Luhrmann Tanya Marie
Department of Anthropology, Stanford University, Stanford, CA 94305, USA.
Am J Psychiatry. 2008 Jan;165(1):15-20. doi: 10.1176/appi.ajp.2007.07071166. Epub 2007 Dec 17.
Many people who struggle with psychotic disorder often refuse offers of help, including housing, extended by mental health services. This article uses the ethnographic method to examine the reasons for such refusal among women who are homeless and psychiatrically ill in the institutional circuit in an urban area of Chicago. It concludes that such refusals arise not only from a lack of insight but also from the local culture's ascription of meaning to being "crazy." These data suggest that offers of help-specifically, diagnosis-dependent housing-to those on the street may be more successful when explicit psychiatric diagnosis is downplayed.
许多患有精神障碍的人常常拒绝心理健康服务机构提供的帮助，包括住房援助。本文采用人种志方法，探究芝加哥市区机构体系中无家可归且患有精神疾病的女性拒绝此类帮助的原因。研究得出结论，这种拒绝不仅源于缺乏洞察力，还源于当地文化对“疯狂”的意义赋予。这些数据表明，向街头流浪人员提供帮助——特别是依赖诊断的住房援助——若淡化明确的精神病诊断，可能会更有效。
