Centre for Mental Health, Melbourne School of Population and Global Health,The University of Melbourne,Melbourne,Australia.
Epidemiol Psychiatr Sci. 2018 Aug;27(4):346-356. doi: 10.1017/S204579601600113X. Epub 2017 Jan 11.
The aim of the current study was to carry out a national population-based survey to assess the proportion of people disclosing mental health problems in a variety of settings. A further aim was to explore respondent characteristics associated with disclosure.
In 2014, telephone interviews were carried out with 5220 Australians aged 18+, 1381 of whom reported a mental health problem or scored highly on a symptom screening questionnaire. Questions covered disclosure of mental health problems to friends, intimate partners, other family members, supervisors or other colleagues in the workplace, teachers, lecturers or other students in the educational institution, health professionals and others in the community. Other than for intimate partners or supervisors, participants were asked whether or not they told everybody, some people or no one. Multinomial logistic regression was used to model the correlates of disclosure in each setting.
For friends and family, respondents were more likely to disclose to some people than to everyone or to no one. In most other domains, non-disclosure was most common, including in the workplace, where non-disclosure to supervisors was more likely than disclosure. Disclosure was associated with having received treatment or with support in all settings except healthcare, while it was only associated with discrimination in two settings (healthcare and education).
Disclosure of mental health problems does not appear to be linked to discrimination in most settings, and is typically associated with receiving support. Selective or non-disclosure may be particularly critical in workplaces, education and healthcare settings.
本研究旨在开展一项全国性的基于人群的调查,评估在各种环境下人们披露心理健康问题的比例。进一步的目的是探索与披露相关的受访者特征。
2014 年,对 5220 名年龄在 18 岁及以上的澳大利亚人进行了电话访谈,其中 1381 人报告了心理健康问题或在症状筛查问卷中得分较高。问题涵盖了向朋友、亲密伴侣、其他家庭成员、主管或工作场所的其他同事、教师、讲师或教育机构中的其他学生、卫生专业人员和社区中的其他人披露心理健康问题。除了亲密伴侣或主管外,参与者被问及是否告诉了所有人、一些人或没有人。使用多项逻辑回归模型来分析每个环境下披露的相关因素。
对于朋友和家人,受访者更有可能向一些人而不是所有人或没有人披露。在大多数其他领域,不披露是最常见的,包括在工作场所,不向主管披露比披露更常见。在除医疗保健之外的所有环境中,披露与接受治疗或支持有关,而在两个环境中(医疗保健和教育),披露仅与歧视有关。
在大多数环境中,披露心理健康问题似乎与歧视无关,通常与获得支持有关。在工作场所、教育和医疗保健环境中,选择性或不披露可能尤为关键。