从“去机构化”到“再机构化”:文化契合性如何影响社区精神康复共同体的公共性被引量：20

From“De-institutionalization”to“Re-institutionalization”:How Cultural Fit Affects the Publicity of the Mental Rehabilitation Community

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摘要 “去机构化”和建构社区共同体,是应对“生物—医疗”精神康复模式诸多弊端的有效途径。但是在中国语境中,文化的不契合性成为阻碍建构社区精神康复共同体的因素。研究运用参与观察和访谈法,对某市实施近十年的社区精神康复实践项目进行分析,探讨该项目从最初倡导多主体参与和多元化职业康复模式的“去机构化”构想,到服务单一、对象同质性、多样职业康复弱化的“再机构化”的演变过程,以及其中的文化影响因素。研究从制度文化和社会文化两方面分析文化契合性的重要性,在社区精神康复实践中,制度文化表现出管控性较强和服务性不足;社会文化出现区隔性社区文化与家长权威制文化并存,它们阻碍了社区精神康复共同体公共性的形成。研究的意义在于提出在中国语境中,精神康复实践“去医学化”遇到的阻力及可改善的途经,以及文化契合性对中国实施“去机构化”社区精神康复的重要性及其在社区治理中具有功能性。 “De-institutionalization”and the construction of community care could be effective ways to deal with many disadvantages of the bio-medical mental rehabilitation model.However,in the Chinese context,cultural mismatch has become an obstacle to the mental rehabilitation community.After three years of observations and interviews,we analyzed a community mental rehabilitation practice project that had been implemented for nearly 10 years.In this paper,we discussed the project s evolution from the“de-institutionalization”concept which initially advocated multi-agent participation and diversified occupational rehabilitation mode,to the process of“re-institutionalization”of single service,the homogeneity of objects,the weakening of diversified occupational rehabilitation,and the cultural influencesat work throughout these changes.We analyzed the importance of cultural fit from the perspectives of institutional and social culture.In the practice of community mental rehabilitation,institutional culture showed a tendency of strong control and insufficient service;social culture showed compartmentalized community culture and authoritative parental culture.Several cultures jointly hindered the publicity of a community mental rehabilitation.We explored the resistance encountered in the“de-medicalization”of local mental rehabilitation practice in the Chinese context and the ways to improve it.We also suggested that cultural fit is important for the“de-institutionalization”of community mental rehabilitation in China,and found culture to be functional in community governance.

作者吴莹胥璇 Ying Wu;Xuan Xu

机构地区中央民族大学民族学与社会学学院山西农业大学资源环境学院

出处《公共行政评论》 CSSCI 北大核心 2021年第6期85-103,198,199,共21页 Journal of Public Administration

基金北京社科基金规划项目“影响社区精神康复的社会性因素:以北京为例”(项目号:21SRB007)。

关键词社区精神康复共同体去机构化再机构化文化契合性公共性 Mental Rehabilitation Community De-institutionalization Re-institutionalization Cultural Fit Publicity

分类号 D63 [政治法律—中外政治制度]

作者简介吴莹,中央民族大学民族学与社会学学院副教授;胥璇,山西农业大学资源环境学院助理教授。