대리(de Facto) 정신보건 서비스 체계의 이용에 영향을 미치는 요인에 관한 분석

Abstract

The paradigm of care for persons with chronic mental illnesses has recently been shifted in Korea from institutionalization to community integration. Numerous changes in the service environment tend to target clients of mental health care organizations while a considerable proportion of people with similar clinical conditions have been institutionalized in various types of organizations whose auspices are other than mental health care. Under the current circumstances in which the subgroup of people, who tend to be socio-economically disadvantaged, has no viable alternative in the community to using such de facto mental health organizations, their chances of deinstitutionalization may decrease. This study thus aims at providing an increased understanding of the characteristics of the users and their service utilization, which in turn enables us to establish differentiated strategies within the current service context. In this study, a survey is conducted on the residential history of those with chronic mental illnesses both in the community and in institutions. Major characteristics of the users of de facto services are investigated along with the extent of their use of various existing mental and non-mental health services. Included is also an examination of the subjects' clinical and individual factors that may influence their use of de facto services. The study findings demonstrate relative disadvantages in deinstitutionalization in a subgroup of the population with chronic mental illnesses under the current mental health policies, and the author suggests intervening strategies specific to this population.