八八風災後兒童心理健康的復原歷程：以MHPSS為視角的現象學研究

Abstract

每當天災人禍發生時，被影響的人們其自身的心理狀態與社會連結都會被嚴重的衝擊，更甚者還會造成長期的心理影響（IASC, 2007），是故，在回應人道危機中災民的心理需求時，不能只關注在單獨個體之上，心理社會（Psychosocial）的部份也須一併考量，於是在回應的介入方案之中，機構間常設委員會（Inter-Agency Standing Committee, IASC）所提出的「心理健康與心理社會支持」（Mental Health and Psychosocial Support, MHPSS）工作模式，就提供了助人工作者或者單位一個介入設計的方向。

儘管在臺灣，尚未有機構完全以此作為災變回應的框架，然而，在實務上卻可能已經將其原則或精神運用在現地，而研究者身為兒童福利暨援助機構的一份子，一方面希望更了解受災兒童的心理健康復原歷程，並且以MHPSS的框架來了解是否回應行動可以更加精進，是故，此篇研究欲以MHPSS的視角出發，來探討當時的兒童經歷八八風災巨大的災變，從接受幫助到生活得以重建的歷程樣貌，並進一步探索及了解什麼是對於兒童心理健康的轉變帶來正向或負向的影響的人事物，提供服務兒童的助人工作者與機構作為未來規劃災難回應介入或方案的參考。

本研究採取立意取樣，以受到八八風災衝擊甚鉅的臺東縣金峰鄉嘉蘭村為研究場域，邀請6位當時仍為兒童的青年作為訪談對象分享其風災經驗，所得到之資料以現象心理學方法分析之。

研究結果呈現6位研究參與者之風災經驗置身結構，並且在他們的普遍現象中看見其復原歷程隨著莫拉克颱風侵襲嘉蘭村之後而依「時序」在不同「空間」中轉換，換句話說，受災兒童的復原歷程是由「時間」與「空間中的涉入」構築而成，這些空間包含「家屋」、「鄰里」、「學校」及「社會」，其中的互動影響了當時兒童的心理健康狀態。

依據研究分析結果提出的建議如下：（1）災後回應方案及策略以兒童與空間的互動及涉入作為考量的基礎；（2）復原歷程中應以強化保護因子與消除危險因子為活動設計導向；（3）特定的階段可以舉辦活動或者儀式來回顧事件，重新對焦於盼望；（4）設計災後心理回應方案時，納入如何整合當地支援系統；（5）設計活動需根據兒童的需求及意見，且明確設定要達成的目的及指標；（6）利用機構優勢即時提供基本心理照護；（7）以量化方法驗證保護及危險因子；（8）國內MHPSS工作模式的實證研究；（9）前往不同研究場域及訪談不同對象。Inter-Agency Standing Committee (ISAC) proposed the Mental Health and Psychosocial Support (MHPSS) as a common framework for humanitarian workers and institutes to design the response projects for the mental health in emergency setting.

Although this framework has not been fully adopted by any organsition to design disaster response plan in Taiwan, the core principles might have been naturally applied in the field already. Being a student in postgraduate school and a staff member of an INGO striving for child wellbeing. It is beneficial to take the advantage of conducting research to learn more about the recovery process of Children’s mental health after disaster and identify how the response action can be improved simultaneously. Therefore, the purpose of this study is to explore the recovery process of children’s mental health during the rehabilitation period after Typhoon Morakot through the len of MHPSS. The results will not only be provided to the humanitarian workers but also to the aid organsations or agency as a reference to make the response plan or intervention in the future.

This study adopted purposive sampling method to recruit participants in Jia-Lan village of Tai–Tung county where was severely affected by Typhoon Morakot. These participants were children and are youths for the time being. The data was collected from interviews and analysed by phenomenological approach.

The results presented the situated structures for the six participants and found that their recovery process commenced after Typhoon Morakot impacted Jia-Lan village as time went by and changed in different spaces. In other words, the recovery process of children was constructed by “time” and the “involvement in the spaces”. These spaces, namely “home”, “neighborhood”, “school” and “society”. The interactions occurred in these spaces influenced mental health of children in the process.

According to the research results, the suggestions for humanitarian workers and organisations are as follows. (1)The children’s involvement and interaction in different spaces should be taken into account to make disaster response project or strategy. (2) The interventions design during the recovery process should focus on enhancing the protective factors and eliminate the risk factors. (3) Organise event or ceremony to review the disaster on the specific timing and have the affected people refocus on the hope out of their experience. (4) Incorporate the local integrated support systems into the project for responding the post disaster mental needs. (5) Aid organisations should design the activities and interventions based on children’s needs and opinions. The SMART goal and corresponding indicators should be set. (6) Take the advantage of an organization which has worked in the field to provide basic mental health care (7) Verify the protective and risk factors with quantitative method. (8) Conduct domestic evidence-based research for MHPSS. (9) Conduct the similar research in different places and group of people.