20世纪中期美国对精神障碍儿童的社区照顾探析  

Community Care of Children with Mental Disorders in the United States in the Mid-20th Century

作　　者：孙帆 Sun Fan

机构地区：[1]肇庆学院旅游与历史文化学院、西江流域中外文化交流研究中心

出　　处：《历史教学(下半月)》2024年第12期34-46,共13页History Teaching

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。Before the mid-20th century, most children with mental disorders in the United States were institutionalized 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 application of antipsychotic drugs helped stabilize the moods of many children, enabling them to reintegrate into community life. In 1963, the U.S. passed the Community Mental Health Act, marking the formal 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 policies, 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, detachment from reality, and operational confusion, the model has effectively facilitated connections between medical institutions and children's families. It has enabled the more rational use of social resources, reflected the humanitarian spirit in treating mental disorders, and achieved the intended treatment 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.

关 键 词：美国儿童 社区照顾 精神障碍 去机构化 

分 类 号：K705[历史地理—历史学]