Hsieh Meng-Hsuan, Chang Heng-Hao
Case Manager and Occupational Therapist, New Taipei City Association of Mental Illness (NTC-AMI), Taipei, Taiwann.
Department of Sociology, National Taipei University, New Taipei City, Taiwann.
Int J Qual Stud Health Well-being. 2025 Dec;20(1):2475566. doi: 10.1080/17482631.2025.2475566. Epub 2025 Mar 19.
This study employed institutional ethnography to analyse the experiences of individuals with mental health difficulties in a Taiwanese community rehabilitation centre.
This study applies the institutional ethnography method. Data were gathered through participatory observation; in-depth interviews with individuals with mental health difficulties and professionals; and textual analysis of policies, regulations, and practices within the centre.
First, entrenched power dynamics persist, stifling discourse on the agency of individuals with mental health difficulties. The prevalent medical model continues to govern service provision, reinforcing professional hierarchies that impede collaboration. Second, community rehabilitation centres exacerbate disadvantages for case managers (who are muted in the presence of professionals) and service users (who lose autonomy in professional discussions). Third, compliance assessments overshadow individualized care. Fourth, the community rehabilitation model may inadvertently confine service users, prolonging institutionalization and conforming to societal norms.
This study underscores the need for significant improvements in Taiwan's mental healthcare system to emphasize individuals' rights.
本研究采用机构民族志方法，分析台湾社区康复中心有心理健康问题的个人的经历。
本研究应用机构民族志方法。数据通过参与观察、对有心理健康问题的个人和专业人员进行深入访谈，以及对中心内政策、法规和实践进行文本分析收集。
首先，根深蒂固的权力动态持续存在，抑制了关于有心理健康问题的个人能动性的讨论。普遍存在的医学模式继续主导服务提供，强化了阻碍协作的专业等级制度。其次，社区康复中心加剧了个案管理人员（在专业人员面前话语权微弱）和服务使用者（在专业讨论中失去自主权）的劣势。第三，合规评估掩盖了个性化护理。第四，社区康复模式可能无意中限制了服务使用者，延长了机构化并符合社会规范。
本研究强调台湾心理健康护理系统需要大幅改进，以强调个人权利。
