我國心理衛生政策的回顧與檢討：決策菁英類型之分析

A Review of Mental Health Policy in Taiwan: Types of Elite and the Decision-Making Process

本文由參與我國心理衛生政策「菁英類型」角度回顧我國心理衛生工作。文中將我國心理衛生工作依衛生署醫療衛生政策演變的階段分為三個主要時期：建立期、擴張期與整合期。各個階段中影響我國心理衛生政策方向的菁英各有不同。建立期以聯合國專家顧問為主，擴張期以本土精神科醫師與相關專業人員為主。目前則以衛生署的行政科層人員為主。不同時期菁英類型受限於當時的社會條件與政治現實，因此對我國心理衛生工作的影響各不相同。後期發展，由於有自我倡導團體的加入，積極遊說精神病患者的權益與愊祉，政策內容呈現豐富的變化。因應未來社會的需要，政府有必要將心理衛生工作放入更廣泛的福利與衛生制度中規畫。以建立屬於台灣社會條件的心理衛生政策。

This paper aims to analyze mental health policy in Taiwan in the last several decades. Mental health policy as a national policy should include three major components: prevention, treatment, and rehabilitation. These three polices serve different functions. The author argues that in the last several decades, mental health policy in Taiwan has been affected by different types of elite who have participated in the decision-making process at different stages and played key roles in shaping policy direction. The author applies one particular policy model — elite model — to examine mental health policy in this paper. This paper concluded that mental health work in Taiwan has come a long way, from its early stages of an insufficient number of professionals to deliver services to its current stage, in which it has many self-advocacy groups that are concrete bases for further policy development.