中途障礙社會模式介入與生活重建服務整合－－伊甸、新事暨陽光服務方案為例

Social Model Intervention with Employment Injured and Rehabilitation Services Integration in Taipei City

本文以一位中途發生障礙者與其家庭及現階段台北市三個提供「中途障礙」服務單位為例，探討「中途障礙」生活重建服務瓶頸與未來整合方向。資料包括障礙新定義與社會模式介入相關文獻、實務工作者臨床經驗、及三個單位書面與網站資料。文獻分析發現台灣每年有四千多名勞災導致障礙者；發生障礙與障礙者本人及其家庭個人因素無關，是環境因素導致；「中途」障礙者及其家庭需求是多元、持續、從醫院到社區一連串生心理與社會重建：經濟、醫療、職能與就業、家庭與社會生活重建及各項福利服務，必須跨系統跨專業整合方能滿足。三個提供「中途障礙」生活重建服務民間社服單位檢視結果，就服務對象，三個機構有所區別，就中途障礙者，則有重疊處；以服務方案及目的比較，「伊甸」服務目標為協助障礙者「社會適應」較屬微視介入醫療模式，「新事」與「陽光」介入目的為重回職場；共同瓶頸為社會資源不足及服務系統未能整合。建立一套完整從醫院到社區教育、就業與生活重建整合制度，刻不容緩。

This article aims to explore how to obtain social model intervention and integrate rehabilitation services for persons with disabilities and their families due to employment injured, accident, or illness. A case example of employment injured and three voluntary organizations providing related rehabilitation services in Taipei City-the Eden Social Welfare Foundation, the Rerum Novarum Center and the Sunshine Social Welfare Foundation, are demonstrated in order to recommend a service integration model for working with persons with adventitious disabilities and their families. The literature review, practitioners' experiences, and written document and website information of the voluntary organizations are examined to analyze how the current rehabilitation services are provided for the clients and what obstacles of services of integration are. The study found that there are four thousand persons with disabilities caused from employment injured each year; as yet it's in the lack of reliable statistics to show out the exact number of persons with disabilities resulted from accident or illness. The case in this article, a young person age in 15 with adventitious disabilities was employment injured resulted from his disadvantaged social context-from low-income family, insecure working spot and inaccessible rehabilitation services. The welfare needs such as economic assistance, unemployment allowance, medical and vocational rehabilitation services, and family and social supportive services are demanded; and these multi services need to be provided cross professionals and service centers. Based on the analysis of services provided by these three voluntary organizations, resources limited and rehabilitation services integration become the most significant obstacles for the goals achievement. How to advocate its radical changes, having multi systems and services integrated, will be the most important and priority in order to meet the needs of the users of disability rehabilitation services including caused from employment injured, accident, or illness. Moreover, for persons injured or ill whose first contact with hospitals or clinical centers, how to make the medical systems in the first line mandated to do the intact report and how to require the central and local authorities to build up a cross systems and professionals ”Rehabilitation and Integration Center” will be necessary in the Disability Welfare Law modification.