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对在社区监管下患有精神疾病的成年人采用共同决策的挑战。

Challenges to Employing Shared Decision Making With Adults Under Community Supervision Who Have a Mental Illness.

作者信息

Matejkowski Jason

机构信息

School of Social Welfare, University of Kansas, Lawrence, KS, United States.

出版信息

Front Psychiatry. 2021 Nov 4;12:773411. doi: 10.3389/fpsyt.2021.773411. eCollection 2021.

Abstract

Adults under community corrections supervision and who have a mental illness (MI) are expected to comply with conditions of release which often include involvement with supportive social services. The rates of technical violation, arrest, and incarceration that result from failure to comply with these mandates are exceedingly high. Shared decision making among officer-supervisors and client-supervisees is a promising approach to promote engagement in community corrections services among supervisees who have MI. This paper reviews recent research on shared decision making and identifies three barriers to its implementation in this context: (1) a lack of role clarity, (2) a predilection for risk avoidance, and (3) stigma toward supervisees. Empirically supported recommendations are suggested to aid in overcoming these obstacles, facilitate shared decision making, and promote recovery among this population: (1) unification of supervisor rehabilitative and public safety roles, (2) maximizing opportunities for self-determination through low-stakes events and/or enhancement of supervisee strengths and capabilities, and (3) supervisor training in principles of mental health recovery.

摘要

接受社区矫正监管且患有精神疾病的成年人需要遵守释放条件,这些条件通常包括参与支持性社会服务。因未能遵守这些规定而导致的技术性违规、被捕和监禁率极高。在警官监管人员和受监管对象之间进行共同决策,是促进患有精神疾病的受监管对象参与社区矫正服务的一种有前景的方法。本文回顾了近期关于共同决策的研究,并确定了在这种情况下实施共同决策的三个障碍:(1)角色不明确,(2)倾向于规避风险,以及(3)对受监管对象的污名化。文中提出了基于实证的建议,以帮助克服这些障碍、促进共同决策,并推动这一人群的康复:(1)统一监管人员的康复和公共安全角色,(2)通过低风险事件和/或增强受监管对象的优势和能力,最大限度地增加自我决定的机会,以及(3)对监管人员进行心理健康康复原则方面的培训。

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