嚴重精神疾病康復者之社區精神復健與社區長期照護

Community-Based Psychiatric Rehabilitation and Long-term Community Care for People Recovering from Severe Mental Illness

嚴重精神疾病病程慢性反覆發作，同時伴隨著也會出現整體功能退化現象。在去機構化運動後，台灣目前有9成嚴重精神疾病康復者居住在社區中，不過由於針對精神康復者的社區照護未能完善發展，過去都以醫療體系社區精神復健作為替代；但因社區照護不足，嚴重影響精神康復者的人權，以及社會安全。本文將討論社區精神復健與精神社區照護的異同，並提出可能的互補作業模式，最後建議落實個案管理，建置社區照護平台作為運作的機制。

Chronic and recurrent severe mental illness is usually accompanied by a functional deterioration in overall health. Since the deinstitutionalization movement, 90% of the people who recovered from severe mental illness in Taiwan now reside in residential communities. The general infrastructure needed to provide community care to these people has not been fully developed; as a result, community-based psychiatric rehabilitation has been used as an alternative. If communities continue to provide insufficient care, then this will not only adversely affect the rights of these people but also social security. This paper will discuss the similarities and differences between community-based psychiatric rehabilitation and community-based psychiatric care while proposing complementary models of operation. The paper will also provide suggestions on how to implement a case management system as well as establish and operate a community care platform.