Struch Naomi, Levav Itzhak, Shereshevsky Yechiel, Baidani-Auerbach Alona, Lachman Max, Daniel Noga, Zehavi Tali
DMyers-JDC-Brookdale Institute, Jerusalem, Israel.
Isr J Psychiatry Relat Sci. 2008;45(3):210-8.
Mental health-related stigma causes suffering and interferes with care and social inclusion. This study explored stigma as experienced by mental health service users. Particular attention is given to their use of coping mechanisms. Interviews were held with 167 adults undergoing outpatient psychiatric treatment; two-thirds of them had previously been hospitalized. Examples of frequency of stigma-related situations included the following: Over half of service users expect people to refuse to have a person with a mental disorder as a co-worker or neighbor, or to engage in other types of social contact. A sizeable group acknowledged that they feared or had experienced rejection. A third of respondents reported they feared or had experienced inappropriate treatment by their doctor. Service users utilize several coping mechanisms to deal with stigma, among them: education, withdrawal, secrecy, and positive distinctiveness. Although we studied a convenience sample of service users, our findings provide sufficient basis to suggest different types of intervention, i.e., to address stigma in the course of treatment in the specialist settings, to promote the establishment of mutual support groups, and to raise family physicians' awareness with regard to the stigma that may be present when caring for persons with mental disorders.
与心理健康相关的污名会造成痛苦,并妨碍治疗和社会融入。本研究探讨了心理健康服务使用者所经历的污名。特别关注他们应对机制的使用情况。对167名接受门诊精神科治疗的成年人进行了访谈;其中三分之二的人此前曾住院治疗。与污名相关情况的发生频率示例如下:超过一半的服务使用者预计人们会拒绝与患有精神障碍的人成为同事或邻居,或拒绝进行其他类型的社会接触。相当一部分人承认他们害怕或曾经历过被拒绝。三分之一的受访者表示他们害怕或曾经历过医生的不当治疗。服务使用者会采用多种应对机制来应对污名,其中包括:教育、回避、保密和积极区分。尽管我们研究的是服务使用者的便利样本,但我们的研究结果为提出不同类型的干预措施提供了充分依据,即在专科环境的治疗过程中应对污名、促进互助小组的建立,以及提高家庭医生对在照顾精神障碍患者时可能存在的污名的认识。