臺灣工作壓力問題的演變與政策發展：多元流模式分析

The Evolution of Jobs Stress Problems and the Development of Policy Responses in Taiwan: A Multiple -Stream Analysis

本文回顧臺灣1991至2021年間工作壓力問題的演變及政策發展。作者以「多元流」模式，分析2008年後「議程設定」的影響因素。本文指出，個人問題轉化為政策議題的「問題流」推力來自國際經驗、勞工團體倡議、重大過勞事件及媒體報導；政策問題的形塑則從個別工作者的職業病認定與補償爭議延伸至勞動條件抗爭。在「政策流」面向，勞動主管機關為了回應社會爭議，先後將腦心血管疾病與精神疾病納入職災補償範圍，並在2008年後強化勞動檢查與職業健康管理措施；在職業傷病認定與職業健康管理方面，政策工具的選擇由勞動主管機關內部決策者主導，並受職業醫學專業影響。在「政治流」面向，經濟蕭條與就業困境是工作壓力政策發展的社會脈絡；組織性社會力量、輿論壓力、政黨競爭與政治人物的政策承諾，是議程設定得以成型的社會機制；行政部門內部決策者則扮演關鍵但較為內隱的角色。本文最後從國際比較觀點指出臺灣工作壓力政策發展的特色。

This study reviews the evolution of job stress problems and the development of related policies from 1991 to 2021. The Multi-Stream Model is applied to analyze the agenda-setting process after 2008. This study points out that the“policy stream”transformation was driven by international experiences, advocacy of labor organizations, and media reports on stress-related events. Policy problems were initially restricted to compensation issues but later extended to the regulatory issues of working conditions. Regarding the“policy stream”, labor authorities began by recognizing cerebral and cardiovascular diseases and mental illnesses as compensable diseases and later by strengthening labor inspections and adopting occupational health management measures. The choices of policy tools were dominated by the internal decision-makers inside the labor authorities and relied heavily on the expertise of occupational medical professionals. While economic downturns laid the context for the development of the“political stream”, the agenda-setting process was propelled by organized social actions, public opinion pressure, political party competition, and the political will of politicians. Throughout the process, internal decision-makers inside the administrative branch of the government played a key but less visible role. The characteristics of job stress policies in Taiwan are discussed from an international comparative perspective.