How to Alter the Perception of Mental Health Care in Russia | Olga Kitaina | TED

譯者: Lilian Chiu 審譯者: Helen Chang

For the past five years,

過去五年間，

I've been working as a psychologist in Russia,

我在俄羅斯擔任心理諮詢師，

a country where mental health is stigmatized

在俄羅斯，心理健康被汙名化，

and people are often afraid to seek professional help.

人民通常不敢尋求專業協助。

Right now, people in Ukraine are fighting for their lives.

現在，烏克蘭人正在為生存而戰。

What is happening is devastating and traumatic,

發生這種事，會造成 很大的傷害和創傷，

and everyone, including both Russians and Ukrainians,

所有人，包括俄羅斯人 以及烏克蘭人，

will need mental health support, but on different levels.

都需要心理健康的支持，

但是是不同層級的。

No matter where in the world I'll be working from,

不論我在世界的哪個角落工作，

I'm committed to helping people.

我都會盡力助人。

Psychotherapy for me,

對我而言，心理治療 一直是且將來也還會是

has and will always be a force of understanding,

一種了解、改變，和平靜的力量。

change and peace.

And now it is needed more than ever.

而現在是最需要它的時候。

Unfortunately, there is a lot of resistance to psychotherapy in Russia.

不幸的是，俄羅斯 相當排斥心理治療。

First, for historical reasons.

首先，是因為歷史上的理由。

During the Soviet Union,

在蘇聯時期，精神病學 通常被用來當作政治工具，

psychiatry was often used as a political tool,

and this is just a small part of the state attitudes toward people

國家對人民的態度深深重創了社會，

that deeply traumatized the society.

而這只是其中一小部分。

Since then,

從那之後，

Russia has seen major reforms in the psychiatric system,

俄羅斯的精神病學體制 有了重大改革，

and there are a growing number of good specialists in the mental health industry.

在心理健康產業， 好的專家也越來越多。

Yet problems remain.

但，問題依舊存在。

As in many countries where mental health has been stigmatized,

就如同許多將心理健康 汙名化的國家一樣，

proper regulations for practicing psychologists

俄羅斯從來沒有為心理諮詢師的執業

have never been developed in Russia.

制訂過妥善的規定。

There are no licensing procedures

沒有核發證照的程序，

or any laws protecting clients from incompetence and fraud.

也沒有任何法律來保障遇到 不稱職諮詢師或詐欺的客戶。

There are a lot of scammers,

有很多招搖撞騙的江湖術士， 有人只上過三個月的課，

people who simply took a three-month course,

tarot card readers or astrologers

也有塔羅牌占卜師或占星術士，

who say they're professional psychologists.

他們會自稱是專業心理諮詢師。

As a result,

因此，有很多人

a lot of people don't know how to choose a professional

不知道要如何挑選 適合他們需求的專業人士，

who fits their profile

or are even victimized by such unprofessional help.

甚至會成為這類專業協助的受害者。

In the absence of regulation and interest by the state,

在缺乏法規，政府又沒興趣的情況下，

I saw an opportunity.

我看見了一個機會。

With my team, we created a platform

我和我的團隊創立了一個平台，

with an assessment system for psychologists

平台上有心理諮詢師的評估系統，

and the means to get people connected to the therapists they need,

也能協助人民連結到 他們所需要的心理諮詢師，

therapists they can trust.

是他們能信任的心理諮詢師。

Through this assessment system,

透過這個評估系統，

we help people overcome the risk of being harmed by professional help

我們協助人民降低 被專業協助傷害的風險，

or falling into despair,

避免他們陷入絕望，

of giving up hope they will ever feel better.

不再抱有能改善的希望。

We have based our assessment on a hypothesis backed up with research,

我們評估背後的基礎 是有研究支持的假設，

saying that there are common factors

研究指出，有些共同因素

that significantly contribute to psychotherapy effectiveness.

明顯會影響到心理治療的效果。

This includes a variety of ways

包括有多種不同的方式，

in which a therapist and the client

讓治療師和客戶可以

create a special bond of trust and partnership.

創造出信任與合作的特殊連結。

Unfortunately, in most psychotherapy training programs in Russia,

不幸的是，在俄羅斯， 多數心理治療訓練方案

not much attention is paid to those common factors.

都不太重視那些共同因素。

The bottom line,

重要的是，

having a good diploma is not enough.

光有好的文憑並不夠。

Our psychologists undergo a test and a case study interview,

我們的心理諮詢師要接受 一項檢測和個案研究訪談，

including ethics questions,

內容包含倫理問題，

because the client's safety is the priority.

因為客戶的安全是優先考量。

The sad truth is that only around 15 percent of applicants

讓人感傷的事實是， 只有約 15% 的申請者

pass our selective assessment screening.

通過我們的評估淘汰篩選。

After this assessment,

在這項評估之後，

it is important to match a client with the right specialist.

重要的是將客戶與對的專家配對。

With our current matching algorithm,

用我們目前的配對演算法，

we've already helped more than 35,000 people

我們已經協助了超過三萬五千人

receive safe psychotherapy.

接受安全的心理治療。

We also offer pro-bono sessions

我們也提供不收費的諮詢時段

and free educational materials

以及免費的教育素材，

to support those who can't afford therapy.

來支援無法負擔治療的人。

And I believe the number of people in need of mental health support

我認為，需要心理健康支援的人數

will increase due to the PTSD,

將會增加，原因包括 創傷後壓力症候群、

chronic stress,

慢性壓力、

trauma of two years of the pandemic

創傷，可能是來自兩年的疫情，

and all the global events we are experiencing.

也可能來自我們 在經歷的各種全球事件。

And this is the beginning

有個更大的心理健康災難， 現在只是開端，

of a bigger mental health catastrophe we all need to face.

我們都得面對這災難。

We're trying our best,

我們在盡力而為，

even though we work in a tough environment

雖然我們工作的環境很艱苦，

with the strong stigma

汙名化問題嚴重，

and the cultural memory of psychiatry as an instrument of oppression.

且在大家的文化記憶中， 精神病學就是壓迫工具。

Our goal is to minimize the risk of people giving up on therapy

我們的目標是要將大家 放棄治療的風險降到最低，

because it's dangerous.

因為那樣很危險，

On an individual level,

就個人層面來說，

it means a barrier for well-being, and unfolding potential.

這意味著阻礙安康 以及呈現潛能的障礙。

For the world,

對世界而言，

it means a loss in productivity and economy.

這意味著生產力和經濟狀況走下坡。

Just depression and anxiety disorder

光是憂鬱和焦慮疾病

cause the global economy an estimated one trillion dollars each year

就讓全球經濟的生產力損失

估計達每年一兆美金。

in lost productivity.

But I believe that the most important costs

但，我相信，最重要的成本

are the decrease in the quality of connections between people.

是人與人的連結品質下降、

The loss of self awareness.

失去自我意識、

An increase in hatred and violence.

仇恨和暴力增加。

Psychotherapy is not only about one individual finding help

心理治療的重點並不只是讓個人

針對自己的個人問題尋求協助。

for their individual issues.

When one of us is wounded, all of us share in that wound.

當我們當中的一個人受傷，

那會是我們所有人共同的傷。

Psychotherapy is a way to move forward from the burden of the past

心理治療是向前邁進的方式，

離開過去的重擔

and trauma of the present

以及現今的創傷，

by breaking cycles of hurt,

做法是打破傷痛的循環，

by embracing the path of healing and self-knowledge.

擁抱療癒以及自知的道路。

Because by knowing ourselves and seeking healing from our pain and trauma,

因為，當我們能夠去認識自己

並尋求從我們的痛苦與創傷中療癒，

we also become better human beings in our interconnected world,

在我們彼此相連的世界中， 我們也變成了更好的人，

bringing a real hope for peace.

帶來真正的和平希望。

Thank you.

謝謝。

（掌聲）

(Applause)