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人口贩卖、精神疾病与成瘾:避免诊断遮蔽

Human Trafficking, Mental Illness, and Addiction: Avoiding Diagnostic Overshadowing.

作者信息

Stoklosa Hanni, MacGibbon Marti, Stoklosa Joseph

机构信息

Executive director of HEAL Trafficking and an emergency physician at Brigham and Women's Hospital in Boston, with appointments at Harvard Medical School, the Harvard T.H. Chan School of Public Health, and the Harvard Humanitarian Initiative, and a researcher, advocate, and speaker in the US and internationally.

Inspirational speaker and author and an expert on trauma resolution and addiction.

出版信息

AMA J Ethics. 2017 Jan 1;19(1):23-34. doi: 10.1001/journalofethics.2017.19.1.ecas3-1701.

Abstract

This article reviews an emergency department-based clinical vignette of a trafficked patient with co-occurring pregnancy-related, mental health, and substance use disorder issues. The authors, including a survivor of human trafficking, draw on their backgrounds in addiction care, human trafficking, emergency medicine, and psychiatry to review the literature on relevant general health and mental health consequences of trafficking and propose an approach to the clinical complexities this case presents. In their discussion, the authors explicate the deleterious role of implicit bias and diagnostic overshadowing in trafficked patients with co-occurring addiction and mental illness. Finally, the authors propose a trauma-informed, multidisciplinary response to potentially trafficked patients.

摘要

本文回顾了一名遭受人口贩运患者的急诊科临床案例,该患者同时存在与妊娠相关、心理健康和物质使用障碍问题。作者包括一名人口贩运幸存者,他们利用自己在成瘾护理、人口贩运、急诊医学和精神病学方面的背景,回顾了关于人口贩运相关的一般健康和心理健康后果的文献,并针对该案例所呈现的临床复杂性提出了一种应对方法。在讨论中,作者阐述了隐性偏见和诊断遮蔽在同时患有成瘾和精神疾病的被贩运患者中的有害作用。最后,作者针对可能遭受人口贩运的患者提出了一种基于创伤知情的多学科应对措施。

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