Joyes Emma C, Jordan Melanie, Winship Gary, Crawford Paul
Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom.
Law and Social Sciences, Faculty of Social Sciences, University of Nottingham, Nottingham, United Kingdom.
Front Psychol. 2021 Oct 7;12:690384. doi: 10.3389/fpsyg.2021.690384. eCollection 2021.
The landscape of mental health recovery is changing; there have been calls for a shift from the clinical expertise being the dominant voice within mental healthcare towards a more personalised and collaborative service that supports those in need of mental healthcare to define what recovery is for the individual. Within this new recovery movement, there has been a recognition of the importance of the social environment in which individuals are situated and the relationship of this to mental health and wellbeing. Included in this is the importance of an individual's role within society and the ways in which knowledge, such as experts by experience, can hold an important value. The argument then, is that social connectedness forms part of the recovery journey and that relationships can help us develop or re-connect with who we are in powerful ways. Such a view has only been strengthened by the recent and ongoing global COVID-19 pandemic. Within the UK, discussions of the importance of our wellbeing have become commonplace within the context of restricted social contact. With this heightened awareness of how the social contributes to wellbeing, it is important to consider the environments in which those in receipt of mental healthcare are situated. One of which is institutionalised care, where it is commonplace to restrict social contact. For example, by virtue of being within a locked environment, individuals' freedom of movement is often non-existent and thus contacts with those not residing or working within the institution is restricted. While such restrictions may be deemed necessary to protect the individual's mental health, such environments can be unintentionally toxic. Data are presented from an ethnography that was conducted within an inpatient forensic mental health hospital in the UK to highlight the problematic social environment which some individuals experience. Key interpersonal issues are presented, such as, trust, racism, the threat of physical violence and bullying that was experienced by staff and residents at the hospital. Consideration is given to the coping strategies enacted by residents and the pathologising of such behaviour. The consequences on interpersonal wellbeing are explored.
心理健康康复的局面正在发生变化；人们呼吁从以临床专业知识为主导声音的精神卫生保健，转向一种更个性化、协作性更强的服务，这种服务支持那些需要精神卫生保健的人去界定个人的康复内涵。在这场新的康复运动中，人们认识到个人所处社会环境的重要性，以及它与心理健康和幸福的关系。其中包括个人在社会中的角色的重要性，以及像有生活经验的专家所拥有的知识能具有重要价值的方式。于是，有人认为社会联系是康复旅程的一部分，人际关系能以强大的方式帮助我们发展自我或重新找回自我。最近持续的全球新冠疫情更是强化了这种观点。在英国，关于幸福重要性的讨论在社交接触受限的背景下已变得司空见惯。随着对社会因素如何影响幸福的认识不断提高，考虑接受精神卫生保健者所处的环境就很重要。其中之一是机构化护理环境，在这种环境中限制社交接触很常见。例如，由于处于封闭环境中，个人的行动自由往往不存在，因此与不在该机构居住或工作的人的接触受到限制。虽然这种限制可能被认为是保护个人心理健康所必需的，但这样的环境可能会无意中产生有害影响。本文呈现了在英国一家住院法医精神卫生医院进行的一项人种志研究的数据，以突出一些人所经历的有问题的社会环境。文中呈现了关键的人际问题，比如医院工作人员和住院患者所经历的信任、种族主义、身体暴力威胁和欺凌。文中还考虑了住院患者采取的应对策略以及这种行为的病态化。探讨了其对人际幸福的影响。
