Poltorak Mike
University of Kent.
Transcult Psychiatry. 2016 Dec;53(6):743-765. doi: 10.1177/1363461516679072.
The Global Mental Health (GMH) movement has raised questions of the translatability of psychiatric concepts and the challenges of community engagement. In Tonga, the local psychiatrist Dr Puloka successfully established a publicly accessible psychiatry that has improved admission rates for serious mental illnesses and addressed some of the stigma attached to diagnosis. On the basis of historical analysis and ethnographic fieldwork with healers, doctors, and patients since 1998, this article offers an ethnographic contextualization of the development and reception of Puloka's three key interventions during the 1990s: (a) collaboration with traditional healers; (b) translation of psychiatric diagnoses into local cultural concepts; and (c) encouraging freedom of movement and legal appeal to involuntary admission. Dr Puloka's use of medical anthropological and transcultural psychiatry research informed a community-engaged brokerage between the implications of psychiatric nosologies and local needs that can address some of the challenges of the Global Mental Health movement.
全球精神卫生（GMH）运动引发了关于精神科概念的可翻译性以及社区参与挑战的问题。在汤加，当地精神科医生普洛卡博士成功建立了一个公众可及的精神科服务，这提高了严重精神疾病的入院率，并消除了一些与诊断相关的污名。基于自1998年以来对治疗师、医生和患者的历史分析和民族志田野调查，本文对普洛卡博士在20世纪90年代的三项关键干预措施的发展和接受情况进行了民族志背景描述：（a）与传统治疗师合作；（b）将精神科诊断翻译为当地文化概念；（c）鼓励行动自由以及对非自愿入院进行法律申诉。普洛卡博士运用医学人类学和跨文化精神病学研究，在精神科疾病分类学的影响与当地需求之间促成了一种社区参与的协调，这能够应对全球精神卫生运动的一些挑战。
