Hankir Ahmed, Brothwood Phillipa, Crocker Bethany, Lim Mao Fong, Lever Isabel, Carrick Frederick, Zaman Rashid, Jones Charlotte Wilson
Leeds York Partnership NHS Foundation Trust, Leeds, UK,
Psychiatr Danub. 2017 Sep;29(Suppl 3):469-475.
On the 9 October 2000, Dr Daksha Emson, a London based psychiatrist with bipolar affective disorder, tragically killed herself and her three-month-old baby daughter during a psychotic episode. An independent inquiry into Dr Emson's death concluded that mental health stigma in the National Health Service was a factor that contributed to her death. Despite the morbidity and mortality attributed to the stigma attached to post-natal mental health problems there are very few programmes that have been developed to challenge it. King's College London Undergraduate Psychiatry Society organized an event entitled, 'A Labour of Love': Perinatal Mental Health to address this issue. The event included a talk from an expert by experience, a mother who developed post-partum mental health problems.
We conducted a single-arm, pre-post comparison study on participants who attended the KCL Psych Soc event. Validated stigma scales on knowledge (Mental Health Knowledge Schedule (MAKS)), attitudes (Community Attitudes towards the Mentally Ill (CAMI)) and behaviour (Reported and Intended Behaviour Scale (RIBS)) were administered before and immediately after exposure to the event.
27/27 (100%) of participants recruited responded. There was a statistically significant difference in the pre-MAKS score compared to the post-MAKS score (p=0.0003), the pre-RIBS score compared to the post-RIBS score (p=0.0068) and in the pre-CAMI score compared to the post-CAMI score (p=0.0042).
There were statistically significant reductions in stigma in the domains of knowledge, attitude and behavior following exposure to the KCL Psych Soc event and no adverse effects were reported. Our study revealed that a brief intervention made a highly significant impact and maybe useful in challenging the stigma around post-natal mental illness. However, more research in this area is required to determine if the changes are sustained before we can consider rolling out and scaling up such an initiative nationally and internationally.
2000年10月9日，患有双相情感障碍的伦敦精神科医生达克莎·埃姆森博士在一次精神病发作期间悲惨地自杀，还杀死了她三个月大的小女儿。对埃姆森博士死亡事件的独立调查得出结论，国民医疗服务体系中的心理健康污名化是导致她死亡的一个因素。尽管产后心理健康问题所带来的污名导致了发病率和死亡率，但很少有项目专门为应对这一问题而设立。伦敦国王学院本科精神病学协会组织了一场名为“爱的劳作：围产期心理健康”的活动来解决这个问题。该活动包括一位有亲身经历的专家，一位患有产后心理健康问题的母亲的演讲。
我们对参加国王学院精神病学协会活动的参与者进行了单组前后比较研究。在接触该活动之前和之后，立即使用经过验证的关于知识（心理健康知识量表（MAKS））、态度（社区对精神疾病患者的态度（CAMI））和行为（报告和预期行为量表（RIBS））的污名化量表。
招募的27名参与者全部（100%）做出了回应。MAKS前测分数与MAKS后测分数相比存在统计学显著差异（p = 0.0003），RIBS前测分数与RIBS后测分数相比（p = 0.0068），以及CAMI前测分数与CAMI后测分数相比（p = 0.0042）。
接触国王学院精神病学协会活动后，在知识、态度和行为领域的污名化有统计学显著降低，且未报告有不良影响。我们的研究表明，一次简短干预产生了非常显著的影响，可能有助于挑战围绕产后精神疾病的污名化。然而，在我们能够考虑在国内和国际上推广和扩大这样的举措之前，需要在这个领域进行更多研究，以确定这些变化是否能持续。
