Mancini Michael A, Linhorst Donald M
School of Social Work, Saint Louis University, St. Louis, Missouri 63103, USA.
J Soc Work Disabil Rehabil. 2010;9(2):130-47. doi: 10.1080/1536710X.2010.493481.
Harm reduction is a conceptual framework and set of practices that focus on the minimization of the physical, social, and legal harms substance users do to themselves and to society as a whole. Its application to community mental health settings is relatively new, and can create controversies and ethical dilemmas if not properly designed, implemented, and evaluated. Building on the harm reduction literature, the community mental health literature, and the authors' experiences with a community mental health program that uses a harm reduction approach, the authors offer five guidelines for its successful implementation. The authors conclude that when properly integrated with other recovery-based services, and when appropriately applied to the individual client's stage of change, harm reduction can effectively be used, and should be used, in community mental health settings with clients with co-occurring substance use and psychiatric disorders.
减少伤害是一个概念框架和一系列实践，其重点在于将物质使用者对自身以及整个社会造成的身体、社会和法律伤害降至最低。它在社区心理健康环境中的应用相对较新，如果设计、实施和评估不当，可能会引发争议和伦理困境。基于减少伤害文献、社区心理健康文献以及作者在一个采用减少伤害方法的社区心理健康项目中的经验，作者提供了五条成功实施的指导方针。作者得出结论，当与其他基于康复的服务适当整合，并适用于个体服务对象的改变阶段时，减少伤害可以并且应该有效地应用于社区心理健康环境中同时患有物质使用障碍和精神疾病的服务对象。
