School of Nursing Midwifery, University of Stirling, Stirling, UK.
J Psychiatr Ment Health Nurs. 2013 Apr;20(3):228-35. doi: 10.1111/j.1365-2850.2012.01918.x. Epub 2012 May 27.
The early years of the 21st century have seen successful efforts in a number of countries to reduce the use of restraint in services for people with mental health problems. An underlying emphasis on 'cultural change' is characteristic of such initiatives reflecting, it appears, the re-emergence of interest in the therapeutic milieu. Such efforts have though lacked a comprehensive explanation of how organizational culture plays a role in the development of the excessive use of restraint, which seems to respond to such initiatives. This paper seeks to address that deficit and draws in particular on the concepts of corrupted culture, institutional violence, trauma, parallel processing and contemporary research on restraint and seclusion reduction. In doing so it examines whether restraint reduction initiatives represent part of the solution to the problem of corruption, which is intrinsically associated with the legitimatization of coercion.
21 世纪初，许多国家成功地努力减少在为精神健康问题人群提供服务时使用约束。这些举措的一个特点是强调“文化变革”，这似乎反映出人们重新对治疗环境产生了兴趣。然而，这些努力缺乏对组织文化在过度使用约束的发展中所扮演的角色的全面解释，而这种约束的发展似乎对这些举措做出了反应。本文试图解决这一不足，特别借鉴了腐败文化、制度暴力、创伤、平行处理以及关于约束和隔离减少的当代研究的概念。在这样做的过程中，它考察了约束减少举措是否代表了解决腐败问题的一部分，而腐败问题与合法化的强制行为密切相关。
