替代服务与社区精神康复的转向——以日本“浦和贝塞尔之家”为例

Alternative Service and the Transformation of Community Mental Rehabilitation——A Case Study of Bethel Home in Japan

文章基于对替代服务概念的理解,通过考察日本在开展精神康复中运用替代服务的典型案例,探讨了替代服务的作用及对专业服务所产生的影响。替代服务与专业服务之间的关系既不完全等同于以往传统助人者与受助者之间的专业关系,又不完全体现为去专业化的朋辈支持,而是一种值得探索的独特关系。在这一独特关系中,精神障碍者自助开展的替代服务对社区精神康复而言具有重要意义,它与专业服务之间形成了一种相互支持、互相协作的关系,从而提升了精神障碍者的主体性与生活质量。正是在改善当事者主体性的意义上,文章认为建设精神卫生公共性需要发展替代服务,进而在本土社区精神康复之中,展望开展替代服务的必要性与可能路径。

This paper discusses the concept of the alternative service and the influence of the service in the study of the application of alternative services in the field of mental rehabilitation.The relationship between alternative services and professional services is not exactly the same as that between the traditional helper and the recipient,nor is it fully embodied as a professional support.In this sense,it is of great significance for the mental rehabilitation of the community,which has formed a kind of mutual support with professional service,promoting the subjectivity and the quality of life.Therefore,to improve the subjectivity of the parties concerned,alternative services should be established in reference to the necessity and possible path of the alternative service in the rehabilitation of local communities in China.