苏丹心理健康服务利用的障碍——照顾者和精神科医生的观点
Barriers to mental health service utilisation in Sudan - perspectives of carers and psychiatrists.
作者信息
Ali Sara H, Agyapong Vincent I O
机构信息
Department of Psychiatry, St Patrick's University Hospital, Dublin, Ireland.
Centre for Global Health, University of Dublin, Trinity College, Dublin, Ireland.
出版信息
BMC Health Serv Res. 2016 Jan 27;16:31. doi: 10.1186/s12913-016-1280-2.
BACKGROUND
In order to scale up mental health care nationally, barriers to health services utilisation need to be identified and addressed.
AIM
The aim of this study was to identify barriers to mental health services utilization in Sudan from the perspectives of carer's of mentally ill patients and psychiatrists and to make recommendations to address the identified barriers.
METHODS
Mixed research methods were used in this cross sectional survey. The quantitative part was conducted with carers of mentally ill patients who were staying in Tijani Elmahi psychiatric hospital in Sudan, and the qualitative part was conducted with the psychiatric consultants in the country.
RESULTS
103 carers and six psychiatric consultants participated in the study. According to carers, the main barriers to utilisation of mental health services includes: the beliefs around mental illness, resorting to alternative treatments such as religious and traditional healers, centralization of mental health services, inadequate number of mental health staff, and mental health not being a priority by policy makers. In addition to these barriers, the psychiatric consultants identified stigma, cost of medications, and worries about medication's side effects as barriers to the utilisation of mental health services. The carers and psychiatrists proposed several solutions to address the barriers to health services utilisation.
CONCLUSION
Carers and psychiatrists are aware of the barriers to mental health services utilisation in Sudan. Addressing these barriers require a health policy and political response.
背景
为了在全国范围内扩大精神卫生保健规模，需要识别并解决卫生服务利用方面的障碍。
目的
本研究的目的是从精神病患者照料者和精神科医生的角度识别苏丹精神卫生服务利用的障碍，并就解决已识别的障碍提出建议。
方法
本横断面调查采用混合研究方法。定量部分对苏丹提贾尼·埃尔马希精神病院住院的精神病患者照料者进行，定性部分对该国的精神科顾问进行。
结果
103名照料者和6名精神科顾问参与了研究。根据照料者的说法，精神卫生服务利用的主要障碍包括：对精神疾病的看法、求助于宗教和传统治疗师等替代疗法、精神卫生服务的集中化、精神卫生工作人员数量不足以及政策制定者不将精神卫生作为优先事项。除了这些障碍，精神科顾问还将污名、药物成本以及对药物副作用的担忧确定为精神卫生服务利用的障碍。照料者和精神科医生提出了几种解决卫生服务利用障碍的方案。
结论
照料者和精神科医生意识到苏丹精神卫生服务利用的障碍。解决这些障碍需要卫生政策和政治回应。
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