日前一位鋼琴家在直播表演時，因承受長期壓力而透露輕生念頭，然而網路上的酸民不但未給予支持，反而以冷漠的態度挑釁嘲諷，最終竟釀成悲劇。身為精神科醫師，這則新聞令我深感悲痛，這類悲劇正是當前不健康數位環境、殘酷的網路世界最血淋淋的案例，更呈現出我們新型態心理創傷的無力感。
https://enews.tw/article/1233871
在網路e世代，前所未有的自由讓人際互動不受時空限制，界線模糊且難以阻擋恣意的侵入，導致霸凌造成的創傷更加無所限制、變本加厲！原本存在校園的恃強凌弱、以大欺小的惡霸，如今幻變成虛擬世界的鍵盤流氓、藏鏡下的酸民，「網路霸凌已成為心理健康的一大隱憂」。據調查，受害者往往是人格尚在發展階段的青少年，可能導致憂鬱症、創傷性壓力症候群等嚴重後果，甚至極可能成為壓垮他們的最後一根稻草，構成青少年輕生的最後一擊。
https://cobolsu.blogspot.com/2020/07/the-unspeakable-mind.html
必須正視台灣精神醫療體系所面臨的困境。自殺是年輕人死亡之主因，兒少精神疾病的盛行率約為三成，病程長，影響學習而自我厭惡，衍生衝動成癮、嚴重精神疾病、犯罪，甚至走向自我毀滅。兒童精神醫療之健保給付不合理，造成專科醫師不足，也無法提供兒少嚴重精神病患得到「尊重自主、隱私安全」的急重症照顧。
賴清德總統積極推動「健康台灣」改革政策，將國民心理健康提升至國家層級。我們力挺此一政策，呼籲社會各界要高度重視網路霸凌問題，尤應在中小學課綱納入更全面的心理健康教育。在歐美國家，心理學和社會情感學習早已被列為與語文、數學、科學同等重要的必修課程。社會情感學習課程著重培養五大素養：自我覺察、自我管理、社會覺察、人際關係技能及負責任的決策能力。不僅可增強學生的自我效能和品格，還能提升情緒調節能力和心理韌性，對預防網路霸凌行為具有關鍵作用。
https://cobolsu.blogspot.com/2021/03/20210314.html
許多教師和家長對精神疾病有錯誤迷思（不信有精神疾病、不信有過動症憂鬱症、反對醫藥治療、不自覺的歧視污名化心理疾病...），在兒童青少年的成長過程、乃致出社會後的長期對心理疾病和腦醫學的認知偏見，會造成多麼全面性的影響。因此，針對中小學的健康體育課綱，強化精神心理疾病教育單元刻不容緩。
做為精神科醫師每天看病都有很深刻感觸，若能把科學和醫學，特別是精神醫學的常識，帶到社會情感學習教育當中，不僅對精神醫學，更對全民心理健康有巨大意義。精神治療的人力和資源永遠不足，特別是考慮醫療資源比較不足的族群，應大力推動「心理健康的數位轉型」，著力於「線上診療」及「數位治療」，歐美的治療指引一定會強調：治療輕中度焦慮病和憂鬱症時，勿把開藥當作常規，要和病人討論非藥物療法，並推薦多種數位化、線上心理治療的App。
https://cobolsu.blogspot.com/2024/04/blog-post.html
健康不只是靠醫療或靠健保，國家的目標應該是「賦能全民」，應將焦點從治療疾病轉移到預防保健，從單一醫療服務轉移到整合性的健康促進。
（作者是安南醫院副院長、憂鬱症中心主持人；總統府健康台灣推動委員會委員）
Promoting mental health awareness
ReplyDeletehttps://www.taipeitimes.com/News/editorials/archives/2024/08/30/2003822981
Fri, Aug 30, 2024 page8
By Su Kuan-pin 蘇冠賓
Translated by Tim Smith
A few days ago a pianist said during a live stream broadcast of his recital that he felt suicidal from numerous stressful life events. People in the comment section were ruthless toward the pianist. Not only did they not support this person in a moment of fragility, but these commentators also coldly taunted and mocked him. In the end, tragedy struck.
As a psychiatrist, I was deeply distraught by this turn of events. This saga not only reminds us of the brutality of the online world, but also serves as a bitter reminder that society must rightly recognize the psychological trauma that cyberbullying can cause. In the Internet “e-era,” unprecedented freedoms allow people to disregard the limits of time and space. Borders are blurred and it is difficult to halt unbridled attacks, leading to unrestricted harm — or much worse — caused by bullying.
Schoolyard bullying from back in the day, when bullies relied on physical strength to torment those weaker than themselves, has morphed into today’s virtual world of keyboard thugs and malcontents who hide behind a screen, engaging in cruel dogpiling where several anonymous users could attack a single person in a coordinated instant. Cyberbullying has become a major factor impacting one’s mental health.
A survey showed that cyberbullying victims tend to be younger people whose personality and identity are still developing. Being bullied could lead to depression, post-traumatic stress disorders, and in extreme instances, could be the last straw — the final blow before they decide to take their own life.
Suicide is a leading cause of death in younger people. The prevalence of psychiatric disorders among adolescents is about 30 percent of the age group. These illnesses and disorders have long prognoses, impact learning and create self-loathing. They lead to impulsive comorbidities, severe mental illness, criminal behavior and even self-destruction. There is inadequate health insurance system support for pediatric psychiatric care, which leads to a dearth of specialists. This situation makes it impossible to provide acute care to adolescents coping with psychiatric disorders or illnesses in a manner that respects autonomy, privacy and safety.
President William Lai (賴清德) is enthusiastically rooting for his “Healthy Taiwan” healthcare reform policy, which would elevate mental health to a national-level policy issue. We should stand behind this new policy and encourage all sectors of society to put greater focus on the problem of cyberbullying. In particular, we should incorporate comprehensive mental health education into elementary and junior-high-school curriculums.
In Europe and the US, psychology and social and emotional learning (SEL) classes have long been required courses, holding the same weight as languages, mathematics and science courses. SEL courses place an emphasis on cultivating five key qualities: introspection, self-control, social awareness, interpersonal relationships and responsible decisionmaking. Cultivation of these qualities not only enhances a student’s self-efficacy and self-worth, but could also increase emotional regulation capabilities and mental resilience, playing key roles in preventing cyberbullying.
Su Kuan-pin is a professor of psychiatry at China Medical University’s College of Medicine, deputy director of Tainan Municipal An-nan Hospital and a member of the Presidential Office’s Healthy Taiwan Promotion Committee.
Promoting mental health awareness
ReplyDeletehttps://www.taipeitimes.com/News/editorials/archives/2024/08/30/2003822981
Fri, Aug 30, 2024 page8
By Su Kuan-pin 蘇冠賓
Translated by Tim Smith
....
Many educators and parents have been misled into believing that psychiatric conditions, such as attention deficit hyperactivity disorder or clinical depression, do not exist. They have been misled into opposing medication and therapy, and have unwitting bias against and are dismissive of psychiatric conditions. As adolescents develop and as they join society, their long-term knowledge of and biases against psychiatric conditions and neurological science create compounding effects. There is no time to waste when it comes to improving health curriculums for elementary and junior-high-school students, enhancing lessons on psychological conditions.
As a professional psychiatrist, each day I see the devastating impacts of misunderstanding of psychiatric and brain disorders on patients and their families. If I could take science and medicine — common-sense psychology in particular — and bring that to an SEL curriculum, it would have far-reaching implications for not only psychiatric treatment, but also on society’s overall mental health.
Psychotherapy in Taiwan has long been plagued by a lack of personnel, funding and resources, especially when it concerns population groups who cannot afford treatments and therapy. We ought to be heavily promoting a transition toward digitalized mental health treatment, putting efforts into telehealth diagnostics and digital treatment.
Treatment guidelines in Europe and the US are clear on their recommendations: There are guidelines to not prescribe medication when treating light to moderate anxiety disorders and depression. Treatment providers must discuss with patients the option of not using medication as treatment, while also recommending the use of multiple digital and online treatment applications.
Health is not just a matter of treatments or health insurance. A nation’s goals ought to be to “empower all of its people.” A government should be concerned with the transition from just the treatment of illnesses to preventive healthcare. It should be concerned with evolving from medication treatment services to the promotion of comprehensive, holistic health.
Su Kuan-pin is a professor of psychiatry at China Medical University’s College of Medicine, deputy director of Tainan Municipal An-nan Hospital and a member of the Presidential Office’s Healthy Taiwan Promotion Committee.