從WHO心理衛生報告-探討台灣社區老人的心理衛生問題和政策

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ၡāࢋĈˠ˾ҁ̼̏јࠎ͵ّࠧன෪Ăέ៉ࢬᓜ੼᛬̼ۤ ົҁѐˠ۞͕நઉ૵યᗟᅮдϏֽ߆ඉّᛉᗟՀ ΐͽࢦෛĄώ͛ͽ WHO 2001 ѐ೩΍۞͕நઉ૵ ಡӘࠎጱ͔Ă޽΍߆عᅮдᗁᒚ໰ᜪវր׶ੑચ გந˭Ăטࢎ͕ந኎Ϡ߆ඉֽܲᅪ׶Լචϔி۞ ͕நઉ૵Ą߆ඉטࢎ۞ึԔߏෞҤ͕நઉ૵۞ᅮ Րăڇચ೩ֻăڼᒚă࿰֨׶ܳซඉரĂ֭౅࿅ ׶׎΁ڇચր௚ЪүĂ၆ٺ͕நઉ૵ඕڍϺᅮࢋ జႾീ׶̶ژͽ޺ᜈԼච̈́ࢬ၆Ϗֽ۞߄ጼĄឰ ԧࣇͽ͵ࠧ኎Ϡ௡ᖐ೩΍۞઼छ͕ந኎Ϡ߆ඉࠎ ણ҂ᖡဦĂᒉౄԧࣇۤડҁˠ͕நઉ૵۞छ๩Ą ᙯᔣෟĈ͕ந኎Ϡă͕ந኎Ϡ߆ඉăّҾ͹߹̼Ą

݈āā֏

ˠ˾ҁ̼̏јࠎ͵ّࠧன෪Ăԧ઼Ϻּ̙γĄҖ ߆ੰགྷޙົˠ˧ఢထ఍Ğ2002ğ޽΍ϔ઼ 91 ѐέ៉ гડᓁˠ˾ࠎ 2,249 ༱ˠĂշّπӮዶ׻ࠎ 73.1 ໐Ă ّ̃ࠎ 79.0 ໐ĂଯҤҌ 140 ѐॡ૟ົؼܜҌ 79 ໐׶ 86 ໐ĄѩγĂҁѐˠ˾ּͧ૟Ϥϔ઼ 91 ѐ̝ 9.0% ᆧҌ 140ѐ̝ 29.8% ć׎̚ 75 ໐ͽ˯ҁҁˠ˾Κ 65 ͽ˯ˠ ˾ ͧ ּ Ϻ ૟ Ϥ ϔ ઼ 91 ѐ ̝ 37.8% ᆧ Ҍ 140 ѐ ̝ 52.7%ĂѺ໐ˠ༄זϔ઼ 140 ѐॡ࿰ࢍ૟෹࿅ 2 ༱ 3 ˼ ˠĂ֖֍έ៉੼᛬̼۞ᚑࢦଐڶĄҌٺϏֽˠ˾ѐ᛬ ඕၹϺ૟ϤܦӴ̝፶᝕ݭၗĂు႙ซˢ੼᛬̝ࣆܛᛗ ݭၗĂГซ҃ᖼតјᘦؠ̝ܜߗݭၗĄ έ៉ҁˠ่̙ߏˠᇴ޺ᜈᆧΐĂΩϤٺ̂ᒖဩ۞ ኏ᑝᇆᜩĂۤົԣిᖼݭ࿅඀Ăΐ˯ዋె͵ّࠧགྷᑻ ̙ഀঈĂ็௚ࣖந྽ᇇఢቑ̈́ۤົᆊࣃ៍هዎצ݈ٙ Ϗѣ۞ԼតĂ็௚छलዳ׊֨ҁ̝Αਕు႙ഴऴĂະ ҁૣԂ̝׽ѣᆊࣃ͟႙ё຋ĂҁˠᙱҺ΍னአዋӧ ᙱĂԛјۤົ௲Ԕன෪Ą໰ᜪҁˠయЇϺϤछलБొ ٚፉĂซ҃ᖼјࢋՐ߆عԷႊՀ᎕ໂ۞֎ҒĂтҖ߆ ੰ८ؠĶາ͵ࡔઉ૵໰᜕ࢍ൪ķ۞ેҖĂͽĶдгҁ ̼ķࠎϫᇾĂഇ୕ޙϲۤડҁˠܜഇ໰᜕۞ፋЪّڇ ચშඛĞҖ߆ੰۤົ჊Ӏଯજ؎ࣶົĂ 2000ğĂд၁ រۤડ̚ԧࣇ࠻ז੫၆ҁˠ͕ந኎ϠڇચĂᔵ೩ֻε ംҁˠ͟ม໰ᜪ͕̚Ăҭѣᙯҁˠ͕ந኎Ϡ۞߆ඉ׶ ઉ૵ܳซ߿જ̪Ϗצז҂ณĄ ҁˠд୎ѐϠ߿૱ѣᇎ៭۞ଐԛĂҭݒ૱జنෛ ᄃᄱ෧ćѩγĂܠൄঔᐵ̈́׎ι়ঽٙౄј۞εംা ҁѐˠϺдᆧΐćϏֽĂ͕ந኎Ϡ඗၆ߏ̙ΞᔖҺ۞ યᗟĄଂ઼ᅫ߆ඉֽ࠻ѩયᗟĂᓑЪ઼ 2002 ѐҁ̼ Җજ઼ᅫඉரĞthe International Strategy for Action on Ageingğ೩΍ࢬ၆ 21 ͵ࡔ۞ˠ˾ҁ̼ன෪ĂЧ઼ᑕૻ አˬ̂͞ШĈĶҁ̼͵ࠧ۞൴णăᆧซҁѐˠ۞ઉ૵ ᄃض჊щှĂቁֹܲਕᄃ͚޺۞ᒖဩķć҃ѩˬ͞Ш ӈߏઇࠎ྿זјΑዋᑕҁѐ͵ࠧ߆ඉ۞޽͔Ą׎̚ дᆧซҁѐˠ۞ઉ૵ᄃض჊щှ۞ඉர̝˘݋পҾ ૻአĶࢦෛҁѐˠ۞͕ந኎ϠᅮՐķĞUnited Nations, 2001ğĄͅ៍ԧ઼дࢬ၆Ϗֽҁ̼ۤົ൴ण࿅඀̚Ă տౣઇ˞̦ᆃćҌϫ݈ࠎͤĂ̪࠻̙זፋវᄃܜഇ۞ ఢထć׎̚ᙯٺҁѐˠ۞͕ந኎ϠᅮՐᄃ͕நઉ૵Հ ߏ࠻̙ז׍វ۞߆ඉᄃ͞ШĄЯѩĂώ͛ഇАϤ̬௜ ᓑЪ઼ ( United Nations, UN ) ̝ҁ̼ކ֏׶ WHO ͕ந ኎ϠಡӘ̰உֽᑭෛԧ઼ۤડҁˠ࠹ᙯ̝͕ந኎Ϡય ᗟĂ֭ГኘϏֽԧ઼ۤડҁˠ͕ந኎Ϡ߆ඉ۞၆ᑕĄ

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ҁ̼ކ֏׶

WHO

͕ந኎ϠಡӘ

ԧ઼дҘ̮ 2002 ѐ 1 ͡ 1 ͟ึӀซˢ͵෶௡ᖐĂ ϫ݈Ϻ᎕ໂ۞ࢋՐΐˢᓑЪ઼ᄃ͵ࠧ኎Ϡ௡ᖐĂд੠

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WHO

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** ᄂΔᗁጯ̂ጯ᜕நጯրᓾरĂέ៉̂ጯ̳኎ጯੰ኎Ϡ߆ඉᄃგநጯ ࡁտٙ౾̀঱ࡁտϠāᄂΔᗁጯ̂ጯ᜕ࡁٙրି଱ * έ៉̂ጯ̳ ኎ጯੰ኎Ϡ߆ඉᄃგநጯࡁտٙઘି଱Ă͵͕ࠧந኎Ϡᓑ༖நְ ** ఼ੈү۰гӬĈૺā 100έΔξ̥ຑྮ˘߱ 1 ཱི ࿪āāྖĈĞ02ğ23123456 ů 8348

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Ր઼ᅫᄅέ۞гҜπඈॡĂԧࣇᅮࢋϒෛ͵ࠧ۞ᔌ ๕Ą၆ٺБ஧੼᛬̼۞൴णĂᓑЪ઼̂ົॲፂ “ҁ̼ ކ֏” ޽ؠ 1999 ѐࠎ઼ᅫҁˠѐĂ 10 ͡ 1 ͟ߏ઼ᅫҁ ˠ͟Ąѩކ֏পҾ੫၆ҁˠ೩΍Ăϫ۞д೶઼ܳᅫۤ ົࢋΐి౅࿅Чࠧᄃ઼छ۞ЪүĂᕖ̈́ٺ൴णۤડă ಫវĂϔᒉЋຽొܝᄃѐᅅ͵΃Ă̂छВТӅ˧౹ౄ ˘̶̙࣎ѐ᛬ăˠˠВֳ۞ۤົĄ࿅Ν͵ࠧЧ઼၆ˠ ˾ҁ̼۞߆ඉĂк݀ࢨٺ೩ֻҁˠ໰ᜪ׶ܲᅪ׎ٙ଀ щБĂ҃ܕֽ̏࠹ᚶଳפܳซ᎕ໂăઉ૵ҁ̼Ğpro-moting active ageingğ۞ඉரĂ೩΍ೳୢҁˠߏֶᏥˠ ˾۞็௚࠻ڱĂᄮࠎ߆عᑕฟ൴ҁˠˠ˧ྤώăአፋ छलăۤડ׶ۤົĂଂ຋៍ă̚៍ז࿝៍Ğmicro, meso and macroğ۞ᒖဩăࢫҲҁˠ౻જણᄃ۞ᅪ ᘣă᎕ໂ೩ֻҁˠᇅّ׶ొ̶̍ॡ۞̍ү፟ົĂͽЯ ᑕˠ˾តዏᔌ๕Ąˠ˾ҁ̼׶གྷᑻ൴ण඀ޘ੼۞઼ छĂࢬ၆ҁҁˠ˾۞ᆧΐ׶̍үѐ᛬ˠ˾۞ഴ͌ĂӮ ࡭˧ٺૻ̼छल׶ۤડ۞ΑਕĂ೩چۤົྤώĂͽฟ ൴ѐᅅҁˠˠ˧ྤώĞUN, 1999ğĄϤߏΞۢĈБ஧ ̼ҁѐˠ˾߆ඉᄃ൴णĂૻአͽҁˠ̝ˠᝋࠎૄᖂ۞ ͞ڱĂΞֹܳҁˠԆБણᄃĂॲੵѐ᛬۞ڡෛĂᑕ૟ ҁˠෛࠎѣјಶᄃ಴ᚑ۞࣎វĂ̙ᑕ૟ҁѐˠෛࠎᄃ ׎΁ѐ᛬ᆸ̙࠹ट۞Ă΃ม̝࠹̢ᙯܼᑕҋ൒ͷခᐽ ൴णĄ ͵ࠧ኎Ϡ௡ᖐд˟˩˘͵ࡔ۞ฟؕӈ೩΍ 2001 ѐ͕ந኎ϠಡӘĂځࢎ͹ᗟࠎĶ͕ந኎ϠĈາ۞˞ ྋăາ۞ԓ୕ķĞ2001 Mental Health Report: New Understand, New HopeğĄྍಡӘ޽΍͕ந኎Ϡᛉᗟߏ ͕֗ઉ૵۞ૄᖂĂ͕ந኎Ϡયᗟ̝ࣧЯΒӣ઼छ߆ඉ ۞טؠ̙БĂεຽăళ቎ă੼ᑅ˧̍үᒖဩăّҾڡ ෛăᇷ˧ăᘽۏᑿϡඈЯ৵Ą 2001 ѐϺߏ።ѐֽ͵ ࠧઉ૵ ͟͹ᗟᄃ WHO ൴ο۞ಡӘ࠹ТĂ֭ࢎؠ͹ᗟ ࠎĶઃͤଵϋă݌ٺᙯᘃķĞStop Exclusion-Dare to CareğĂײ៰͵ࠧЧ઼ࢦෛჟৠ়ঽયᗟĂ೩ֻ։р ۞ჟৠᗁᒚ໰ᜪ̈́ഴ͌၆ჟৠ়ঽঽଈԎෛ׶দО ĞWHO, 2001ğĄྍಡӘ޽΍͕நયᗟ̈́Җࠎᅪᘣ়ଈ Ҥࢍ̂ࡗҫ˞Б஧Ѻ̶̝˩˟۞়ঽ࢑ፉĂ൒҃ೀ࣎ ͹ࢋ઼छ۞͕நઉ૵࿰ზݒҫ̙זБొઉ૵གྷ෱۞Ѻ ̶̝˘Ă఺჌д়ঽ࢑ፉ়̈́ঽ܅෱۞ᙯּܼͧߏ࠹ ༊۞̙πӮ۞ĄБ஧ѣ෹࿅Ѻ̶̝α˩۞઼छ՟ѣ͕ ந኎Ϡ߆ඉć෹࿅Ѻ̶̝ˬ˩۞઼छా͕நઉ૵ࢍ൪ ˵՟ѣĄ WHO 2001 ѐ̝͕ந኎ϠಡӘૻአன̫ੵᑕ ၆͕ந኎Ϡયᗟѣड़ڼᒚ͞ёγĂإᅮ౅࿅߆ඉ̈́ۤ ົ჊Ӏڇચטޘ൴णֽΐૻ͕நઉ૵۞ྤੈĄ߆ع၆ ჯ઼᜕ˠ۞͕நઉ૵۞యЇᄃϠநઉ૵˘ᇹࢦࢋĄ͕ நઉ૵߆ඉ۞Αਕдٺഴ͕͌நયᗟ۞൴ϠăםӄϠ ঽ۰̈́ॡಶᗁ̈́ԼචϠ߿ݡኳăঐੵЯ͕நᄃଐჰય ᗟ͔ٙ੓۞দОă೩ֻᅮࢋ۰ѣड़۞̬ˢ͞९ă֭Ξ ܳซЧ჌ଣ੅ڼঽࣧЯᄃڼᒚ۞࠹ᙯࡁտĄ͕நઉ૵ ߆ඉ۞טࢎΞഴ͌Я৿ͻ߆ඉĂጱ࡭൑ᙸഀă൑؟ў ۞યᗟĂ֭Լචมᕝ൑ड़ڍ۞̍үĂ׶ᔖҺჟৠ়ঽ ڼᒚ۞঎෱Ą

έ៉ۤડҁˠ

͕ந኎Ϡયᗟ۞ᇆᜩЯ৵

ۤડҁˠ͕ந኎Ϡયᗟົצኑᗔ۞Ϡந׶ۤົЯ ৵࠹̢ᇆᜩĂд׎΁ѐ᛬ᆸᔵϺΞਕ൴ϠĂҭҁˠϤ ٺٽ਑ऴّăዋᑕྤ໚͌׶၆͕ந኎Ϡڇચ۞ֹϡத ҲĂ߇ٙౄјયᗟ۞኏ᑝಶՀࠎᑅ˧Ąͽ˭ಶϠந׶ ۤົ۞ᇆᜩΐͽଣ੅̝Ĉ ˘ăϠந͞ࢬ۞ᇆᜩ ֶፂҖ߆ੰ̰߆ొ௚ࢍ఍Ğ2000ğ၆너гડҁ ˠېڶአߤၡࢋ̶ژ޽΍Ăԧ઼ۤડҁˠ۞ҋᛇઉ૵ ېڶͽрᄃܧ૱р۰Κ౵кĞ41%ğĂҭ̙рᄃܧ૱ ̙р۰ϺΚ 22% Ăͷ׶׎΁ѐ᛬࠹ͧ݋൴னҋᛇېڶ ྵमĄԧ઼ҁˠᎮଈ়ঽ۞݈̣ีֶԔࠎ͕ҕგ় ঽă੻ᐪ҉়҇ঽăீ়҅ঽă̶̰ک̈́΃ᔁ়ঽᄃ քࡤབඈঐ̼ր௚়ঽć҃ҁѐˠ͹ࢋѪЯ݈̣Ҝࠎ ೋّཚሳăཝҕგ়ঽă͕᝙়ঽăᎤԌঽă۱ۆ ĞҖ߆ੰ኎ϠཌĂ 2001ğĂϤѩۢҁѐˠ˾়ঽѣၙّ ̼׶ܜഇ̼۞้ШĄϤٺϠந়ঽΞਕົు႙ጱ࡭ε ਕĂᅮࢋԸˢ࠹༊۞ˠ˧ăॡม׶ܛ᏿ć၆ٺ়ঽ۞ εਕĂຍᏜ඾ҁˠΞਕЯѩεΝ፾ϲϠ߿۞ਕ˧Ă֭ ൴Ϡᇎ៭ăҲҋ಴Ă֭إΞਕᇆᜩҁˠ̝Ϡ߿႕ຍޘ ĞBlalock, 1992ğĄᙯٺّҾᛉᗟĂҁ̼၆ّ̃۞ᇆᜩ ׎၁ޝ፾পͷՀᑕࢦෛĂЯࠎ̂ొ̶۞ҁˠߏّ̃ć ൒ّ҃̃ု׻ᔵͧշّܜĂݒ้ШٺՀк۞়ঽ׶Α ਕεአĄѩγĂҁѐّ̃ՀྵշّፉЇ඾໰ᜪ۰۞֎ ҒĞЯࠎ൑ኢдϒёٕܧϒё۞໰ᜪវր̚ĂΑਕֶ Ꮵҁˠ̝໰ᜪ۰ͽّ̃ࠎ͹ğĂ׎ม݋ߏ஝ঘזវ˧ ̙͚ᄃ̙ಝ࢑ఈ۞યᗟĄϤٺّҾ֎Ғۤົ̼۞म ளẴّ۞็௚֎ҒߏҲᆊࣃ۞Ă֭Ξਕጱ࡭Ҳҋ಴ ̙̈́೷ѣᇒՐćΐ̝Ăҁѐّ̃дࢬ၆୎ѐ኏ᑝ۞໤

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౯ޘྵҁѐշّ͌ĂЯѩĂү۰၁ᄮࠎѣυࢋĂ֭ޙ ᛉᑕͽ “ّҾᑭෛ” ៍ᕇଣ੅ҁ̼࠹ᙯ۞ᛉᗟĄ ˟ăۤົ͞ࢬ۞ᇆᜩ ۤົ۞གྷᑻېڶߏፋវ͕நઉ૵ෞҤ̚ޝࢦࢋ۞ ˘ᒖĄϤٺҁˠళ቎Ğpovertyğ۞ּͧޝ੼ĂѩЯ৵ Հ̙टنෛĄд઼̰ࡗѣα˩̣༱ҁˠϠ߿൑Їңܲ ᅪĂᅮߏያҁˠ჊ӀϠ߿ߺ෭ഭ͟ĞҖ߆ੰགྷޙົĂ 2002ağĄԧ઼ҁˠ͹ࢋགྷᑻֽ໚ͽ̄̃؇ዳ۰౵кĂ ׎ѨࠎੜЃܛᇬףܛٕܲᐍග;۰Ăགྷᑻېڶѣӧᙱ ۰Κ 19% ĂͷϠ߿෱πӮՏ͡ࡗ 9414 ̮ĞҖ߆ੰ̰ ߆ొ௚ࢍ఍Ă 2000ğĄౄјҁˠགྷᑻӧඃયᗟ۞јЯ ѣޝкĂΒ߁ੜЃޢ۞ќˢ̙֖ăঽଐΐࢦ׶ດֽດ ࢦ۞ᗁᒚ࢑ፉăѣّҾڡෛ۞ੜЃܛග;Ğкᇴ۞ҁ ѐ૎̃ߏֶᏥۤົщБାӄٕ׎΁۞छˠ؇ዳࠎϠĂ ҃ܧͽ̍үྤ።ᒔ଀۞ੜЃࢿࠎќˢć҃ੜЃܛ൴ٸ ݋хдѣّҾ̙πඈ۞ன෪ğăͽ̈́གྷᑻࣤ݇׶ഡ ᙾĄϠ߿቎ӧ۞ˠͧ੼ۤགྷгҜ۞ˠѣྵ੼۞Ѫ˸ தĂઉ૵ଐԛྵमĂᄃઉ૵࠹ᙯ۞Ϡ߿ݡኳϺྵम ĞNajman, 1993; Thorslund and Lundberg, 1994ğĄдטࢎ ҁˠ໰ᜪඉரॡĂࡶ৿ͻ҂ᇋళ቎఺ีྤफ़ॡӈѣΞ ਕົౄј၆ঽଈΞӀϡ۞ྤ໚ઇ˞̙ϒቁ۞઄నćซ ҃Ξਕֹ଀ঽଈజᄱᄮࠎߏ̙Ъүă̙ᏲଂᗁឤĄЯ ѩĂ߆ඉטࢎᅮࢋᛇۢҁѐళ቎યᗟĂͽ̈́ѩયᗟ၆ ઉ૵ྤ໚۞ΞϡّĂ࿰ޢ׶ჯ޺ઉ૵ඈ͞ࢬ۞ᇆᜩĄ

έ៉ۤડҁˠ૱֍۞͕ந኎Ϡયᗟ

ᄃҁѐѣᙯ۞ჟৠ়ঽ౵૱֍ߏᇎ៭াĞdepre-ssive disorderğ׶εംাĞdementiağĄ઼̰ᇎ៭াᓁ ஽ҖதӮ੼ٺѝഇ߹ҖঽጯಡӘĂҁˠᇎ៭া஽Җத Ϻ ѣ ᆧ ΐ ۞ ᔌ ๕ Ğ Ղ Ă 2000ğĄ ҁ ѐ ˠ ˾ շ ّ ѣ 0.4%Ẵّѣ 1.4% νΠᎮଈࢦ៭াĂ҃ࡗѣ 2% Ꭾଈ ᅅ៭াĂ 4% ࠎ૲ѣᇎ៭াې̝ዋᑕᅪᘣଈ۰Ğૺă เăၐĂ 2001ğĄҋ୭Ğsuicideğߏҁˠᇎ៭౵̙ض ۞ޢڍĂҁˠЯҋ୭࡭Ѫ۞ͧதͧ׎΁ѐ᛬ᆸ۞ҋ୭ Ѫ˸தౌᔘֽ଀੼ĂҜا઼̰ҁѐˠ˾۞ௐ˩αҜ ĞҖ߆ੰ኎ϠཌĂ 2001b ćౘăเĂ 2001ğĂѣॡҋ୭ ҖࠎϺົజܧۡତ۞ҋ๋Җࠎٙପ࿹ĞЯѣֱҁˠ֭ ܧଳפ͹જҋ୭ҖࠎĂ҃ଳజજܲч۞͞ёֽၙّҋ ୭ğĂΒ߁ੜᒺăنෛઉ૵ٕࢅޞҋ̎ă١඗ତצᗁ ᒚăຍγ๋चඈĄҁˠଈѣεംাͧதࠎ 2ę4%Ăଯ

Ҥέ៉ѣ 5ę8༱εംҁˠĞLiu, Lin, & Chen, 1996ğĂ ͷѩͧதົᐌ඾ѐ᛬۞ᆧΐ҃࠹၆۞ᆧΐĄΩҁѐˠ إΞਕߏᘽۏᄱϡ׶ᑿϡ۞੼ПᐍཏćࣧЯΞਕ΍ٺ גຍٕܧגຍ۞ֹϡĄҁѐˠᘽۏᑿϡٕᄱϡ۞ଐڶ Β߁࿅ณٕ̙ఢ݋۞ֹϡᘽۏĂҋҖ୹ྃᘽۏĞ׎̚ ̂кᇴߏֹϡјᘽğă׶׎΁ˠϹೱᘽۏڇϡă̙ዋ ༊۞఍ٕ͞ͽ࿪ྖฟϲ఍͞ĄΩγҁˠΞਕ΍ன۞͕ ந኎Ϡયᗟإѣ੧ჟᑿϡĂѣѩયᗟ̝ҁˠΑਕېၗ ૱ົצזᚑࢦ۞ᇆᜩĂጱ࡭฀ࣆ׶ຍγ๋च۞Пᐍّ ᆧ੼ćѩγĂ੧ჟᑿϡҁˠإΞਕ΍னᒉዳ̙։ă኎ Ϡតमă൑ڱ፾ҋϠ߿ă੃ጸಉεᄃዩᝫඈયᗟć͍ ׎Ϥٺޝкѐࡔ̂۞੧ᝒ۰૱ߏ፾ҋಅ੧Ăયᗟ૱ົ జପᖟĄҁˠ੧ᝒ፾ا۰ۤϹ࿣ᗓ۞ඕڍĂ݋Ξਕౄ јຏءו፬ഴ͌Ă҃ᆧΐ͕ം৴ใăயϠ͑ᛇ۞፟ ົĂТॡ˵̂̂೩੼ҝซᗁᒚ፟ၹ۞ПᐍĞAtkinson, Ganzini, & Bernstein, 1992ğĄ

дҁѐഇٽԛјࠦᛵাĞMolly, 2000ğĂপҾߏ ّ̃Ąҁѐˠ૱चُ̈́ፉᇎ۞યᗟѣϠந়ঽăڼ щăགྷᑻă፟ၹ̼ăֶᏥă਽ҁ׶૚ွć఺ֱౌ׶ѐ ࡔ̂ăຏଐ਑ऴͷ߿જצࢨѣᙯĄۤડҁˠགྷ૱Яࠎ ߙֱࣧЯᄃۤົ̈́ˠᅫழᗓĂઉ૵࠹ᙯˠࣶࢋͿ௟ෞ Ҥ Ă ߏ ӎ ߏ ߙ ᙷ ݭ ۞ ࠦ ᛵ া Ą Ω γ Ă ҁ ѐ ᇋ ঽ া ĞBusse, 1989ğĂΞਕҁˠົᖣϤ֗វ̙ዋ༊јߏ࣎ˠ ੟ᔖፉ͕۞ְІٕүࠎεୀ۞ᖣ˾Ăٕགྷរזດֽດ к۞ˠᅫ࿣ᗓĂٙଳפ၆׹ಛ΁ˠ۞аᑕĂᖣϤ૟ᙯ ڦ۞൏ᕇٸдҋ̎۞֗˯Ă͍׎֗វ׶Αਕ̙ዋ۞ܑ ྿ĂΞਕயϠܢ૲ќᘥĂϺΞព΍ঽˠ۞֎Ғ҃੟ᔖ ۤົ׶׎΁۞ཌྷચĞBusse, 1989ğĄᙯٺҁѐᇋঽ াĂ઼̰ϫ݈̪৿ͻ࠹ᙯࡁտĂҭ̙Ξӎᄮ၆ۤડҁ ˠ҃֏̏ߏࢦࢋ۞͕ந኎Ϡયᗟ߇̙ΞنෛĄ ன̫ჟৠᗁጯᔵ̏ѣ಼̂ซणĂҭ֗צჟৠ়ଈ ̝ࡴ۞ҁˠĂ૱Я၆়ঽ۞̙˞ྋ̈́ԟᏕזჟৠࡊՐ ෧ĂϏਕᒔ଀෧ᕝᄃዋ༊۞ڼᒚĂ၆໰ᜪ΁ࣇ۞छल ̈́፟ၹ҃֏Ă˵ౄј࠹༊̂۞࢑ፉĄࠎՀк˞ྋҁˠ ͕ந኎Ϡன෪ᄃώኳĂᑕӔனՀк͕ந኎Ϡڇચᅮ ՐĂ֭೩ֻΞܕّ̈́Ξّ̈́ڇચྤ໚Ą

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͕ந኎ϠಡӘ

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ኘέ៉ۤડҁˠ۞͕ந኎Ϡ߆ඉ

૟ҁѐ̼યᗟଯШБ஧ᛉᗟߏࢦࢋ۞Ă׎̚υื ܳј߆ඉ۞ፋЪĂӈᅮాඕҁ̼ᄃۤົགྷᑻ൴णăˠ

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ᝋඈߛၹĄጐგ̙Т઼छ̈́гડ̝ҁ̼߆ඉ̙ТĂҭ ࢬ၆ཏវҁ̼̝ВТᑅ˧Ă̪ᑕ૟˧ณഈШБ஧̼۞ ԛၗ൴णĂ၆ٺԛј͕நઉ૵߆ඉѣֱᙯᔣّ۞યᗟ ΞֻᑭෛĂᖣͽ઼ֹछ͕ந኎Ϡ߆ඉՀࠎԆፋĂ߇ᙯ ᔣّયᗟт˭ٙЕĂΞֻણ҂̝ĞWHO, 2001ğĈ ʔ߆ඉߏܳซͽۤડૄᖂࠎ໰᜕۞൴ण๜ĉ ʔ߆ඉߏӎ၆࿰֨׶ܳซඉரѣዋ༊۞ᙯڦĉ ʔ߆ඉߏခᐽ࣎ˠăछल׶ઉ૵૞ຽ̝มူҡᙯܼ ۞൴ण๜ĉ ʔ߆ඉߏܳซ࣎ˠăछल׶ۤડม۞·ᝋ๜ĉ ʔ߆ඉ౹ౄ˘࣎၆͕ந়ঽ಴ࢦă᜕ܲ׶ጾѣˠᝋ ۞ր௚๜ĉ ʔ߆ඉٙ೩ֻ۞ڇચߏፋវͷፋЪٺૄᆸઉ૵໰ᜪ ̚ĉ ʔ߆ඉٙેҖ۞̍үߏͽ၁ᙋࠎૄᖂ۞൴णĉ ʔ၆ڇચ೩ֻ۰ਕѣዋ༊۞੊ቚĂͽܮ߆ඉਕે Җĉ ʔ߆ඉਕቁᄮऴ๕୉ཏ۞͕நᅮՐĉ ʔ߆ඉߏӎ౹ౄ΍˘࣎ਕͅߍऴ๕ཏវᅮՐ۞ր ௚ĉ ʔ߆ඉߏӎజ޺ᜈ۞Ⴞീ׶ෞᆊڇચĉ ʔ͕நઉ૵ڇચ׶׎΁ઉ૵ڇચߏӎѣࢦኑ࠹Тĉ ʔ߆ඉߏӎਕాତ͕நઉ૵׶׎΁ొܝ۞Ъүĉ 2002ѐ͵ࠧЧ઼૞छጯ۰ᄃ၁ચ̍ү۰ຉፋ˘Њ

Ķ઼छ͕நઉ૵߆ඉᄃࢍ൪ķĞMental Health Policies and PlansğĂ̰टࠎ͕ந኎Ϡ߆ඉ۞൴णăࢍ൪ᄃ၁ Җ͞ڱĂԧ઼Ϻٺ 2002 ѐΡฟఢထ઼छ͕நઉ૵߆ ඉࡁ੅ົĞૺĂ 2002 Ă 4 ͡ğĂ၆ٺ઼̰ۤડҁˠ۞ ͕ந኎Ϡ߆ඉטࢎĂ˭ࢗ͞Шࣃ଀ԧࣇϏֽࢎؠ߆ඉ ॡણ҂̝Ą ˘ăᅮՐෞҤ ϫ݈ԧ઼৿ͻপؠ۞ҁˠ͕ந኎Ϡ߆ඉĂჟৠ኎ Ϡڱ׶ჟৠᗁᒚშΪߏ׎̚۞˘ొЊ҃̏Ăͷઐࢦ෧ ᕝăڼᒚăೇઉ۞ᆸࢬĂنர͕நઉ૵ܳซ׶࿰֨ᆸ ࢬ̝߆ඉĄ׎΁ҁˠ჊Ӏ൴णĂтҁˠ჊Ӏڱăۤົ ାӄڱăБϔઉ૵ܲᐍڱ̈́࠹ᙯ̝ੜЃ̈́ܲᐍڱ९ ĞּтĈ̳ચˠࣶੜЃڱă౻̍ܲᐍ୧ּČğඈĂ၆ ҁѐˠ೩΍˞̙͌჊Ӏ߆ඉĂҭ׍វ͞९̪ѣޞΐૻ ར၁Ăͷϫ݈ٙ൴ٸະҁ჊ӀϠ߿ߺ෭֭ܧৌਕԼච ҁˠళ቎Ăᑕፋវ҂ณ̝Ąӈֹ჊Ӏ߆ඉԆ౯Ă่ߏ ͕ந኎Ϡ߆ඉ۞ૄᖂĂԧ઼͕நઉ૵߆ඉᅮࢋՀк៍ ه۞ᗃ୻Ă̖ѣ׍ᙸഀăᆊࣃă໤݋ᄃϫᇾ۞߆ඉĂ ͷ૟ĶّҾ͹߹̼ķĞgender mainstreamingğ۞៍ᕇ ৼˢ߆ඉԛјᄃ̶ژ۞͹߹ĞૺăౘĂ 2000ğĂะඕ ҁˠ۞͕ந኎ϠᅮՐĂࢎؠϫᇾĂ̖ߏৌϒར၁۞ඉ ரĄдטࢎ߆ඉॡĂᑕ૟ “ ᅮՐෞҤ ” ઇࠎઉ૵ࢍ൪ ̈́გந۞ࢦࢋ۞ૄᖂĞChu & Simpson, 1994ğĄٙᏜᅮ ՐΞ̶ࠎα჌Ă ૞छᅮՐĈ޽གྷϤ૞छጯ۰ۡତࢎ ؠ۞߆ඉć ຏᛇᅮՐĈ޽གྷϤ၁ᅫణኘ଀ۢ༊ְ۰ ຍ֍ޢٙטࢎ۞߆ඉć ӔனᅮՐĈགྷϤአߤ۞ᇴፂ ྤफ़ٙӔனېၗ۞ᅮՐĂ҃ޢטࢎ۞߆ඉćͽ̈́ ͧ ྵᅮՐĈགྷϤ͛ᚥણ҂Ă׶΁ˠͧྵଣ੅ٙ଀ۢ۞ᅮ ՐĞBradshaw, 1972ğĄͽـԧ઼͕ந኎Ϡ߆ඉטࢎк ͽයࡻᙷݭՙඉࠎ͹ĞͳĂ 1997ğĂࢦෛ૞छᅮՐ׶ ӔனᅮՐĂ҃نரຏᛇᅮՐ̈́ͧྵᅮՐ۞ෞҤĄϏֽ ԧࣇᑕྍឰҁˠࣇણᄃҋ̎۞߆ඉఢထĂᄮТҁѐˠ ၆ۤົ੒ᚥ̝ਕ˧Ă֭ତצᄃฟ൴ҁѐˠдϏֽ൴ण ૄᖂ۞ሕਕćᖎ֏̝ĂϏֽдଣ੅ҁˠ͕ந኎Ϡ࠹ᙯ ߆ඉॡĂ߆ඉ۞ԛј࿅඀ߏࢋΐૻҁˠĞڇચֹϡ۰ğ ۞ણᄃć߆ඉ۞טࢎߏϤਨॲ΍൴Ă྿ז̂ிણᄃĄ ˟ăҖજඉர ҁˠ͕ந኎Ϡ߆ඉᑕͽ᎕ໂăઉ૵ҁ̼۞ඉரࠎ ൴णϫᇾĄඉர˯ᑕ಴ࢦҁˠ۞͹ᝋăംᇊᄃ಴ᚑć ֭౅࿅ିֈ׶̂ிಫវ೩̿ҁˠ۞ԛ෪ĂԼචۤົߊ х၆ҁˠ̝גڕО෪ć֭ࢦෛ̈́ͅߍҁˠ۞ܜ఍׶੒ ᚥĂ࡭˧ٺҁˠˠ˧ྤώ۞ฟ൴ĂΐૻҁˠԠ̍۞ۤ ົ߿જણᄃඈҖજĄѩγĂ൴णБࢬّ۞͕நઉ૵໰ ᜪڇચĂቑಛᑕҋઉ૵ܳซăѝഇ࿰֨׶ڼᒚזۤડ ೇઉć֭ᅮࢦෛ׶׎΁ڇચր௚ЪүĂѣड़ඕЪ̳ռ ొܝĂΒ߁઼छăг͞߆عă઼ᅫ௡ᖐăҁˠώ֗ᄃ Чᙷ௡ᖐᓑ༖ВТЪүćѩᙷᓑ༖Β߁ྤܛ͚ӄ۰ă ૞ຽဥវăЋຽ௡ᖐăጯఙಏҜăࡁտಏҜăିֈ፟ ၹă؟ି௡ᖐᄃಫវඈ፟ၹĄ൴णፋЪݭྭొົЪү ͞९ĂᔖҺҁˠڇચវր̶೸Ăౄјྤ໚ࢦኑԸྤă ঎෱ᄃ̶੨̙ӮĂѣड़ඕЪ኎Ϡăᗁ᜕̈́ۤ჊̝ྤ ໚ĂВޙፋЪّ۞ಏ˘ڇચშඛĂֹҁˠٽٺଂಏ˘ ր௚̚଀זٙᅮ۞ڇચĂߏޙϲѣड़ాᜈّҁˠڇચ វր̝ࢦࢋᙯᔣĄΩдҖજඉர˯آଳϡ “ۤડᒉౄ” ۞͞ڱĂඕЪϔม௡ᖐᄃ˧ณĂଂۤડҁˠ۞ᅮՐࢬ ΍൴Ăͽۤડҁˠ̝Вᙊ “ Ϥ˭҃˯ ” ፋЪྤ໚Ăֹ ׌̂វր۞૞ຽڇચ೩ֻ۰̈́யءጯˬ͞ࢬᛸ͘Ъ үĂͽ྿ྤ໚ѣड़ፋЪ̝நຐϫᇾĄΩдҖ߆ੰགྷޙ

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ົٙ൴ܑ̝Ķ߄ጼ 2008 Ĉ઼छ൴णࢦᕇࢍ൪Ǖາ߇ ฏۤડᒉౄࢍ൪ķ̚Ă೩̈́Ϗֽԧ઼ᑕஎਆᗁᒚ໰ ᜪڇચۤડ̼۞ܜഇ໰᜕შྮĂ֭੨ЪĶঐ෱۰ጱ Шķ̈́Ķдгҁ̼ķĞaging in placeğ۞நهఢထĂֹ εਕ઼ˠ଀ͽᒔ଀ాᜈّ۞ڇચĞҖ߆ੰགྷޙົĂ 2002bğĄҌٺ͕நઉ૵ڇચϺᑕඕЪٺѩࢍ൪̚Ă൴ णۤડٕاछё۞ᗁᒚ໰᜕ڇચវրĂֹۤડјࠎҁ ˠ໰᜕ڇચ۞८͕ĄГ۰͕நઉ૵ඕڍᅮࢋజႾീ׶ ̶ژĂͽ޺ᜈԼච̈́ࢬ၆Ϗֽ۞߄ጼĄ ˬă൴णࡁտ ੫၆ҁѐ়ঽ̝ࡁտ̈́֨ڼĂপҾߏ͕நઉ૵ᄃ ়ঽ࿰֨Ăтҁѐᇎ៭াă൏ᇋা׶εംাඈĂᑕޙ ϲ̂ఢሀ۞݈ᖀّ੠ᖸࡁտĂซ˘Վᒢྋۤડҁˠ۞ ೇࣧЯ̄Ğresilienceğ׶͕நયᗟႊซĂͽଣ੅Пᐍ Я̄۞үϡ፟טĄѩγĂ RobertĞ2002ğ೩΍ҁ̼࠹ ᙯ۞ࡁտإᑕᆧΐ၆ۤડਔඛĞcommunity contextğ ۞ᒢྋĂЯࠎۤડਔඛߏϠ׻ன෪׶ҁ̼ࡁտ۞ࢦࢋ ૄᖂĄҌٺࡁտ͞ڱ݋Ξଳϡኳّ׶ณّ۞ࡁտన ࢍĂͽՀ·̶ೠ೪ҁˠ̝͕நઉ૵ᅮՐᄃېၗĂѣӄ ٺˠ˾ҁ̼۞߆ඉטࢎĄ

ඕāāኢ

Ϗֽԧ઼͕நઉ૵߆ඉᑕѣลّ߱ϫᇾć׎̚ܕ ඀ϫᇾᑕӈॡаᑕٕᗃ୻൴Ϡ࠹ᙯ͕ந኎Ϡ۞ۤົְ ІٕᛉᗟĂෞҤ̏གྷซҖ۞Чี͕ந኎Ϡ͞९Ą̚඀ ϫᇾĞ˘ѐ̰ğᑕԆјטؠ઼छ͕ந኎Ϡ߆ඉĂར၁ Чొົםአ̶̍Ă೩΍͕நઉ૵Ϩϩ३ĄҌٺᅈ඀ϫ ᇾ݋ߏഇ୕ޙϲҖજඉரᄃෞҤ޽ᇾĂͽ̈́ซҖ͕ந ઉ૵Ϩϩ३ར၁۞ෞᝥĄፋវ҃֏Ăέ៉гડ۞ҁˠ ͕நઉ૵̍ү̙Ϊࠎ࣎ˠయЇĂϺࠎۤົయЇć̙ᑕ ΪߏĶ˸ѿྃկķĂ҃ߏᑕĶϏܥძᒼķĄѩγĂд͞ Ш˯ᑕ૟ϫ݈ઐШჟৠᗁᒚ̝ௐ˟߱ᄃௐˬ߱࿰֨̍ үᖼ҃ࢦෛۤડ͕ந኎Ϡ̝ௐ˘߱࿰֨̍ү׶͕நઉ ૵ܳซĄឰԧࣇͽ͵ࠧ኎Ϡ௡ᖐ೩΍۞઼छ͕ந኎Ϡ ߆ඉࠎણ҂ᖡဦĂᒉౄԧࣇۤડҁˠ͕நઉ૵۞छ๩Ą

ણ҂͛ᚥ

ͳ઼ҀĞ1997ğĆԧ઼͕ந኎Ϡ߆ඉ۞аᜪᄃᑭ੅Ĉ ՙඉයࡻᙷݭ̶̝ژĆ̚ර͕ந኎ϠጯΏĂ 10Ğ1ğĂ 29 ů 47Ą Җ߆ੰ̰߆ొ௚ࢍ఍Ğ2000ğĆ너гડҁˠېڶአ ߤĆέΔĈү۰Ą Җ߆ੰགྷޙົĞ2002ağĆ઼ϔѐܛטޘఢထĆέΔĈ ү۰Ą Җ߆ੰགྷޙົĞ2002bğĆ߄ጼ 2008 Ĉ઼छ൴णࢦᕇ ࢍ൪ĆέΔĈү۰Ą Җ߆ੰགྷޙົˠ˧ఢထ఍Ğ2002ğĆ̚රϔ઼έ៉г ડϔ઼ 91 ѐҌ 140 ѐˠ˾ଯࢍĆέΔĈү۰Ą Җ߆ੰۤົ჊Ӏଯજ؎ࣶົĞ2000ğĆޙၹܜഇ໰᜕ វրАጱࢍ൪ĆέΔĈү۰Ą Җ߆ੰ኎ϠཌĞ2001ğĆέ៉гડҁѐˠ˾͹ࢋѪ˸ ࣧЯĈϔ઼˝˩ѐĆέΔĈү۰Ą ՂāߒĞ2000ğĆ੼ฯгડᇎ៭া߹ҖঽጯአߤĈǶ “ᇎ៭া஽ҖதᄃПᐍЯ̝̄ෞҤ”ĆҖ߆ੰ઼छࡊጯ؎ࣶ ົಡӘĄ ૺ३഑ăเ؟ϒăၐ̀඀Ğ2001ğĆҁѐᇎ៭া۞߹ Җঽጯ׶෧ᕝĆέ៉ҁѐᗁጯົົੈĂ 44 Ă 1 ů 7 Ą ૺā ăౘ܆ࢁĞ2000ğĆέ៉૎̃ઉ૵߆ඉ۞ّҾ ̶ژĂ̚ර̳В኎ϠᗔᄫĂ 19Ğ5ğĂ 366 ů 380 Ą ૺā Ğ2002 Ă 4 ͡ğĆ͕நઉ૵ᝋƝ͕ந኎Ϡ߆ ඉĈ͵ࠧᔌ๕Ćٺ̚ර͕ந኎Ϡםົ͹ᏱĂࠎઉ૵҃Җ જĈఢထ઼छ͕நઉ૵߆ඉࡁ੅ົᓾཌྷĆέΔĈέΔξϲ ᒚዳੰĄ ౘ݄цăเ؟ϒĞ2001ğĆҁѐᇎ៭াᄃҋ୭Ćέ៉ ҁѐᗁጯົົੈĂ 44 Ă 14 ů 16 Ą

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WHO (2001). The World Mental Health Report: New Understand, New Hope. Geneva: WHO.

Discussing Mental Health Problems of

and Policy Toward Community Elderly in Taiwan:

From the Vision of WHO Mental Health Report

Chia-Jung Hsieh

ʔ Shwu-Jiuan Liu

*

ʔ Chueh Chang

**

ABSTRACT: The ageing of populations is a world wide phenomenon. It is very important that the policy issues of mental health problems among community elderly in Taiwan be addressed. The paper is based on the WHO 2001 Mental Health Report, which shows that governments need to set policies within the context of general health systems and financing arrangements that will protect and improve the mental health of the population. It requires priorities to be set among mental health needs, services, treatments, and prevention and promotion strategies, and choices to be made about their funding. Mental health services and strategies must be well coor-dinated among themselves and with other services. Mental health outcomes must be monitored and analyzed so that decisions can be continually adjusted to meet existing challenges. The WHO Mental Health Report is a blueprinted plan that will provides references for our country's mental health policies for the community elderly.

Key words: mental health, mental health policy, gender mainstreaming.

RN, MSN, Instructor, College of Nursing, Taipei Medical University, Doctoral student, Institute of Health Policy and Management of Public Health, National Taiwan University; *RN, PhD, Professor, College of Nursing, Taipei Medical University; **PhD, Associate Professor, Institute of Health Policy and Management of Public Health, National Taiwan University, World Federation for Mental Health board member at large.

Address correspondence to: Chueh Chang, No. 1, Jen-Ai Rd., Section 1, Taipei 100, Taiwan, ROC. Tel: 886(2)2312-3456 ext. 8348; E-mail: Chueh@ha.mc.edu.tw