Draine Jeffrey, Salzer Mark S, Culhane Dennis P, Hadley Trevor R
Department of Psychiatry, Center for Mental Health Policy and Services Research, University of Pennsylvania, Philadelphia 19104, USA.
Psychiatr Serv. 2002 May;53(5):565-73. doi: 10.1176/appi.ps.53.5.565.
Research on mental illness in relation to social problems such as crime, unemployment, and homelessness often ignores the broader social context in which mental illness is embedded. Policy, research, and practice will be improved if greater attention is given to social context. The authors critically analyze the approach used in much of the psychiatric services literature to infer links between mental illness and social problems. They compare these studies with studies that have been more validly conceptualized to account for social context. With this broader perspective, the impact of mental illness on crime, unemployment, and homelessness appears to be much smaller than that implied by much of the psychiatric services literature. Poverty moderates the relationship between serious mental illness and social problems. Factors related to poverty include lack of education, problems with employment, substance abuse, and a low likelihood of prosocial attachments. This relationship is often complicated and is not amenable to simple explanations. Research and policy that take this complexity into account may lead to greater effectiveness in interventions for persons with serious mental illness.
关于精神疾病与犯罪、失业和无家可归等社会问题之间关系的研究，往往忽视了精神疾病所处的更广泛社会背景。如果能更多地关注社会背景，政策、研究和实践将会得到改善。作者批判性地分析了许多精神科服务文献中用于推断精神疾病与社会问题之间联系的方法。他们将这些研究与那些对社会背景进行了更有效概念化处理的研究进行比较。从这个更广阔的视角来看，精神疾病对犯罪、失业和无家可归的影响似乎比许多精神科服务文献所暗示的要小得多。贫困缓和了严重精神疾病与社会问题之间的关系。与贫困相关的因素包括教育程度低、就业问题、药物滥用以及亲社会依恋的可能性低。这种关系往往很复杂，难以简单解释。考虑到这种复杂性的研究和政策可能会提高对严重精神疾病患者干预措施的有效性。
