過去公共衛生護理人員一直是台灣社區精神病患的主要照顧者，但在量變與質變的社會情境下，公共衛生護理人員是否仍合適擔任此工作或者該由誰來擔起照顧之責的問題，仍備受爭議。本文乃運用「STEP (social-technological-economicalpolitical assessment)」分析模式，剖析巨觀環境變化對衛生所之社區精神衛生工作的衝擊、公共衛生護理人員於社區精神衛生業務的角色定位與未來發展問題，並提出相對應的策略與建言。

Public health nurses are the largest manpower component in community-based psychiatric care in Taiwan. However, controversies related to primary responsibility for such have erupted and must be addressed in order to ensure patients receive the most appropriate care and healthcare professionals are adequately trained and supported. This article used the STEP (social-technological-economicalpolitical assessment) method to assess the macro-level contextual changes that have affected health-care centers and public health nurses providing community psychiatric care as well as their role function and development. This study recommends several policy changes based on findings.