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关护纠葛:智利学校如何运用精神卫生诊断维护差异

Care entanglements: Upholding difference through the uses of mental health diagnosis in Chilean schools.

机构信息

Faculty of Education and Social Sciences, Andres Bello University, Santiago, Chile.

Pontifical Catholic University of Chile, Santiago, Chile.

出版信息

Sociol Health Illn. 2023 Jul;45(6):1317-1333. doi: 10.1111/1467-9566.13506. Epub 2022 Aug 5.

DOI:10.1111/1467-9566.13506
PMID:35929528
Abstract

This article draws upon findings from fieldwork conducted with Chilean mental health practitioners and school staff to explore how children's mental health diagnoses can be used in the school setting as a particular rationale to mobilise and convey new forms of care practices (Mol, The logic of care: Health and the problem of patient choice, 2008). Inspired by the framing of care as an interrelational, interdependent and more-than-human affair promoted by Science and Technology Studies, and drawing from conceptual tools offered by post-humanist approaches, we focus our examination on the diagnosis of attention deficit-hyperactivity disorder (ADHD). Following the diagnosis since its formulation by clinicians in the public sector to its enactment in an urban school in Santiago, Chile, we explore how certain caring/uncaring practices are enacted in relation to the diagnosis, reconfiguring the classroom by incorporating (non)human actors to care for the diagnosed child. However, care is ambivalent, and the diagnosis can be put into action for other purposes as it interweaves with educational policies and other agendas. Thus, to produce policies that truly foster inclusion, attention must be given to the micropolitical level where disabilities and disorders are enacted, developing appropriate ethico-political and affective sensitivities to care accordingly.

摘要

本文借鉴了与智利心理健康从业者和学校工作人员进行的实地调查结果,探讨了如何在学校环境中使用儿童心理健康诊断作为动员和传达新形式的护理实践的特定理由(Mol,《关怀的逻辑:健康与患者选择问题》,2008 年)。受科学技术研究中提出的关怀作为一种相互关联、相互依存和超人类事务的框架的启发,并借鉴后人类主义方法提供的概念工具,我们将关注点放在注意力缺陷多动障碍(ADHD)的诊断上。从临床医生在公共部门对其进行诊断到智利圣地亚哥的一所城市学校实施该诊断,我们探讨了某些关怀/不关怀的实践是如何与诊断相关联的,通过将(非)人类参与者纳入到对被诊断儿童的关怀中来重新配置课堂。然而,关怀是矛盾的,诊断可以出于其他目的而付诸实践,因为它与教育政策和其他议程交织在一起。因此,要制定真正促进包容的政策,必须关注残疾和障碍实施的微观政治层面,培养相应的伦理政治和情感敏感性来关怀。

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