Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
Int J Ment Health Nurs. 2022 Dec;31(6):1542-1551. doi: 10.1111/inm.13072. Epub 2022 Sep 20.
This perspective paper aims to present a personal viewpoint on the impact of psychiatric discourse on the principles of recovery in mental health care. Mental health services espouse these principles, yet psychiatric discourse remains the dominant model. A critical analysis will examine how psychiatry maintains this dominance. The aim is to examine how psychiatric discourse constructs both the nature of mental distress and its treatment, and how it maintains its power as the dominant authority and its relationship to recovery principles. The paper concludes that psychiatric discourse is the antithesis of recovery principles and that its authority is perpetuated through co-opting a medical explanatory model, claiming expertise in the ability to predict social risk, and maintaining a tightly controlled echo chamber. A way forward involves the dismantling of the hierarchical service delivery model based on psychiatric discourse and replacing it with a more horizontal service delivery model in which the lived experience of mental distress is central. Regular audit of services needs to prioritize recovery principles. The implications for mental health nursing are considered.
这篇观点文章旨在就精神病学话语对精神卫生保健中康复原则的影响提出个人观点。精神卫生服务拥护这些原则,但精神病学话语仍然是占主导地位的模式。批判性分析将研究精神病学如何保持这种主导地位。目的是研究精神病学话语如何构建精神痛苦的性质及其治疗方法,以及它如何保持其作为主导权威的权力及其与康复原则的关系。本文得出的结论是,精神病学话语与康复原则背道而驰,其权威是通过采用医学解释模型、声称有能力预测社会风险的专业知识以及保持严格控制的回音室来维持的。前进的道路包括拆除基于精神病学话语的层级服务提供模式,代之以更具横向服务提供模式,将精神痛苦的生活体验置于中心地位。服务的定期审计需要优先考虑康复原则。还考虑了对精神健康护理的影响。