Davidson Larry
Larry Davidson (
Health Aff (Millwood). 2016 Jun 1;35(6):1091-7. doi: 10.1377/hlthaff.2016.0153.
The recovery movement, which broadly recognizes the ability of people with mental illnesses to participate in the mainstream of society, stems from a confluence of factors, including longitudinal data showing that many people eventually recover from serious mental illness. Perhaps as important to the emergence and growth of the recovery movement has been the increasing role that people "in recovery" have played in advocating for person-centered care, greater self-determination for those with mental illnesses, and an enhanced focus on restoring functioning for individuals above and beyond symptom reduction. The Americans with Disabilities Act of 1990 redefined serious forms of mental illness as disabilities, which led to the development of a range of accommodations to enable people with psychiatric disabilities to live in their own homes, work, go to school, and perform other normative adult roles such as parent and parishioner even while suffering symptoms. The Affordable Care Act provides additional levers for expanding the use of peer health navigators and shifting care to a collaborative model in which people can play active roles in their own care. While stigma and discrimination continue to pose formidable obstacles, the foundations have been laid for mental health practice to come closer to resembling health care for other medical conditions.
康复运动广泛认可患有精神疾病的人参与社会主流生活的能力,它源于多种因素的融合,包括纵向数据显示许多人最终从严重精神疾病中康复。对于康复运动的兴起和发展而言,或许同样重要的是“康复者”在倡导以患者为中心的护理、为精神疾病患者争取更大的自决权以及更加注重恢复个体功能(而非仅仅减轻症状)方面所发挥的日益重要的作用。1990年的《美国残疾人法案》将严重形式的精神疾病重新定义为残疾,这促使一系列便利措施得以发展,使患有精神疾病的残疾人即便在出现症状时也能够在家中生活、工作、上学,并履行诸如为人父母和教区居民等其他正常成年人的角色。《平价医疗法案》为扩大同伴健康导航员的使用以及将护理模式转变为一种协作模式提供了更多手段,在这种模式中人们能够在自身护理中发挥积极作用。尽管耻辱感和歧视仍然构成巨大障碍,但心理健康实践已奠定基础,有望更接近于针对其他医疗状况的医疗保健。