<論文>精神障害者の「社会復帰」 : 個人誌解釈の意義とワーカーの使命

Abstract

In the sociology of mental health, the ex-patients' rehabilitation has been long thought to be impossible. But this proved to be wrong in the light of the results of mental-health-policy reforms in U.S.A., U.K., Canada, Italy and other nations. In Japanese notorious mental health care, medical practice was said to be the same as farmers' management business to keep domestic animals (patients) in order to make profits in the meadow of health-insurance systems. But, by many people's efforts, the support for the rehabilitation of the mentally disabled are at last burgeoning. In this paper, I examined the earliest trial-and-error case. The protagonist could successfully "rehabilitate" after 15 years' efforts. For the frame of interpretations, I made use of N.K. Denzin's concept of Epiphany; the "moment of problematic experience that illuminates personal character, and often signifies a turning point in a person's life". This biography was written by a Psychiatric Social Worker, and may be not wholly qualified as a good exemplar of "thick description" labelled as "relational-interactional" or "descriptive-contextual". But, we can still look it over for some rarely mentioned facts. The main Epiphanies for the protagonist was that he could not work in town as a normal person because of the sub-effects of medication and hospitalization. Facing total loss of confidence, he could not stay out of hospital without other encouraging Epiphanies. Various social resources were no use for him to regain the will to autonomous living. The best remedy was neither medications nor professional care, but self-help-groups like gatherings of his hospital fellows. Under the total denial of mental patients' human rights, the PSWs, if having a good ear, were the only hope for systems reform which enhance ex-patients' group formation. Their Interpretations of biographies were vital in that vein.