本研究採用建制民族誌，以社區復健中心作為研究場域，透過參與式觀察、深度訪談，以及文本分析，探究精神困擾者在社區復健中心的決策參與。研究發現有三：（一）專業化與制式化的建制，限制了精神困擾者的決策。多重專業的文書作業使參與者在分工與溝通上形成知識落差，將精神困擾者的經驗碎片化，失去對個人整體性的理解。（二）精神醫療專業與跨專業工作模式受到推崇，在社區復健中心形成多重專業人員──個管師──個案，從上至下的權力位階關係；在權力不對等之下，使用者需求容易被忽略。（三）專業人員在提供服務時受衛政制度框限，但仍為實作場域中最具權力的一方；個管師與案主經歷不同的角色和工作，同是場域中的弱勢者。

The researcher serves as an occupational therapist in a community rehabilitation center and observed that people with mental difficulties are often "arranged" instead of arranging for themselves. In the context of human rights advocacy, this study focuses on the process of using community rehabilitation services, how will people with mental difficulties be affected by their participation in decision-making? What are the social process and power relations behind the mental health institution? And how do participants cooperate with the mental health professional governance?
This study used institutional ethnography and took the community rehabilitation center as the research field. The research includes a participatory observation, in-depth interviews, and textual analysis. There are three findings: (1) The professional and institutionalized system restricts the decision-making of people with mental difficulties. (2) The psychiatric professionals and the trans-disciplinary model are highly respected, but the participants are divided rather than cooperative resultantly. A hierarchical relationship is formed in the mental health service team among multiple professionals, case managers, to clients. (3) Both the case manager’s thoughts and the user’s needs are easily neglected under unequal power.