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非机构化与无家可归的精神病患者。

Deinstitutionalization and the homeless mentally ill.

作者信息

Lamb H R

出版信息

Hosp Community Psychiatry. 1984 Sep;35(9):899-907. doi: 10.1176/ps.35.9.899.

Abstract

Although homelessness among the chronically mentally ill is closely linked with deinstitutionalization, it is not the result of deinstitutionalization per se but of the way deinstitutionalization has been carried out. The lack of planning for structured living arrangements and for adequate treatment and rehabilitative services in the community has led to many unforeseen consequences such as homelessness, the tendency for many chronic patients to become drifters, and the shunting of many of the mentally ill into the criminal justice system. It has become clear after two decades of deinstitutionalization that what is needed is a vast expansion of community housing and other services and a whole revamping of the mental health system to meet the needs of the chronically mentally ill for support and stability. In addition, mental health professionals must accept the full extent of the dependency needs of many chronic patients.

摘要

虽然长期精神病患者中的无家可归现象与非机构化密切相关,但这并非非机构化本身的结果,而是非机构化实施方式所致。在社区中,缺乏对结构化生活安排以及充分治疗和康复服务的规划,导致了许多意外后果,比如无家可归、许多慢性病患者沦为流浪者的倾向,以及许多精神病患者被分流到刑事司法系统。经过二十年的非机构化,有一点已经很清楚,即需要大幅扩大社区住房及其他服务,并全面改革心理健康系统,以满足长期精神病患者对支持和稳定的需求。此外,心理健康专业人员必须充分接纳许多慢性病患者的依赖需求。

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