摘要
在20世纪中期之前,美国大部分精神障碍儿童被收容于精神病院等机构化组织中.随着精神病院的丑闻频发、机构内患儿人数的增加以及社会对人性化治疗的诉求,美国开始探索新的治疗模式.抗精神病药物的应用使许多患儿的病情趋于稳定,让他们具备重返社区生活的条件.1963年,美国《社区精神健康法》的颁布标志着社区照顾模式在美国正式确立,并得到政府、医学界和社会组织的支持.这些机构分别通过政策调整、增设服务部门、接受社区照顾理念等方式响应社区照顾的实施.尽管美国有观点批评社区照顾偏离疾病治疗的本质、脱离实际和运行体系混乱等问题,但该模式有效连接了医疗机构和患儿家庭,实现社会资源的合理利用,体现了精神障碍治疗的人道主义精神,并在一定程度上符合治疗的预期目标.社区照顾的实施不仅反映了 20世纪中期美国乐观激进的政治氛围对疾病治疗的影响,也是美国城市化进程的必然结果.
Abstract
Before the mid-20th century,most children with mental disorders in the United States were insti-tutionalized in facilities such as mental hospitals.However,with the rise in scandals surrounding these institutions,the increasing number of children with mental disorders,and a growing social demand for more humane treatment,the U.S.began to explore alternative models of care.The development and ap-plication of antipsychotic drugs helped stabilize the moods of many children,enabling them to reinte-grate into community life.In 1963,the U.S.passed the Community Mental Health Act,marking the for-mal establishment of the community care model,which was supported by the government,the medical profession,and social organizations.In response to this shift,institutions adapted by adjusting their pol-icies,expanding service departments,and embracing the community care concept.While some critics argue that community care suffers from issues such as a misalignment with the nature of treatment,de-tachment from reality,and operational confusion,the model has effectively facilitated connections be-tween medical institutions and children's families.It has enabled the more rational use of social re-sources,reflected the humanitarian spirit in treating mental disorders,and achieved the intended treat-ment goals to some extent.The implementation of community care not only reflects the influence of the optimistic and radical political climate of mid-20th century America on healthcare but also represents an inevitable consequence of the country's urbanization process.
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