Hansson Lars, Markström Urban
Department of Health Sciences, Lund University, Lund, Sweden.
BMC Psychiatry. 2014 Feb 25;14:55. doi: 10.1186/1471-244X-14-55.
Stigma and discrimination are still prominent features of the life situation of persons with mental illness, adding to the burden of the illness, causing a lowered self-esteem, quality of life and affecting possibilities of adequate housing and work. It is also a major barrier to help seeking. The deinstitutionalization of mental health services has led to a significant increase in contacts between the police and persons with mental illness. It has been argued that police officers should be provided education and training to enable them to interact adaptively and with good outcomes with people with mental illness. The present study is investigating the effectiveness of an anti-stigma intervention in a basic police officer training programme at a university in Sweden.
The study was performed as a controlled pre-post intervention study using a comparison group, and a 6-month follow-up of the intervention group. Attitudes, mental health literacy and intentional behaviour were assessed. Main analyses were made on an intention to treat basis using repeated measures ANOVA. A total of 120 participants at a basic police officer training programme were included.
Time by group analyses showed improvements in the intervention group in overall score of attitudes and regarding the subscale Open minded and pro integration, in intentional behaviour (willingness to work with) and in 4 out of 6 items assessing mental health literacy. At the 6-month follow-up the intervention group had, as compared to baseline, improved attitudes in both overall score and in two of the subscales. Intentional behaviour had also improved in terms of an increased willingness to live or work with a person with mental health problems. Mental health literacy had improved in 3 out of 6 items.
The anti-stigma intervention proved to be effective in changing attitudes, mental health literacy and intentional behaviour. Improvements mainly endured at the 6-month follow-up. The intervention seems promising in facilitating encounters between the police and persons with mental illness. Further studies are needed to disentangle the relative effectiveness of the components of the intervention before further implementation.
耻辱感和歧视仍是精神疾病患者生活状况的突出特征，加重了疾病负担，导致自尊降低、生活质量下降，并影响获得适当住房和工作的可能性。它也是寻求帮助的主要障碍。精神卫生服务的去机构化导致警察与精神疾病患者之间的接触显著增加。有人认为，应该为警察提供教育和培训，使他们能够与精神疾病患者进行适应性互动并取得良好效果。本研究正在调查瑞典一所大学在基础警察培训项目中开展的一项反耻辱干预措施的效果。
本研究采用对照组进行对照前后干预研究，并对干预组进行6个月的随访。评估了态度、心理健康素养和意向行为。主要分析采用重复测量方差分析，基于意向性治疗原则进行。共有120名基础警察培训项目的参与者纳入研究。
组间时间分析显示，干预组在态度总分、“思想开放和亲融合”子量表、意向行为（与……合作的意愿）以及评估心理健康素养的6项指标中的4项上有所改善。在6个月的随访中，与基线相比，干预组在态度总分和两个子量表方面都有改善。在与有心理健康问题的人一起生活或工作的意愿方面，意向行为也有所改善。在6项指标中的3项上，心理健康素养有所提高。
反耻辱干预措施在改变态度、心理健康素养和意向行为方面被证明是有效的。改善情况主要在6个月的随访中持续存在。该干预措施在促进警察与精神疾病患者之间的接触方面似乎很有前景。在进一步实施之前，需要进行更多研究以厘清干预措施各组成部分的相对有效性。
