Can Two Wrongs Make a Right?
Can Two Wrongs Make a Right?
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两个错误能构成一个正确吗？
DOI：
10.1353/ppp.2004.0060
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发表时间：
2004
期刊：
影响因子：
--
通讯作者：
Toby Williamson
中科院分区：
文献类型：
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作者：
Toby Williamson
服务使用者，照顾者和专业人士不同意精神障碍的性质在惊人的新启示！初看起来，富尔福德和科隆博使用语言分析和实证方法来证明这一点，似乎并没有告诉心理健康界的人他们还不知道的任何事情。两极/辩证轴（根据你的意识形态立场选择你喜欢的术语）一端是反精神病学运动，另一端是生物遗传学家，这是众所周知的，也是有据可查的。然而，正是这种轻率和由此产生的实际影响，使这项工作对21世纪初的心理健康实践的理论、应用和经验具有根本性的重要意义。关于不同模式的精神障碍的讨论通常在服务内部或服务与服务用户和非正式护理人员之间的争论中进行，关于解决服务用户需求的最适当方法，或者关于心理健康和心理健康问题的性质的抽象讨论（通常在下班后喝酒）。从斗牛场里的血毛飞扬，到天空中的燕子无休止地追逐着自己的尾巴。可悲的是，这样做的结果往往是痛苦和未解决的冲突，不同的当事方进一步陷入防守，根深蒂固的立场，最不强大的（通常是服务用户）遭受最严重的后果。双方都认为对方是错的，但又无法说服对方;这是一个两个错误不等于一个正确的例子，尽管略有不同。辩论很少以建设性的、创造性的和解决问题的方法为基础，部分原因是迄今为止似乎既没有足够的经验证据作为基础，也没有解决问题的概念和实践工具。一般来说，心理健康的主流研究往往侧重于症状和治疗干预等问题（James and Burns 2002）。然而，对服务用户意见的调查显示，用户接受和体验服务的方式仍然存在相当大的问题（Rose 2001）。其他调查，以及用户主导的研究，如心理健康基金会的生活战略，也表明用户关注的重点可能与服务提供者的关注重点非常不同（Faulkner和Layzell，2000年; Nicholls等人，2003年; Repper，2000年）。事实上，在20世纪90年代进行的一项研究表明，服务使用者优先考虑的实际问题，如个人财务，住房和社会支持，而专业人士认为治疗和监测等问题是最优先的（Shepherd，Murray和Muijen 1995）。结合这一点，人们很可能会认为，有相当明确的证据表明，“
SERVICE USERS, carers, and professionals disagree about the nature of mental disorder in startling new revelation!” On first appearances Fulford and Colombo’s use of linguistic-analytic and empirical methods to demonstrate this point may not seem as if it is telling those in the mental health world anything that they do not already know. The bipolar/dialectical axis (choose your preferred term depending on your ideological position) with the anti-psychiatry movement at one end and the biogeneticists at the other is both well-known and welldocumented. Yet it is precisely that flippancy, and the practical implications that flow from it, that make this work so fundamentally important to the theory, application, and experience of mental health practice at the beginning of the twentyfirst century. Discussions about different models of mental disorder usually play themselves out in arguments within services, or between services and service users and informal carers, about the most appropriate approach to take in addressing a service users needs, or in abstract discussions (often over a drink after work) about the nature of mental health and mental health problems. From blood and fur flying in the bull pit, to swallows endlessly chasing their tails high in the sky. Sadly, the results of this all too often are bitter and unresolved conflicts, different parties digging themselves even further into defensive, entrenched positions, and the least powerful (usually service users) suffering the most as a consequence. Both sides believe the other to be wrong yet cannot convince them of this; an example, albeit with slight variation, of two wrongs not making a right. Rarely are the debates grounded in a constructive, creative, and problem-solving approach on a day-to-day basis, partly because hitherto there does not seem to have been either sufficient empirical evidence to base this upon, or the conceptual as well as practical tools with which to grapple with the issues. Generally speaking, mainstream research in mental health has tended to focus on issues such as symptoms and treatment interventions (James and Burns 2002). However, surveys of service users’ views still show considerable problems in the way services are received and experienced by users (Rose 2001). Other surveys, together with user-led research, such as Strategies for Living at the Mental Health Foundation, have also shown how the focus of users’ concerns maybe very different to that of service providers (Faulkner and Layzell 2000; Nicholls et al, 2003; Repper 2000). Indeed, a piece of research carried out in the 1990s, which would probably still hold true today, showed that service users prioritized practical issues such as personal finance, housing, and social support, whereas professionals saw issues such as treatment and monitoring as being the highest priority (Shepherd, Murray, and Muijen 1995). Combining this, one might well argue that there is fairly clear evidence of the “