居場所型デイケアのもつ可能性 --<私>が<育つ>場の治療--

Abstract

近年, 我が国における精神障碍者支援は「目標・目的地志向型」に大きく傾き, 格差や疎外を生み出しつつある. 一方で障害者自立支援法施行以前は豊富にあった「居場所型」支援は, 悪質な「囲い込み」との質的区別の問題を乗り越えられず, 廃れゆく途上にある. 本稿では居場所型デイケアの丁寧な質的記述を通し, 居場所型と囲い込みとを区別することと, 現行の支援傾向を再検討することを目的とした. 結果・考察から居場所型には隣の他者からのまなざしや, 共同的かかわりがあることを明らかにし, 「囲い込み」との違いを明確にした. さらに居場所型における<私>の<育ち>を支える側面を提示し, 現行の支援における居場所型の重要性を指摘した.

The mainstream of psychiatric care in Japan has been leaning toward the "goal oriented" model, and this trend has been inducing disparity among, and alienation of, all mentally challenged individuals. On the other hand, the "place of dwelling" model, which flourished before the implementation of the Service and Supports for Persons with Disabilities Act, has been in decline because of the difficulty of distinguishing between malignant establishments, often labelled "enclosures." This paper attempts to investigate the complex practices of "the place of dwelling" model, and make a distinction between this model and "enclosures, " as well as to re-examine the current mainstream psychiatric care. Finally, the author ascertained a difference between the "place of dwelling" model and "enclosures, " in terms of the attentive attitude of neighbors and the collaborative nature of relations. Moreover, it was revealed that "the place of dwelling" model places emphasis on "development" of "self", and it is suggested to be of importance for today's psychiatric care.