力有助於社會工作者面對工作層面上的議題複雜性。至於社工學生部分,因現實層面的受限,例如學生本身的思維、生命經驗有限、課程時間過短,以及授課老師的實務經驗不足,使得社工學生於此部分的歧視壓迫反思能力養成窒礙難行。 三、社會工作與精神疾患去污名化:此部分探討精神社工與社會工作系學生對於精神疾患人權的看法,並歸納受訪者對於精神疾患在就醫、就業兩個面向中的看法與限制。研究結果發現,無論精神社工或社會工作系學生,精神疾患人權的議題存在著支持與反對兩派觀點,並非全然認為精神疾患人權與一般社會大眾所享有的權利概念相同。進一步來說,所有受訪者均認為傳播媒體係污名化精神疾患的最大源由,建議能透過接觸經驗、教育、翻轉媒體不實的報導,以及抗爭的方式來為精神疾患去除污名。 並且,研究者於文末針對社會工作教育、社會工作人員、傳播媒體、政府當局以及未來研究提出部分建議,期待此份研究能作為社會工作教育改革與精神疾患去污名化方面之參考依據。

並列摘要


Background People with mental illness are one of the most stigmatized groups. Persons with mental illness frequently experience discrimination such as lack of access to proper medical care and shelter; maltreatment in their places of living or institutions; lack of employment opportunities and lack of social interaction. Resisting stigma and promoting quality of life for people with mental illness require not only the efforts of the patients themselves, but also those of mental health professionals. This should involve integrated service in which there is a search for resource connections and strengths. Social workers, in particular mental health social workers, are perceived as health professionals who work closely with people with mental illness. To provide supportive services and formulate positive policies and programs for people with mental illness, it is necessary to explore the attitudes of mental health social workers and social work students toward people with mental health issues. Purposes The aim of this dissertation is to understand the attitudes of mental health social workers and social work students toward people with mental illness and especially if they harbor negative stereotypes or stigma. Personal experiences of mental health social workers and social work students before and after making contact with people with mental illness were analyzed. Then, anti-discrimination, anti-oppression and reflexivity strategies in social work education were explored. Finally, some of the key attitudes of social workers and social work students toward human rights and mental illness are discussed. Methods Qualitative interviews were adopted as the research method. Participants included 11 mental health social workers and 9 social work students. Results According to the findings, contact with people with mental illness can reduce stigma. Participants’ personal experience played an important role in changing attitudes toward people with mental illness. However, some participants harbored negative attitudes toward people with mental illness due to the development of neoliberalism in the social work field, such as low pay, long working hours and accountability pressure. In terms of social work curricula, few courses focus on concepts of anti-discrimination, anti-oppression and reflexivity, apart from those emphasizing gender and ethnic groups (indigenous peoples, marriage immigrants). As reflexivity can enhance sensitivity and respect for self-determination, educational training strategies to reduce stigma toward people with mental illness in social work practice were considered helpful. Finally, a human rights approach to removing the stigma of mental illness was proposed. There was no consensus among the participants as to whether a human rights approach can be a mainstream strategy for eliminating the stigma of mental illness. However, participants did agree that the media is important in shaping and reducing mental health stigma. Conclusions By examining attitudes of mental health social workers and social work students toward mental illness, the results provide possible strategies against discrimination and stigma, namely improving social work education regarding stigma, increasing personal contact with people with mental illness, and increasing discussion and debates on issues of mental illness.

參考文獻


態度量表之信效度研究-以高中生為例。護理雜誌,61(6),48-56。
周立修、楊偉成(2012)。DSM-5 倫理與性別議題:DSM-5中文譯名與疾病社會污名化議題。DSM–5通訊,2(4),30-32。
陳萱佳(2012)。精神疾病反污名首部曲–一起推動全民參與的精神分裂症更名
教育部(2016)。特殊教育學校各教育階段班級數統計。取自
林耀盛(2012)。正常與存有:精神病理的反思實踐。身心障礙研究季刊,

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