---
title: Disability, impairment or illness? The relevance of the social model of disability to the study of mental disorder
date: 2021-03-20
tags: 障礙研究, 北大
---

# 〈Disability, impairment or illness?〉
[TOC]
:::spoiler
> - abandon：拋棄
>
> - plight: an unpleasant condition, especially a serious, sad, or difficult one
> 困境，窘境
>
> - revolving：圍繞
>
> - redirect: to change the direction of something, especially to send a letter to a new address
> 改變方向（re+direct）
>
> > redirect .... from .... to ....
>
> - discrimination: treating a person or particular group of people differently, especially in a worse way from the way in which you treat other people, because of their skin colour, sex, sexuality, etc.
> 歧視；區別對待
>
> - exclusion：排斥、排除在外
>
> - orient:
> verb. to discover the position of yourself in relation to your surroundings:
> Noun. 東方國家
>
> - multiplicity：多樣性
>
> - diagnose：診斷
>
> - disadvantage：劣勢
>
> - oppression：壓迫
>
> - vigorous：充滿活力的、旺盛的
>
> - examine：仔細檢查、審查、調查
>
> - address: to give attention to or deal with a matter or problem
> 對付、應付、解決
:::

## Introduction
:::spoiler
> - severe: causing very great pain, difficulty, worry, damage, etc.; very serious.
> 非常嚴重的
> - foster: to take care of a child, usually for a limited time（收養、代養）
> to encourage the development or growth of ideas or feelings.（鼓勵、促進、培養）
:::

- 社會學理論與社會學研究並不關心精神障礙者的處境。並未分析精神健康政策的轉變，也並未促進能改善他們生活品質的社會政策。
- *Sociological theory and research has not provided either a much-needed analysis and critique of the major changes taking place in mental health policy or fostered any recent social policy directed towards improving the quality of life for people diagnosed as suffering from sever mental illness who live the community.* (p.583)
:::spoiler
> - psychiatric：精神病學的
>
> - assessment：評估、估價、評估結果
>
> - crude：粗糙的、簡陋的、未加修飾的
>
> - unsophisticated：不複雜的、簡單的
>
> - blanket：總括的、綜合的
: including or affecting everything, everyone, or all cases, in a large group or area
>
> - condemnation：譴責、指責、聲討
>
> - intervention：干涉
>
> - portray：描繪、描述、描寫
>
> - disrepute：失去信任、不受尊重
>
> - discursive：推論的、論證的
>
> - relevant：有關的、相關聯的
:::

- *The focus in this paper on people with serious mental disorders is based on the assumption that for a small, but significant category of people, mental disorder is associated with sever restrictions on social, psychological and physical wellbeing.*

:::spoiler
> - severity：verb. 嚴重
>
> - symptom：（疾病的）癥狀
>
> - fluctuate：（持續的）波動、起伏不定
>
> - chronic：（疾病或不好的事物）慢性的、長期的
>
> - schizophrenia：精神分裂症
>
> - psychosis：精神病（複數: psychoses）
>
> - affective：感情的、情感的
>
> - mood：心境、心情、情緒、精神狀態
>
> - manic-depression：躁鬱症
（manic狂躁、depression抑鬱）
>
> - obsessive-compulsive：強迫症
>
> - phobias：恐懼、懼怕
>
> - milder：溫和的、和緩的、輕微的
:::

## Disability theory
:::spoiler
> - barrier：障礙、阻礙、阻隔
>
> - appropriate： 適當的、恰當的、合適的
>
> - nonetheless：然而、但是、儘管
>
> - deficit：赤字、逆差、虧損
>
> - defect：
noun. 缺點、缺陷、瑕疵
verb. 脫離、退出、叛逃
>
> - institutionalize：機構化
:::

### 障礙研究的取徑
- disability與impairment的差異（頁584）
- *Writers challenge conventional 'individualist and deficit views of disability' (Barton 1993: 235). A distinction is made between impairment and disability. ...... Michael Oliver writes: '[disability is] the disadvantage or restriction of activity **caused by a contemporary social organization which takes no or little account of people who have physical impairments** and thus **excludes them from the mainstream of social activities**' (1990: 11). Impairment, ......refers to some **bodily defect**, usually **constituting 'a medically classified condition'** (Barnes et al. 1999: 7).*
- 從個人問題轉移到「社會建構」：亦即disabilty（障礙）作為一種社會排除、歧視、壓抑的過程。
- *This location of the conceptualisation and analysis of disability within a social framework redirects analysis from **the individual to processes of social oppression, discrimination and exclusion**. The disadavantage experienced by disabled people is seen to be **'institutionalized throughout society'**.*

:::spoiler
> - consequence：（不好的）後果、結果
> - examination： noun. 檢查、審查、調查
> - ideological component: 組成部分、成分、零件
> - self-worth： 自我價值
> - worth: 值錢的、擁有財產的
> - inject： 注射；投入、增添；引入、帶來
> - vigour： 體力、精力、活力
> - symbolic： 代表的、象徵的
> - anxiety-ridden：充滿焦慮的
> - ridden: 充滿…的、滿是…的
> - stereotype： 刻板印象、成見
> - doom： noun.死亡、毀滅、厄運
(verb.) 使註定、使必然發生
> - manoeuvring：策略
> - manoeuvre: (noun.) 精巧動作；軍事演習；策略、花招
(verb.) 操縱、控制；努力使（某人）以特定方式行事
> - deny：否認、否定
> - recreation：娛樂、消遣
> - recreate：使再現、再創造
> - delivery：運送、遞送、投遞
> - linkage： 聯繫、關聯、相關
> - rhetoric：修辭（學）、雄辯（術）
> - reassessment：重新考慮、再次評估
> - reassess (verb.)
> - legislation：法律、立法
> - vehicle：（陸上）交通工具、車輛、機動車
> - generic： 一般的、普通的、通用的
> - general: 全體的、總的、普遍的
> - genetic: 基因的、遺傳的
> - programme：節目
> - program：程式
> - narrow：(adj.)狹窄的、狹隘的、有侷限的
(verb.) （使）變窄、（使）縮窄
> - regulate：控制、管理、調節、調整（=control）
> - refine：精鍊、提煉、改進、完善（=improve）
> - whilst： 在……的時候、與……同時（=while）
> - comprehensive：全面的、綜合的、詳盡的。
> - pertinent：有關的、直接相關的(=relating)
> - dilemmas：左右為難、兩難處境
> - controversy：爭議、爭論
> - incorporate：包含、將……包括在內(=include)
> - incorporating
> - incorporation
> - tension: （精神上）緊張、焦慮、焦急（=nervousness）
> - applicability：適用性
:::

- *The social approach to disability demands an identification and analysis of the social, political and economic conditions that restrict the life opportunities of those suffering from an impairment. Central to this work is a focus on the **rights of people with disabilities and the consequences of the deveploment of a collective identity for social action and social change.** Thus, in addition to promoting new ways of conceptualising and analysing disability, the social approach to disability **has an ideological component.***
- *Although disability theorists have rarely included psychiatric disability in their work....... The application of the social approach to disability to the study of mental ill health orients research and theoretical development towards an analysis of the complexity and multiplicity of the social restrictions faced by people diagnosed as 'mentally ill', and the social disadavantage and oppression they face. It directs sociologists to **identify the sites and the mechanisms of institutionalised oppression.***
- *......the reality of systems of 'community care' for people with psychiatric disabilities in an era dominated by **managerialism, privatization, the introduction of the market ideology and the mixed economy of welfare** would be assessed. A focus on oppression, citizenship and rights within the sociology of mental health challenges sociologists to ground the relevance of their theoretical and empirical work inthe lives of people suffering from seriuos psychiatric disorders.*
- *......Disability theorists' examination of the current policy focus on **needs instead of rights**, the linkage of **rights and responsibilities of citizens**, and the analysis of the gap between **the rhetoric of inclusive citizenship** and the **reality of resource delivery** living with a serious psychiatric disorder. The social approach to disability also calls for a reassessment of the role of **legislation as a vehicle for social change**.*

- 過往的精神障礙研究並不考慮社會條件對障礙者的影響：
- *Existing mental health policy is based on the assumption that the major problems and 'medical symptoms' faced by people with serious psychiatric disabilities result from their illness. **Broader social structural factors that affect an individual's experiences of illness, such as poverty, inequality, discrimination and exclusion are not targeted.***
- *The relevance of narrow mental health legislation which **primarily regulates the delivery of medical services in hospitals**, to **the needs of people living in the community has not been challenged**. The sociology of mental health has done little to clarify the nature of the social barriers faced by people with serious psychiatric disorders living in the community.*
- 本文主旨（？）
- *This paper argues that these debates highlight issues and dilemmas of major relevance to the study of psychiatric disability. Three areas of controversy with disability theory will be examined. First, the relative importance of **incorporating an understanding of the differences that exist between disabled people is a source of tension between theorists**. A second concern relates to the importance of **theorising impairment**, as well as a concern to examine **the relationship between impairment, identity, disability and empowerment**. Finally, disability theorists have questioned **the applicability of work in the sociology of health and illness to the study of disability**.*

## Significance of difference
:::spoiler
> - acknowledge: 承認
> - contend: 聲稱、斷言、主張（to say something is true）
> - monolithic: 龐大的、大一統的
> - disinterest: 缺乏興趣、沒有興趣
:::

- *A major debate within disability theory relates to the importance of acknowledging differences between people with disabilities........Others contend that the conceptualisation of disability as a monolithic experience ignores differences that exist **between people with disabilities based on class, gender, race and ethnicity, sexual orientation and age.***
- *Associated with this failure to acknowledge difference [...] is a disinterest in people's perceptions of living with impairment and disability.*

:::spoiler
> - detract (+from): 對…產生不利影響、貶低、有損
> - enhance: 提高、增加、增強、增進。
> - simultaneously: 同時地
> ironically: 諷刺地
> - ironic: 諷刺的
> - interpretive: 解釋的、闡釋的
:::

- *Ironically, whilst the work of interpretive sociologists in labelling theorists [...] has provided a critique of psychiatry and itsimpact on 'mental patients', this work has actually reinforced some of the **worst aspects of medicalisation.***

:::spoiler
> - victim: 受害者
> - personhood: 人格
> - transformative: 徹底改觀的、顛覆的、有改造能力的。
> : causing a major change to something or someone, especially in a way that makes it or them better
> - diversity: 多樣性
> - delivery: 運送、遞送、投遞
> - undifferentiate: 無異的
> - distress: 憂慮、悲傷、痛苦
:::

- *As Barnes and Shardlow (1996: 131) point out, 'it is important to understand and to theorise personal responses of mental distress in order to **make the link between such experiences and collective action**'.*

:::spoiler
> - interface:
> +between 相互做聯繫、相互作用
> - wide: 寬廣的
:::

- *......Two recent qualitative studies of the experiences of users of mental health services (Rogers et al.1993, Wadsworth and Epstein 1998) address the **importance of understanding the perceptions of individuals accessing mental health services**. These studies explore **the interface between medical services and the users of these services**. While this focus is understandable, given the importance of medical treatment in the lives of people suffering from serious psychiatric disorders, **the social location of the individual** and **their perceptions of the significance of their mental health problems** in terms of **their wider life experiences**, **is not [...] addressed**.*

:::spoiler
> - inclusion: 包括、包含

:::

- *Barham and Hayward (1991) explore the wider significance of a mental disorder in the lives of a small group of people diagnosed as suffering from a schizophrenic illness. A particularly significant aspect iof this qualitative study is **the researchers' inclusion of their participants as active collaborators in the research process**.*
- *The research identifies both **the participants' perceptions of the difficulties they face in negotiating their illness and its treatment, as well as their active attempts to maintain or creat an identity as a person rather than as a mental patient.***
- *More research [...] compares the experiences of different categories of people living in the community with serious mental disorders is essential.*

## Impairment and disability

:::spoiler
> - fundamental：基礎的；主要的、根本的
> - ascendancy: 權勢顯赫、優勢、支配地位(a position of power, strength, or success)
> - blame: 責怪、責罵
> - dissipation: 消失、消散 (the process of gradually disappearing)
> - dissipate: （使）逐漸消失、（使）逐漸浪費掉
> - conversely: 相反、反面(noun., adj.)
> - advocate: 主張、擁護、支持、倡議
> - exhaustion: 精疲力竭、疲憊不堪
> - frustrate: 使灰心、使氣餒
> - ridicule: 嘲笑、奚落、戲弄
> - abuse: (verb,noun) 濫用；虐待；辱罵
> - undeniable: 不可否認的 (un-deny)
> - dimension: 空間、尺寸
> - explicitly: 清楚明白地、明確地、不含糊地
> - explicit: 清楚明白的、明確的、不含糊的
> - discourse: 對話、交流
> - disregard: 漠視、忽視、無視(=ignore)
> - dualism: 二元論、二分法
> - unproblematic: no difficult to solve or decide. 沒有困難的
> - impeding: 妨礙、阻礙、阻止
> - ontological: 本體論的
> - loath:
: unwilling to do something contrary to one's ways of thinking
: reluctant
> - to loath to do sth : 不願做、不情願做
> - confront: 面對、面臨、遭遇、直面
> - paranoid: 偏執的、多疑的
> - delusion: 幻想、錯覺
> - succinct: 簡明的、言簡意賅的 (said in a clear and short way)
> - origin: 起源、源頭、起因 (刺客教條：起源 Assassin's Creed Origins)
> - assistance: 幫助、協助、援助(=help)
> - consolidate: 鞏固、加強
:::

- 損傷跟障礙的差別很重要，過度強調「損傷」會把討論的焦點再次引導回「醫療模式」的困境。
- *[......]For many disability theorists, the distinction between impairment and disability is fundamental. [......] They are concerned that the acknowledgment of the pain of impairment **will lead to a renewed focus on physical limitations** (Shakespeare 1996). A **return to the ascendancy of the medical model**, with its focus on blaming the victim will lead to the dissipation of the disability political movement (Shakespeareand Watson 1997).*
- 損傷跟障礙是同一體的，忽略損傷的同時也就忽略了他們生活中具體的障礙經驗。
- *Conversely, those theorists advocating a focus on the differences between people with disabilities are concerned to ensure that **the social approach to disability incorporates an analysis of impairment**. They argue that to ignore impairments is to ignore the 'reality' of the lived experiences of people with disabilities.*
- *[......] as Williams argues, disability is 'at some level, undeniably to do **with the pain or discomfort of bodies**, and this is a dimension of the oppressive quality of chronic illness and disability for large numbers of people.'*
- 社會學對精神異常的研究長期忽略「受損狀態」，也不重視個人的生命經驗。
- *Sociological work in the area of mental disorder has largely ignored issues of impairment; the **individual's experience of illness is disregarded**.*
- 標籤理論的研究的焦點更多放在社會互動（及其本質），而不是放在那些被貼標籤的人的看法
- *The focus of the research of labelling theorists is on the **nature of the social reaction**, rather than on **the perceptions of those labelled***.
- *Labelling theorists [...] disregard impairment and focus only on **those aspects of a person's identity believed to be related to the social reaction to their condition**. The major argument of these theorists is that **the role of the mental patient is consolidated by the social reaction of friends, relations and medical professionals**(Goffman 1968).*
- 精神疾病患者的情況被視為是一種「社會互動下的產物」，這樣的觀點限制了社會學對於精神疾病的研究。
- *......The ontological status of madness has been viewed, however, as far more problematic. Although the portrayal of mental disorders as social constructions has provided a much-needed challenge to the essentialist view of the body portrayed in medical science, it **has placed major limitations on sociological inquiry.***
- 確實有一部分的人會因為精神障礙而難以從事某些活動。迴避精神障礙的受苦經驗，讓社會學的研究越來越與這些人無關。
- *Sociologists working in the area of mental health have been loath to confront the possibility that a range of mental impairments exists **which make the performance of certain activities difficult** for people who suffer from these impairments. Traditionally, sociologists have avoided the dilemmas of confronting the implications that may flow from an acknowledgment that some people **experience severe pain and discomfort** as a result of disorganised thinking, racing thoughts, fixed paranoid delusions, inability to control thought processes or perceptions of external thought control. This makes their work **increasingly irrelevant for many people experiencing serious mental distress**.*
- 及此，Barnes與Shardlow認為社會學在精神障礙研究上，缺乏替代的解釋模型： *[......]Barnes and Shardlow (1996: 130) [......] argue that the sociology of mental health has not been able to develop 'an alternative model (equivalent to the social model of disability) which can provide the basis for both **understanding the origin and nature of distress** and p**roviding enabling and empowering assistance to those experiencing such distress**'.*

## Embodied impairment

:::spoiler
> - reductionist
> - depiction
> - corporeality
> - corpse
> - sensory: 感官
> - dissolve
> - interdisciplinary
> - concede
> - sole: 唯一的
> - province: 省、領域、認知範圍
:::

- 社會取徑：障礙必須被看成是「鑲嵌在身體上的」
- *These theorists argue that **the social approach must see impairment as 'embodied'**,rather than as presenting a biologically reductionist depiction of the body where the body is seen as separate from society.*
- *One's experience of the embodiment [...] is **the result of a complex relationship between society and corporeality**. As the body is both a corporeal and a social construction, so our experience of embodiment is both **sensory and 'shaped by social relation and ideas' about normal bodily form.** ...... The mind/body dualism has discouraged an exploration of **how people make sense of their physicality and corporeality and how this in turn impacts on the identity**.*
- 社會取徑中鑲嵌的問題：
- *...... If we accept these arguements we are led to **acknowledge that 'selves', identity and agency cannot be studied independently of bodies, whether impaired or otherwise**.*
- 鑲嵌的非理性（embodied irrationality）
- *......We can speak of 'embodied irrationality'. The concept of embodiment dissolves the mind/body distinction. ...... it also eliminates the need to distinguish between physical and mental impairment. As Seymour points out: 'If sociology is the interpretative understanding of social action, then **embodied human beings, human personality and consciousness embodied in human material**, are engaged in that action '(1998: 9).*

- 從鑲嵌的非理性出發，所提供的「跨領域與綜合研究」
- 研究人們如何理解自身的錯亂經驗，而非回到單純的生物決定論
- *The concept of embodiment allows sociologists to see the body as both a 'biological phenomenon' and a 'social production' (Seymour 1998: 12). A focus on 'embodied irrationality' **encourages the study of how people make sense of the bodily experiences of insanity** without falling back on a biologically determinist view of 'madness'.*
- 此外，也為社會學提供了跨領域研究的可能：
- *The concept of embodied irrationality provides a focus for a sociological contribution to **the understanding of the complex relationship between biological and social factors**. This conceptualisation allows '**the possibility of interdisciplinary research** between [...] the biological and the social sciences '(Seymour 1998: 13) rather than conceding this territory to the biological sciences.*
- 鑲嵌的非理性如何擴展研究？
- 研究病識感 (the 'insight' of his/her illness)：
- *Research into **people's explanations of the significance, meaning, and status they attribute to what appear to be psychotic symptoms**, such as hallucinations, is an example of an area where the concept of embodied irrationality could be pursued (Barrett 1996).*
- 鑲嵌的非理性研究，是要在過往醫學研究獨斷的情況下，納入更多的可能因素與情境。
- *Sociologists [...] must do so within a framework that allows for the incorporation of ideas about 'biological disorder', cultural meanings, professional ideologies and social structural constraints.*
-
- 鑲嵌的受損性的研究提供了對障礙者所經歷的障礙處境更細緻的分析：亦即納入：(1) 受損、(2)障礙以及(3)環境
- 案例：視障者與公共空間 (Butler & Bowl, 1997)：障礙的經驗作為一種「賦權」過程，提供障礙者適應、參與、協商公共空間的參與過程。
- *[......] **the use of public space by people with visual impairments**. By focusing on **individuals' perceptions of their experiences in public spaces** the researchers analyse **the different way people with visual impairments confront and negotiate** a range of social and physical barriers. [......] They illustrate how shared understandings and expectations about disability affected their respondents' '**embodied experience of being in public space and how their physical experiences interact with their views of themselves and their relationship to others**'(1997: 422).*
- 案例二：慢性關節炎勞動者如何調適(Pinder, 1995)：障礙的偶發性與不穩定性讓他們調適自己的工作狀況。
- 精神障礙的研究較為稀少，此領域的社會學研究者較少針對受損狀態、障礙、以及環境進行整合分析：
- 精神障礙學生的學習情況（(National Centre for Vocational Education Research, 1999）提供了精神障礙學生在學習上遇到的困難。
- *Research in Australia [......] has shown that university students suffering from psychiatric disorders face major problems in **completing their courses**, partly **due to impairment-related factors**. In addition to s**tigmatising treatment by staff and fellow students**, many encountered problems in **completing assessment tasks within the stipulated time frames** or in **regularly attending classes** because of **their fluctuating symptom**.*

- 鑲嵌的受損性研究（其實也就是鑲嵌的非理性研究）如何賦權？
- 結合社會結構、agency(中介者)、意義，透過探討受損情境來為障礙者賦權。
- *These disability theorists [...] argue that the focus on individuals' understandings of how impairment and disability is experienced **restores a focus on agency and identity**. ...... [More important is that] how positive self-identity can be established and how the experience of impairment can lead to empowerment rather than disempowerment.*
- 賦權的案例：精神障礙者尋找「障礙空間」安頓自身，並融入社會 (Parr, 1997)
- *......[people with mental disabilities] seek out [...] 'insane space' places: 'a bedroom, a park, a cafe, a pavement － **momentary fleeting "insane spaces" where people can simply be themselves**'. [...these] respondents' identities were influenced **both by their interpretation of their mental attributes** and the '**common sociocultural codings and understandings of how the self should be presented in everyday life**'. [...for example these] respondents identify those aspects of their behaviour **that they see as causing concern in the community**. They speak [...] **of feeling 'high', losing inhibition or having thinking that is 'a bit warped'**.*

## Medical sociology and the study of disability
- 受損狀態、障礙與慢性病的情況有所相似，但過度的「醫療化」會對障礙研究帶來不利的後果：
- *Most disability theorists accept that there are some similarities between impairment and chronic illness [... However] They are concerned that a **focus on illness will restrict the ability of the social approach to disability** to move **from an individualistic to a social structural analysis of disability***.
- 過度關注「病與障礙」的相似性，會讓關注的焦點更加著重在疾病本身，並忽略社會結構所帶來的影響（也就是社會結構如何塑造對「障礙／受損狀態」的意義）。
- *...... it highlights the negative aspects of illness and **neglects the structural context within which meanings are shaped**.

- 障礙的社會取徑（social approach）的限制：仍把「身體」的解釋權歸還給醫學：
- *......It is argued that the essentialist conceptualisation of the body within the social approach limits **any challenge to medical dominance**. ......, although the social approach critiques the medical model, it '**concedes the body to medicine and understands impairment in terms of medical discourse**'.*
- 事實上，障礙者的確會尋求醫療途徑來解決自身問題（不管這個是障礙的、是受損狀態、還是真的是疾病），這個事實並未被重視。
- *......The recognition of a link between illness, impairment and disability would **include an acknowledgement that some people with disabilities will and do seek medical treatment**. The distinction between impairment and disability leads theorists to ignore the **'legitimate' medical work related to the treatment of disease and illness **of people with a disability.** The social approach to disability must acknowledge the **legitimacy of medical activities**......*
- 重點仍然是要看見複雜的結構脈絡
### 障礙研究對社會學的啟示：
- 第一，重新省視「後去機構化」時代下醫療的社會控制
- 精神醫學上的處置方式仍然是以醫療行為為主，包含住院治療以及服用醫療藥物：
- *......the dominant response by institutional psychiatry to people with serious mental disorders still **utilizes preventative detention** and a range of ‘**hospital-centred biological treatments’.** The dominant mode of treatment for most people suffering from serious mental disorders is **the prescription of psychotropic medication**.*
- 服用藥物的副作用會限制障礙者的行為能力，因此在英美澳地區多半會輔以「強制社區治療令」
- *This medication frequently has major side-effects that can **severely restrict the ability of the user to engage in a range of social activities**, including paid employment. The fact that medication is often enforced by the use of **compulsory community treatment orders** further complicates the effects of this treatment regime on the lives of those involved. *
- 第二，醫療意識型態如何影響精神醫療政策制定，以及其實行
- 精神障礙者的經歷有很大一部分是因為「精神障礙」被認定是「疾病」，同時這仍然是如今相關單位制定政策的重要考量
- *The disability experiences of people with a mental disorder are **closely related to the conceptualisation of their 'problems' as essentially medical**.*
- 儘管有越來越多政府部門的資料顯示精神障礙者的處境與其社會因素有關，因此需要提供鄉對應的社會福利機制。
- *...... There is, of course, an increasing acknowledgement in policy documents, of the relevance of social factors in the lives of people living with major mental disorders and the necessity to develop links between health services and generic social support and welfare services.*
- 但障礙研究者也只出了，對障礙的歧視性困境並不會因為這些社會福利機制的增設而得到改善：
- *......that issues of control, discrimination, dependency creation and exclusion will **not dissipate with** the development of such partnerships.*

- 第三，必須在「承認疾病會帶來不利」與「個人受損狀態的經驗」中取得解釋的平衡
- *......The work of the disability theorists suggests that a balance must be reached between acknowledging the ideological and conceptual disadvantages associated with a focus on illness, while recognising individuals' experiences with and concerns about impairment*
- *Clearly for some people medicalisation provides meaning, understanding and legitimisation of their experiences of impairment (Broom andWoodward 1996). Sociologists should also, then, reassess medicalisation critiques in terms of the meaning of both disability and impairment in the lives of mental health consumers.*