Hopper Kim
Sociomedical Sciences, Columbia University Mailman School of Public Health New York, 722 W, 168th Street, New York, NY 10032, USA.
Soc Sci Med. 2007 Sep;65(5):868-79. doi: 10.1016/j.socscimed.2007.04.012. Epub 2007 May 17.
Resurgent hopes for recovery from schizophrenia in the late 1980s had less to do with fresh empirical evidence than with focused political agitation. Recovery's promise was transformative: reworking traditional power relationships, conferring distinctive expertise on service users, rewriting the mandate of public mental health systems. Its institutional imprint has been considerably weaker. This article takes sympathetic measure of that outcome and provides an alternative framework for what recovery might mean, one drawn from disability studies and Sen's capabilities approach. By re-enfranchising agency, redressing material and symbolic disadvantage, raising the bar on fundamental entitlements and claiming institutional support for complex competencies, a capabilities approach could convert flaccid doctrine into useful guidelines and tools for public mental health.
20世纪80年代末，精神分裂症康复的希望再度燃起，这与其说是因为新的实证证据，不如说是因为有针对性的政治鼓动。康复的前景具有变革性：重塑传统权力关系，赋予服务使用者独特的专业知识，重写公共精神卫生系统的使命。但其在制度上留下的印记却要弱得多。本文对这一结果表示理解，并提供了一个关于康复可能意味着什么的替代框架，该框架借鉴了残疾研究和森的能力方法。通过重新赋予能动性、纠正物质和象征性劣势、提高基本权利的标准，并要求为复杂能力提供制度支持，能力方法可以将空洞的理论转化为公共精神卫生的有用指导方针和工具。
