Corrigan Patrick W
University of Chicago, Center for Psychiatric Rehabilitation, 7230 Arbor Drive, Tinley Park, IL 60477, USA.
Psychiatr Q. 2002 Fall;73(3):217-28. doi: 10.1023/a:1016040805432.
The health goals of persons with serious mental illness are greatly improved when their personal power is advanced. Two targets of empowerment are discussed in this paper: treatment partnerships and community opportunities. Strategies that enhance treatment partnerships include provider endorsement of recovery rather than promoting an approach that suggests poor prognoses, treatment plans that are collaborative rather than unilateral decision making that is perceived as coercive, and treatment services provided in the person's community rather than geographically or psychological distant institutions. Approaches that focus on the person and treatment relationship are not sufficient however. Stigma and discrimination are significant barriers to the kind of community opportunities that are necessary to help people attain life goals. Communities that substitute stigmatizing attitudes and discriminatory behaviors with realistic views of mental illness are more likely to provide the kind of reasonable accommodations that some people need for work and independent living opportunities.
当严重精神疾病患者的个人能力得到提升时,他们的健康目标会得到极大改善。本文讨论了赋权的两个目标:治疗伙伴关系和社区机会。增强治疗伙伴关系的策略包括:提供者认可康复而非宣扬预后不良的方法;治疗计划采用协作方式而非被视为强制性的单方面决策;在患者所在社区提供治疗服务,而非在地理位置或心理上遥远的机构。然而,仅关注患者与治疗关系的方法是不够的。耻辱感和歧视是帮助人们实现生活目标所需的那种社区机会的重大障碍。用对精神疾病的现实看法取代污名化态度和歧视行为的社区,更有可能提供一些人工作和独立生活所需的合理便利。