| Summary: | 碩士 === 靜宜大學 === 社會工作與兒童少年福利學系 === 107 === After years of hard work, the paradigm for services offered to people with chronic mental illness in Taiwan has shifted from the traditional “treatment of illness” towards “community inclusion”. The support network and assistance for community psychiatric rehabilitation offered by halfway houses have a certain level of importance when people with chronic mental illness are returning to the community. The purpose of this research is to understand how social workers of halfway houses view community inclusion for people with chronic mental illness and strategies social workers use to promote community inclusion under the pressure from community residents. It examines the potential challenges halfway houses face when helping patients return to their communities and the solutions used in face of these challenges. Based on the research purposes, the researcher conducted depth interviews to collect and analyze qualitative data. The researcher used purposive sampling for this research by calling and inviting seven interviewees after looking through the Ministry of Health and Welfare’s list of established psychiatric halfway houses. The research results are as follows:
1. Halfway house social workers’ views on community inclusion for their residents:
(1) helps residents use community resources to make interactions
(2) elevates their ability to reach independent living
(3) improves their autonomy in daily life
(4) decreases the impact of stigma on mental illness
2. Strategies used when promoting community inclusion services:
(1) Empowerment of the residents: improve the residents’ adaptability; letting the residents direct life choices and problem solving
(2) Support offered by the organization: promoting work and employment; creating and maintaining relationships with the community
3. Challenges faced when promoting community inclusion and their solutions:
(1) Challenges faced when promoting community inclusion:
a. Residents’ personal factors: It is more challenging for middle-aged and elderly residents to reach independent living. Residents are unmotivated or unable to return to the community due to the interference from the symptoms of their mental illness.
b. Familial factors: Different views on community inclusion among residents, their family members and social workers affect the results of community inclusion.
c. Internal factors of the organizations: Lack of finances and raised operating costs limit the manpower and quality for community inclusion promotion. Different standpoints of the social workers and managers make it even more challenging for social workers to implement community inclusion. The burden of trivial administrative work shortens the time social workers have for case work and community inclusion services. Inflexible operating models neglect the principle of prioritizing the needs of residents when designing service programs. Different values held by the different professions impact the outcome of teamwork.
d. External environment and the service delivery system: remote locations of the organizations affect resource usage; stereotypes held by the public towards halfway houses, their residents and activities related to community inclusion; community residents’ unfriendly attitude towards halfway houses and their residents; limitations of the service delivery system
(2) Solutions to the challenges faced when promoting community inclusion:
a. Personal aspect: hosting events suitable for the residents’ participation with the clients’ best interest in mind; communicating and negotiating with the residents; social workers using daily observations to collect information on the residents
b. Family aspect: changing the views of family members by letting them see the change in the residents; clearly informing family members of their responsibilities
c. Community aspect: answering to community residents’ complaints; using the residents’ self-control to clarify misunderstandings with the locals
d. Interprofessional teamwork aspect: cultivate strong team chemistry; learning from each other in interdisciplinary settings; better understanding of each other within the professional team through meetings
Lastly, the researcher offers the following advice based on the findings mentioned above:
1. For policy making:
(1) Include ideas from multiple sources in performance evaluation to help organizations operate more practically.
(2) Make modifications to the healthcare insurance benefit rules and increase manpower to offer services.
(3) Raise awareness among the public to help with destigmatization.
(4) Improve the current service delivery system.
2. For organizations:
(1) Give social workers an appropriate amount of power.
(2) Improve team cohesion between the professionals.
(3) Create better connections with the family members of the support network.
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