Institute of Psychology, Health and Society, Department of Mental and Behavioural Health Sciences, University of Liverpool, Block B, Waterhouse Buildings, 1-5 Brownlow Street, Liverpool L69 3GL, United Kingdom.
Health Place. 2012 May;18(3):536-51. doi: 10.1016/j.healthplace.2012.01.011. Epub 2012 Feb 15.
Guided by theoretical perspectives of relational social science, this paper draws on reanalyses of multiple qualitative datasets related to a multi-ethnic, economically disadvantaged area in Liverpool, UK, with the aim to advance general understanding of access to primary mental health care while using local Somali minority as an instrumental focus. The findings generate a novel concept: the space of access. The shape and dynamics of the space of access are determined by at least four fields of tensions: understandings of area and community; cognitive mapping of mental well-being, illness and care; positioning of primary care services; and dynamics of resources beyond the 'medical zone' of care. The conclusions indicate a need for de-centring and re-connecting the role of medical professionals within primary care which itself needs to be transformed by endorsement of multiple avenues of access to diverse support and intrepid communication among all involved actors.
本研究以关系社会科学的理论视角为指导,重新分析了与英国利物浦一个多民族、经济贫困地区相关的多个定性数据集,旨在推进对初级心理健康保健的理解,同时以当地的索马里少数民族为重点。研究结果提出了一个新概念:“准入空间”。准入空间的形状和动态由至少四个紧张领域决定:对地区和社区的理解;心理健康、疾病和护理的认知映射;初级保健服务的定位;以及医疗保健“医学区”之外资源的动态。研究结论表明,需要去中心化和重新连接初级保健中医疗专业人员的角色,这需要通过认可多种途径来获得多样化的支持,并在所有相关行为者之间进行勇敢的沟通来实现。