國外心理健康部門之親密關係暴力防治

 

  由於暴力將對人們身心健康造成劇烈的、長短不一的影響,英國Department of Health指出家庭暴力與性暴力帶給心理健康服務很重大的挑戰,是以,世界衛生組織、英國、澳洲、加拿大等心理健康政策白皮書中,皆可看見國際將暴力防治,特別是預防與避免對婦女的各種形式暴力,視為心理健康政策關鍵目標之一 (Department of Health, 2011, 2014; World Health Organization, 2016; Department of Health & Human Services, 2012; Mental Health Commision of Canada, 2012)。

 

  有鑑於醫療體系服務人員很可能是暴力或性暴力受害者第一,甚至是唯一的接觸對象,世界衛生組織出版了一系列提供給醫護人員服務受暴者之手冊,包括:辨識親密伴侶暴力及其臨床照顧、性侵害之臨床照顧、親密伴侶暴力和對女性性暴力防治之訓練、提供服務之政策與方案、親密伴侶暴力之責任通報等,更期待藉由出版物及宣導,引起健康照顧領域與政策制定者對婦女暴力之關注,使相關人員能更了解需求,以提供適合的、個人化的醫療健康體系回應(WHO, 2013; Department of Health, 2014)。

 

  美國疾病管制與預防中心(CDC)更將性暴力列為心理健康政策重點項目,透過精準周延的資料庫把關,提升以數據呈現暴力事件現況的準確度,進而研擬對症下藥的介入及預防政策;多數預防政策或方案皆強調從基層組織深耕,如:校園、社區型機構等,並且著重規劃、執行與評估三階段的落實,目標在於期能有效達到預防各種性暴力不再發生(Centers for Disease Control and Prevention and National Center for Injury Prevention and Control, 2010, 2015, 2016)。

 

  張玨、張菊惠、江東亮(2013)將先進國家介入親密關係暴力之心理健康方案依標的對象分為下列三項:一、對家暴受害者/加害者及其家人的心理健康,二、家暴受害者/加害者生活的場所(學校、家庭、職場或醫院)相關人員,以及三、對提供服務者(醫事人員、社工或其他服務提供專業人員)。

 

  與我國的防治工作對照,國際上的防治工作更著重實質的預防工作,包括建立完整及精確的數據資料庫以呈現暴力事件現況、設計評估表以衡量預防工作的完善程度,結合地區性衛生部門服務高風險家庭、降低家暴發生率,或在婦女產檢時主動詢問是否有家暴跡象,並提高警覺。暴力發生後,除了受害者治療與輔導服務外,不論公、私部門都極力提供加害者及加/受害者家人的健康評估與輔導服務,這都是台灣目前仍有改善空間的防暴工作缺口。此外,除了在學校加強宣導反家暴知識外,澳洲國會在2012年更與部分企業達成家暴休假津貼協議,須尊重受暴者並保密、提供給薪假和轉介國內支持性服務等(張玨、張菊惠、江東亮,2013)。

 

  由國外的作為,可看到我國主管心理健康之公部門,除了提供經費補助、規劃教育訓練或處遇標準之外,仍有許多值得發展與推動的親密關係暴力心理健康議題,而這也有賴民間部門實務經驗累積與倡議。盼以下政策與方案能成為我國發展親密伴侶暴力防治工作之借鏡。

 

參考資料:

World Health Organization(2016)。Comprehensive mental health action

plan 2013–2020。2016年11月3日,取自網路:

http://www.who.int/mental_health/action_plan_2013/en/

Centers for Disease Control and Prevention, National Center for Injury

Prevention and Control, Division of Violence Prevention (2010).Training

Professionals in the Primary Prevention of Sexual and Intimate Partner

Violence. 5th Feb., 2017 Retrieved from

https://stacks.cdc.gov/view/cdc/5760

Centers for Disease Control and Prevention, National Center for Injury

Prevention and Control, Division of Violence Prevention (2015).Intimate

Partner Violence Surveillance Uniform Definitions and Recommended Data

Elements, Version 2.0. 1st Feb., 2017 retrieved from 

https://www.cdc.gov/violenceprevention/pdf/intimatepartnerviolence.pdf

Centers for Disease Control and Prevention, National Center for Injury

Prevention and Control, Division of Violence Prevention (2016).Sexual

Violence on Campus: Strategies for Prevention. 1st Feb., 2017 Retrieved from 

https://www.cdc.gov/violenceprevention/pdf/campussvprevention.pdf

Deparment of Health (2014) Annual report of the Chief Medical Officer 2013.

Public Mental Health Priorities, Investing in the Evidence. 7th Oct., 2016 retrieved from https://www.gov.uk/government/uploads/system/uploads/attachment

_data/file/413196/CMO_web_doc.pdf

Deparment of Health (2014) Domestic and sexual violence and abuse. 7th Oct., 2016 retrieved from

https://www.gov.uk/government/publications/domestic-and-sexual-violence-and-abuse

Department of Health & Human Services (2012)Using policy to promote mental health and wellbeing -

A guide for policy makers.7th Oct., 2016 retrieved from 

http://apo.org.au/resource/using-policy-promote-mental-health-and-wellbeing-

guide-policy-makers

Mental Health Commision of Canada (2015)Informing the Future Mental Health Indicators

for Canada 2015. 7th Oct., 2016 retrieved from 

http://www.mentalhealthcommission.ca/English/document/68796/informing-future

-mental-health-indicators-canada

張玨、 張菊惠、江東亮(2013)。心理健康融入各項政策先驅評估計畫(2年計畫)。衛生福利部委託研究計劃,計畫編號MOHW102-TD-M-111-H003。

 


             資源列表
資源名稱
產出日期
作者
2015/05/08
Department of Health; The Rt Hon Norman Lamb
2011/02/17
Department of Health; Ministry of Justice, National Offender Management Service; Crown
2011/02/17
Department of Health / NOMS Offender Personality Disorder Team; Crown
2004
World Health Organization. Dept. of Mental Health and Substance Dependence, Victorian Health Promotion Foundation, University of Melbourne
2016
Department of Health
2015
World Health Organization
2016
Health and Criminal Justice Programme Liaison and Diversion Development Network
2015
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; Matthew J. Breiding, Kathleen C. Basile, Sharon G. Smith, Michele C. Black, and Reshma Mahendra.
2016
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention
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Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Violence Prevention; Deborah Fisher, Karen S. Lang, and Jocelyn Wheaton.
2017/02
Centers for Disease Control and Prevention

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