精神障礙者自立生活營隊對參與者影響的分析

Exploring the Influences of an Independent Living Skill Camp on Participating Taiwanese with Mental Illness and Their Supporters

台灣的精神障礙者常因疾病污名而被剝奪嘗試自主的機會。本研究以單一組別前後測與3個月後追蹤之研究，針對民間首創營造體驗自主環境之營隊方案，檢視其對參與營隊的37位精神障礙者與11位擔任支持者之專業人員對精神疾病污名以及精神障礙者自我決定看法的影響。資料分析採用描述性統計和無母數統計方法。研究結果發現精神障礙者感受性污名在營隊後降低，而其內化污名中刻板印象之面向在追蹤時下降。支持者對精神疾病的感受性污名沒有明顯改善，但他們觀察精神障礙者的自我決定在營隊結束時以及參與三個月後都有提升。研究結論營隊自主經驗可能有助於精神障礙者破除疾病污名，並建議服務提供更多常態性自主機會以提升精神障礙者自主經驗與能力。

To promote autonomy and ultimately mental health recovery, the Camp ＂We Can!＂ was organized by and for Taiwanese with mental illness, with only assistance from professionals as ＂supporters.＂ The camp was created to be an environment encouraging active participation and autonomy. Camp participants experienced self-management and teamwork throughout the two-day activities. This pilot study explores how the camp may influence participants' experiences with their perceived and internalized mental illness stigma, and with self-determination. The study also explores how the camp experiences may influence supporters' experiences with perceived mental illness stigma and their observation of camp participants. This study used a single-group, pretest-posttest design with a three-month post-intervention followup. Thirty-seven of the 56 camp participants and all of the 11 supporters responded to paper-and-pencil questionnaires. Descriptive statistics and nonparametric statistics were used for analyses. Camp participants' perceived stigma decreased at the posttest (z = -2.41, p<.05), and their stereotype endorsement (z = -2.63, p<.01) decreased at the followup. The pretest-posttest comparison of self-determination (z = 2.08, p<.05) showed a significant increase. While supporters' perceived stigma had no change at either time point, their observations of 27 participants showed a significant increase in self-determination (z = 2.65, p<.01) at the posttest, and the increase remained at the followup (z = 2.69, p<.01). The camp program demonstrated promise to lower participants' perceived stigma immediately, and internalized stereotype endorsement three months, after the camp. This two-day camp program alone, however, was insufficient to sustain participants' self-reported improvement on the self-determination measure. We call for professionals to challenge their mental illness stigma, and for all mental health programs to regularly encourage service users' active participation in order for them to exercise autonomy and experience self-determination, which eventually promotes mental health recovery.