臺灣心理衛生社工的現況、困境與因應

Abstract

臺灣藉由強化社會安全網計畫，提出心理衛生社工(以下稱心衛社工)的設置。本文希望能探索臺灣心衛社工的實務工作現況，促進社區及網絡單位對心衛社工們的認知與支持，同時也呈現實務上心衛社工面臨的困境，提出改進的建議，以期待能協助心衛社工能常駐久任。本文採用質性研究個別深度訪談，於臺灣北部都會地區邀請了5位心衛社工接受訪談，訪談內容轉謄為逐字稿，再以主題分析方法進行歸納與分析。本文發現透過心衛社工的工作，保護性案件中相對人服務的重要性首次被看到。心衛社工藉由減少傷害的工作方法，提供個案、家庭以及社區一個安全、不被評價且感受到支持的正向經驗，進而促使家庭與社區發生改變。心衛社工自身也轉變為更具包容力以及彈性的助人工作者。然而心衛社工遭遇了長時間、高負荷的困境，使得人力不斷地流失。有待建立完善的制度，達到去機構化的目標，使個案能獲得有尊嚴的自立生活。最後本文提出3點建議：1. 持續落實減少傷害，讓選擇減少傷害的方式成為生活態度的一種；2. 以減少傷害為核心，建置相關服務標準指引，並提供更多專業訓練課程；3. 持續推動社區內心理健康識能及減害概念，從認識精神疾病及生活賦能做起，推廣友善社區。

Taiwan has established Mental Health Social Workers (referred to as MH social workers) through the Improving Social Safety Nets Program. This article aims to explore the current situation of MH social workers, promote understanding with community and network units, and also present the practical difficulties faced by MH social workers, offering suggestions for improvement with the hope of assisting MH social workers in achieving long-term and stable positions.The article utilizes a qualitative research method with individual in-depth interviews, inviting five mental health social workers in the metropolitan area of northern Taiwan for interviews. The interview content was transcribed verbatim, followed by thematic analysis for induction and analysis. This article reported the importance of serving the respondent in protective cases was first recognized through the work of MH social workers. By employing harm reduction, MH social workers provide a positive experience of safety, non-judgmental support, and encouragement to client, families, and communities. This leads to transformative changes within families and communities. Additionally, MH social workers themselves transform into empathetic and flexible worker. However, MH social workers face prolonged periods of high workload. There is still a need to establish comprehensive systems and achieve the goal of deinstitutionalization, allowing individuals to lead dignified, independent lives.The article concludes with three recommendations:1. Continue to promote harm reduction, and make it a part of one’s lifestyle attitude.2. Develop service standard guidelines with Harm Reduction, and provide a professional training.3. Consistently advance mental health awareness and harm reduction, for a friendly community.