Mantovani Nadia, Pizzolati Micol, Edge Dawn
Population Health Research Institute, St George's University of London, London, UK.
Department of Economics, Management, Society and Institutions, Università del Molise, Campobasso, Italy.
Health Expect. 2017 Jun;20(3):373-384. doi: 10.1111/hex.12464. Epub 2016 Apr 28.
Stigma related to mental illness affects all ethnic groups, contributing to the production and maintenance of mental illness and restricting access to care and support. However, stigma is especially prevalent in minority communities, thus potentially increasing ethnically based disparities. Little is known of the links between stigma and help-seeking for mental illness in African-descended populations in the UK.
Building on the evidence that faith-based organizations (FBOs) can aid the development of effective public health strategies, this qualitative study used semi-structured interviews with faith groups to explore the complex ways in which stigma influences help-seeking for mental illness in African-descended communities. A thematic approach to data analysis was applied to the entire data set.
Twenty-six men and women who had varying levels of involvement with Christian FBOs in south London were interviewed (e.g. six faith leaders, thirteen 'active members' and seven 'regular attendees').
Key factors influencing help-seeking behaviour were as follows: beliefs about the causes of mental illness; 'silencing' of mental illness resulting from heightened levels of ideological stigma; and stigma (re)production and maintenance at community level. Individuals with a diagnosis of mental illness were likely to experience a triple jeopardy in terms of stigma.
'One-size-fits-all' approaches cannot effectively meet the needs of diverse populations. To ensure that services are more congruent with their needs, health and care organizations should enable service users, families and community members to become active creators of interventions to remove barriers to help-seeking for mental illness.
与精神疾病相关的污名影响着所有种族群体,导致精神疾病的产生和持续存在,并限制了获得护理和支持的机会。然而,污名在少数族裔社区尤为普遍,从而可能加剧基于种族的差异。对于英国非洲裔人群中污名与寻求精神疾病帮助之间的联系,人们知之甚少。
基于有证据表明基于信仰的组织(FBOs)有助于制定有效的公共卫生策略,本定性研究通过对信仰团体进行半结构化访谈,探讨污名以复杂方式影响非洲裔社区中寻求精神疾病帮助的情况。对整个数据集采用了主题分析法进行数据分析。
对26名在伦敦南部不同程度参与基督教FBOs的男性和女性进行了访谈(例如,6名宗教领袖、13名“活跃成员”和7名“定期参加者”)。
影响寻求帮助行为的关键因素如下:对精神疾病病因的看法;因意识形态污名化程度加剧导致精神疾病被“沉默”;以及社区层面污名的(再)产生和维持。被诊断患有精神疾病的个体在污名方面可能会面临三重困境。
“一刀切”的方法无法有效满足不同人群的需求。为确保服务更符合他们的需求,卫生和护理组织应使服务使用者、家庭和社区成员成为积极的干预措施创造者,以消除寻求精神疾病帮助的障碍。