精神残疾群体的社会保障需求与供给:现状、问题与发展建议

精神残疾人多生活困难,构成社会最为弱势的群体。本文采用实地研究与文献研究的方法,对精神残疾人的社会保障需求与供给进行专门考察。研究发现,精神残疾群体的主要需求包括治疗、基本生活支持、康复、长期照护与监管以及社会参与。对此,我国政府已通过多项社会保障制度安排予以回应,基本满足了精神残疾人的基本生活与治疗需求,但还存在社区康复服务匮乏、替代性照护服务供给不足、就学、就业难等问题。基于以上发现,本文认为精神残疾人的基本生存权虽得到较好保障,但是对其发展权和参与权依然关注不足。原因在于当前精神残疾人社会保障存在三个不平衡:经济保障与服务保障发展的不平衡,医疗服务与社会服务发展的不平衡,以及卫健、民政、残联不同部门能力与投入的不平衡。针对这些问题,笔者对未来政策的完善提出了参考建议。

Needs and Supply of Social Security for People with Mental Disability:Current Situation,Problems and Policy Suggestions

People with mental disability often live a miserable life and constitute a most vulnerable group.Based on field work and document analysis,this article focuses on the needs and social security supply for people with mental disability.It is found that the main needs of people with mental disability include treatment,living assistance,rehabilitation,long-term care and social participation.The current social security system has responded to their needs,and the needs for living assistance and inpatient care have been met.However,the supply of rehabilitation services,alternative long-term care arrangements and social participation support are still underdeveloped.Based on these findings,it is argued that the survival rights of people with mental disability are guaranteed while the rights of development and participation are not well protected.The current social security for people with mental disability exhibits three imbalances,including imbalance between economic security and service provision,imbalance between medical services and social care services,and imbalance of commitments and inputs from different governmental departments.Policy suggestions are put forward to cope with these problems.