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The author:(作者)aaapublished in(发表于) 2013/12/16 0:36:47 Guangzhou psychiatric rehabilitation center problems， patients not to sent back to
-The information on this page times, included correspondent Li Xuebiao Wu Chen Shuhao
Photography information Times reporter Zhu Yuanbin
This week, the third edition of "love Guangzhou" assistive services week. Guangzhou currently mentally ill more than 40,000 people, according to the plan, Guangzhou will build 13 psychiatric rehabilitation services in the city, for the rehabilitation of mental patients in the community provide an appropriate environment and professional social work services. But the pilot's first integrated service centre in Guangzhou the past six months, the results are unsatisfactory. Reporters in yuexiu district comprehensive service center for psychiatric rehabilitation, mental patients family does not understand, it is difficult to recruit professional rehabilitation after training social workers and students in the community was still subjected to discrimination in employment, community rehabilitation of mental illness face three difficulties.
Pilot
Six months service 67-mentally ill
Yuexiu district spirit rehabilitation integrated Service Center (Xia said "fine fully") is located in Wen Denan road precincts 26th, of "love homes" within, is a block quaint of mansion child, here has is Guangzhou Yang love special children parents Club of location, last year May, as Guangzhou psychiatric community rehabilitation of first pilot, official for yuexiu District holding disability card of psychiatric rehabilitation who provides free of community rehabilitation service.
Yuexiu district Rehabilitation Center Director ren l, at present, psychiatric community rehabilitation services are divided into vocational training, halfway houses and social work services 3. Among them, the vocational training includes manual, cleaning, retail services and other types of vocational training half-mainly for the needs of mentally ill community hostel services during the transition period after the treatment; social work services are for mental patients and their families to provide professional psychological counselling, psychological counselling, family relations, adjustment guidance, social programs, rehabilitation and other services.
After six months of operation, yuexiu district, currently "finishing comprehensive" for a total of 67 jurisdictions providing services to the mentally ill, of which 22 people vocational training, social work services in 41 "main" halfway house has hosted 4 mental patients came to stay, at present there are only two people in the House.
Trouble 1
Family members did not understand
Either reluctant to send or send won't pick up
According to the construction plan of community psychiatric rehabilitation service centre in Guangzhou, Guangzhou City by the end of next year to build 13 comprehensive psychiatric rehabilitation service centres, each "fine comprehensive" should be not less than 200 members with mental disabilities or mental patients ability to provide support services. However, yuexiu district "fine comprehensive" testing six months received worth so much less than the expected number of mentally ill.
"The yuexiu district currently registered mental patients to 4,720 people, but it is ' essential comprehensive ' exposure to less than hundred people. Being served, there are some social worker that specializes in psychiatric community rehabilitation ' referral '. In May of this year ' fine comprehensive ' when opened through media reports, consultation and registration for a wave of boom, but now more and less to come to consult. "Ren l said.
Ren l said, they will preach through many communities found that after many mental patients discharged from hospital, family members were "off" in the House are not allowed to go out, is worried that after they are in touch with the community it is easy to "sleeping dogs lie". Years of large doses of medication, most of these patients will appear lethargic, apathetic and other symptoms, is not conducive to their rehabilitation in the future.
Apart from family members do not want to "send" and send out don't want to "answer" go back and "fine arts" met embarrassed one of the social workers. "Halfway house" project social worker jiamin told reporters that the dormitory to the rehabilitation of mental patients provides a community environment, there is a need to involve their families, "we received a number of cases, are parents of sick children to go through after a check, it rarely or even never to visit again, even if it is called social workers told the family is not willing to come. Faced with this situation, we can only send survivors back to the family. ”
Jiamin says, "halfway house" targeted increase of mentally ill patients, in addition to the ability to adapt to community, family life, a more important point is that in order to improve relations between members and their families.
Trouble 2
Social workers far less than
Hearing services patients quit
Currently, yuexiu district, "fine comprehensive" total of 9 staff responsible for the vocational training and halfway houses two projects, only 3 of social workers that have a professional background. "Manning is far from enough, was one of the factors restricting the development of our. "Ren l says," fine comprehensive "staff recruitment notices long hung on a Web site," people have of us, but when they heard that serves mentally ill, a lot of people are discouraged. Not long ago, we hired a girl, all pretty good looking. At Community Jing heard fully, work the next day, the girl's parents came to pick her up. ”
Concerns about the candidate, ren l understood, however she stressed that personnel working in the psychiatric community rehabilitation, professional training, before they are, "we're focused on is less who have, after receiving treatment at the hospital, low level violence, contact with them is still very safe. "In addition, social workers told reporters that when in contact with mentally ill, they will keep a careful watch," If the other body odors, first lax as well, we will as soon as possible, communicate with families, is rushed to the hospital for treatment of the condition of aggravating. "
Predicament 3
With employment discrimination
Snack bar only the lame are not refined residue
Aqin, 41 years old children with milder forms of schizophrenia for almost 20 years, came in June, yuexiu "fine comprehensive" access to vocational training, received training in handmade, and retail. Aqin told reporters that she had many experiences working at clothing stores or grocery stores, at first telling employers of their illnesses, "but after a long time, some weird behavior can cause my boss's attention, was quickly fired. ”
After six months of vocational training, "fine comprehensive" wanted to find a job for aqin within the community, but with great difficulty. "McDonald's and KFC fast-food chain for the acceptance of people with disabilities is still pretty high, but only slightly lame recruiting mentally disabled or handicapped, refuses to accept mentally. "Social workers responsible for vocational training small gong told reporters that at present, only a few attend vocational training have been applying for, such as property companies engaged in cleaning work shall attend to the shelves at the supermarket or in the community. "Community for mental patients in employment, is they are more familiar with the community environment, and second, work flexibility, corporate hourly rate, paid by such means of measurement, more conducive to their integration into society. ”
Case
Depressed boy "housing" for half a year
Live in the civilization Lu Debin, yuexiu district, (not his real name) is 18 years old, was diagnosed two years ago with a two-way mood disorder as well as depression, after hospitalization, bin were his parents sent him to a mental rehabilitation center "halfway house", received from the hospital to a family transition between counselling. "Halfway house" set of services for a period of 9 months to two years.
Responsible for the "halfway house" project social worker jiamin told reporters that the bin when you first entered the dormitory, due to the effects of taking a lot of drugs, the people apathetic, on the surrounding transaction is completely not interested in, and have more than 10 hours of sleep a day, obsessive compulsive disorder, the same action repeated more than 10 times to feel at ease.
Enter the "halfway house", the social worker and the "housemother" to bring tailored professional services project, such as medication management training, through daily medication training, lectures on mental illness, medication forms such as lectures and exchange of personal illness, Gao Bin's own understanding of their condition, as well as habits of self medication. Bin also accepts personal self-care training, social support, community resilience training, financial management training, and so on.
Through six months of "hostel" the life, to bring daily life has been greatly improved, to wash clothes, and consciously participate in collective activities.
(Original title: mentally helpless as "the outcast")
□本版撰文 信息时报记者 吴瑕 通讯员 利雪标 陈树豪
本版摄影 信息时报记者 朱元斌
本周是第三届“爱心满羊城”助残服务周。广州目前有精神病患者4万多人，根据规划，广州将在全市建立13个精神康复综合服务中心，为精神病人在社区里康复提供合适的环境和专业的社工服务。但是广州首个综合服务中心试点半年来，效果并不理想。记者日前在越秀区精神康复综合服务中心了解到，精神病康复者家庭不理解、难以招聘到专业的康复社工以及经过培训后的学员在社区就业仍遭歧视，成为精神病社区康复面临的三大难点。
试点
半年服务了67名精神病康复者
越秀区精神康复综合服务中心(下称“精综”)位于文德南路东横街26号的“爱心家园”内，是一座古朴的大宅子，这里曾是广州市扬爱特殊孩子家长俱乐部的所在地，去年5月，作为广州市精神病社区康复的首个试点，正式为越秀区持残疾证的精神病康复者提供免费的社区康复服务。
越秀区残疾人康复中心主任任莉介绍，目前，精神病社区康复服务主要分为职业训练、中途宿舍以及社工服务3个方面。其中，职业训练包括手工、清洁、零售服务等类别的职业培训；中途宿舍主要为有需要的精神病康复者提供治疗后的社区过渡期宿舍服务；社工服务则是为精神病康复者及家属提供专业的心理辅导、情绪辅导、家庭关系调适、人际交往训练、康复指导等服务。
经过大半年的运作，目前越秀区“精综”共为67名辖区内的精神病康复者提供服务，其中职业训练有22人，社工服务有41名“案主”，而中途宿舍共接待了4名精神病康复者前来入住，目前还有两人在舍。
困境1
患者家属不理解
要么不愿送要么送了不愿接
根据《广州市社区精神康复综合服务中心建设方案》，明年年底前广州全市要建立13个精神康复综合服务中心，每个“精综”应具备不少于200名精神残疾人或精神病康复者提供支援服务的能力。然而，越秀区“精综”试点大半年以来，接待的精神病康复者人数远远低于当时的预期。
“越秀区目前登记在册的精神病康复者为4720人，但目前‘精综’接触到的还不足百人。正在接受服务的对象中，有不少是一些专门做精神病社区康复的社工‘转介’过来的。今年5月‘精综’开张的时候，通过媒体的报道，曾掀起一阵咨询和登记的热潮，但如今前来咨询的家庭越来越少了。”任莉表示。
任莉说，他们通过多场社区宣讲会发现，不少精神病康复者出院后，就被家属“关”在屋内不允许出门，就是担心他们接触社会后很容易“惹是生非”。由于常年大剂量服药，这些患者多数会出现嗜睡、精神萎靡等症状，不利于其将来的康复。
除了家属不愿意“送”出来外，送出来后不愿意“接”回去，也是“精综”社工们遇到的尴尬之一。“中途宿舍”项目社工嘉敏告诉记者，宿舍虽然给精神病康复者提供了一个社区康复的环境，但仍需要其家属一起参与，“我们接待过好几个个案，都是父母将患病的孩子办理了入住手续后，就很少甚至再也不来探望了，即使是社工打电话通知家属也不愿意过来。面对这样的情况，我们最后只能把康复者送回家庭。”
嘉敏表示，“中途宿舍”的目标除了为提高精神病患者适应社区、家庭生活的能力外，更重要的一点是为了改善他们与家庭成员相互间的关系。
困境2
社工人手远不足
一听服务精神病患就不干了
目前，越秀区“精综”里共有9名工作人员负责职业训练和中途宿舍两个项目，其中拥有专业背景的社工仅3名。“人手远远不足，是制约我们发展的因素之一。”任莉表示，“精综”工作人员的招聘启事长期挂在网站上，“前来应聘的人也不少，但一听说服务对象是精神病康复者，很多人都却步了。不久前，我们招聘了一个女孩，各方面条件都不错。听说在社区精综工作，上班第二天，女孩的家长就赶过来把她接走了。”
对于应聘者的担忧，任莉表示理解，然而她强调，从事精神病社区康复工作的人员，事先都会接受专业的培训，“我们主要针对的是程度较轻的康复者，他们在医院接受治疗后，暴力倾向程度很低，和他们接触还是很安全的。”此外，有社工告诉记者，在接触精神病康复者的时候，他们也会保持细心观察，“如果对方出现身体异味、眼神涣散等情况，我们会尽快和家属沟通，病情有加重的就要送往医院治疗”。
困境3
患者就业受歧视
快餐店只愿招肢残不招精残
今年41岁的阿琴患有轻度精神分裂症将近20年，今年6月进入越秀区“精综”接受职业培训，接受手工制作以及零售方面的培训。阿琴告诉记者，她有过多次在服装店或士多打工的经历，起初都瞒着雇主自己的病情，“但是时间一长，我一些怪异的举动就会引起老板的注意，很快就被炒掉了。”
在半年职业训练后，“精综”想在社区内为阿琴找份工作，但重重困难。“麦当劳、肯德基这样的连锁快餐店对于残疾人的接受程度还是挺高的，但只愿意招收智障或者轻度肢残的残疾人，拒绝接收精神病康复者。”负责职业训练的社工小龚告诉记者，目前，仅有几名参加职训的学员成功应聘，如在物业公司从事清洁或者在社区超市负责货物上架等工作。“社区更适合精神病康复者就业，一是他们对社区的环境比较熟悉，二是工作弹性较大，企业采用时薪、计量等方式支付薪水，更有利于他们融入社会。”
个案
抑郁症男孩“入舍”半年变化大
家住越秀区文明路的斌仔(化名)今年18岁，两年前被确诊患有双向情绪障碍以及抑郁症，经过住院治疗后，斌仔被父母送到了精神康复综合服务中心“中途宿舍”，接受从医院到家庭之间的过渡辅导。“中途宿舍”设定的服务期限为9个月至两年。
负责“中途宿舍”项目的社工嘉敏告诉记者，斌仔刚进宿舍时，由于服用大量药物的影响，整个人精神萎靡，对周边事务完全没兴趣，一天睡十多个小时的觉，还有强迫症，同样的动作重复十多次才能安心。
进入“中途宿舍”后，社工和“舍监”要为斌仔量身制定专业的服务项目，如药物管理训练，通过日常服药训练、精神病知识讲座、药物知识讲座和个人病情交流等形式，提高斌仔对于自身病情的了解以及自觉服药的习惯。斌仔还要接受个人自理训练、社交支援训练、社区适应能力训练、理财能力训练等等。
通过半年多的“宿舍”生活，斌仔生活自理有了很大的提高，能够自己洗、晾衣服，自觉参加集体活动。
(原标题：精神病康复者无奈成“弃儿”)
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