| Summary: | 博士 === 國立陽明大學 === 公共衛生研究所 === 95 === This study is to explore the knowledge produced by the psychiatric professionals of Yu-Li Veterans Hospital in creating the therapeutic community for the extended stay psychiatric inpatients to resettle themselves in the local Yu-Li community during the period from 1986 to 2006. In this clinical field study the author applied the methodology of narrative oral history to explore the encounter experiences of how the different individuals, including the patients, their families, their employers, local community inhabitants and hospital workers, to face the mental illnesses in the fields of Yu-Li Veterans Hospital, Yu-Li Town and Taiwan as three levels of therapeutic community. The author and her colleagues have collected the oral histories of 53 inpatients of Yu-Li Veterans Hospital, 4 patients’ relatives, 7 patients’ employers, 17 Yu-Li inhabitants and 16 hospital workers who participate in the psychiatric rehabilitation program. There were total 99 interviewees and 128 interviews.
Through the methodology of narrative, the mental illnesses were no more only objective diagnostic categories. They turn out the indispensable parts of subjective memories and experiences of whole life. Likewise the hospital and community were no more sheerly opposite dichotomy. They are all the parts of the continuum of living and therapeutic experiences. Moreover, as we overcome the bondage of existent knowledge paradigm and pay heed to the change of historical context the new paradigm and solutions will accrue to the inter-subjective experiences.
The author proposed the Yu-Li Veterans Hospital as the first of the three levels of therapeutic community to echo the subjective experiences of the patients’ inner virtual reality and help the patients understand themselves and maintain self-control. As a result, improving their treatment cooperation. The Yu-Li Town as the second level therapeutic community is an extension from the hospital-based intervention to make the patients’ disorders as unnoticeable as possible in the community. This is not only to avoid stigmatizing the mentally ill but also protect their self-image and self-esteem. Owing to the interventions of the first two levels therapeutic community, the burdens of the patients’ families have been lifted up and even the resilience and energy of the families can be restored. As a result, the patients ’families who live far away from Yu-Li and throughout Taiwan are willing to support their hospitalized relatives emotionally and participate in the care again, and thereby consist of the third level therapeutic community.
In the practice of therapeutic community, the workers of Yu-Li Veterans Hospital broke through the professional boundary to expand the realm of participation and encourage more people to participate in the care for the persons with severe mental illness. Through the understanding of the inner virtual reality of the patients the workers play the role of medium between the patients and the community, help the patients restore their relationship with their families and overcome the negative image in the community. Therefore, on the ground of therapeutic community they can regain their life in Yu-Li, which they have identified as their new homeland.
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