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“包括我自己在内的老员工,我们自己也相当制度化了”:加拿大草原地区精神科去机构化从业者叙述中的权威与洞察

"The older staff, myself included, we were pretty institutionalized ourselves": authority and insight in practitioner narratives of psychiatric deinstitutionalization in Prairie Canada.

作者信息

Dooley Chris

机构信息

York University.

出版信息

Can Bull Med Hist. 2012;29(1):101-23. doi: 10.3138/cbmh.29.1.101.

DOI:10.3138/cbmh.29.1.101
PMID:22849253
Abstract

In the early 1960s, Canada's provinces began radically to reduce the in-patient populations of their psychiatric services. This was part of a wider project of trans-institutionalization through which vulnerable people and those who cared for them were shifted across institutional contexts within Canada's evolving welfare state apparatus. This article draws on interviews with Psychiatric Nurses who worked through the transformative mental health reforms of the 1960s and 1970s, and it makes a case for practitioner history. Practitioner narratives offer a window on the vital tensions between the manifest and the latent functions of welfare institutions, between the impulse to support and the impulse to control, and between paternalism and respect for the rights of the mentally ill. It draws upon the authority of practitioners who, retrospectively, have gained insight into their involvement with prior regimes of caring and control and have come to discern institutional logics previously so hegemonic as to have been largely invisible to them.

摘要

20世纪60年代初,加拿大各省开始大幅削减其精神科服务的住院人数。这是更广泛的跨机构化项目的一部分,通过该项目,弱势群体及其照顾者在加拿大不断发展的福利国家体系内的不同机构环境之间转移。本文基于对经历了20世纪60年代和70年代变革性心理健康改革的精神科护士的访谈,并论证了从业者历史的重要性。从业者的叙述为了解福利机构显性功能与潜在功能之间、支持冲动与控制冲动之间、家长式作风与尊重精神疾病患者权利之间的重要紧张关系提供了一个窗口。它借鉴了从业者的权威性,这些从业者回顾过去,深入了解了自己参与先前护理和控制制度的情况,并开始认识到以前如此占主导地位以至于他们基本上视而不见的制度逻辑。

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