Alvidrez J, Azocar F
Department of Psychiatry, University of California, San Francisco 94143, USA.
Gen Hosp Psychiatry. 1999 Sep-Oct;21(5):340-7. doi: 10.1016/s0163-8343(99)00038-9.
Women seen in public gynecology settings are at very high risk of developing psychiatric disorders. Because low-income and ethnic minority women seen in such settings underutilize mental health services, it is important to better understand treatment preferences and obstacles among this high-risk patient population. Public women's clinic patients (N = 105) who reported psychological or emotional distress were asked about their interest in medication, psychotherapy, and psychoeducational classes, as well as perceived obstacles to using these services. The vast majority were interested in receiving some form of mental health treatment, with the most interest shown for individual therapy and general psychoeducational classes about health and stress. Less interest was expressed in group therapy and medication. Women anticipated more instrumental barriers to using services, such as lack of money, transportation, and childcare, than stigma-related barriers, such as fear of embarrassment or rejection. However, Latinas, women with less education, and those with a current mood or anxiety disorder were more likely to anticipate stigma-related barriers to treatment than other women. Implications of these findings for referral and treatment of mental health problems among public women's clinic patients are discussed.
在公共妇科诊所就诊的女性患精神疾病的风险非常高。由于在此类诊所就诊的低收入和少数族裔女性未充分利用心理健康服务,因此更深入了解这一高风险患者群体的治疗偏好和障碍非常重要。对报告有心理或情绪困扰的公共妇女诊所患者(N = 105)询问了她们对药物治疗、心理治疗和心理教育课程的兴趣,以及使用这些服务时所感知到的障碍。绝大多数人对接受某种形式的心理健康治疗感兴趣,对个体治疗以及关于健康和压力的一般心理教育课程兴趣最大。对团体治疗和药物治疗的兴趣较低。女性预计使用服务时会遇到更多实际障碍,如缺钱、交通不便和儿童保育问题,而非与污名相关的障碍,如担心尴尬或被拒绝。然而,拉丁裔女性、受教育程度较低的女性以及目前患有情绪或焦虑障碍的女性比其他女性更有可能预计到与治疗相关的污名障碍。本文讨论了这些发现对公共妇女诊所患者心理健康问题转诊和治疗的意义。