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应对污名化和改善精神疾病及物质使用障碍政策的沟通策略。

Communication Strategies to Counter Stigma and Improve Mental Illness and Substance Use Disorder Policy.

机构信息

Dr. McGinty and Dr. Barry are with the Department of Health Policy and Management, where Dr. Kennedy-Hendricks is affiliated, and with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore. Dr. Pescosolido is with the Department of Sociology, Indiana University, Bloomington.

出版信息

Psychiatr Serv. 2018 Feb 1;69(2):136-146. doi: 10.1176/appi.ps.201700076. Epub 2017 Oct 2.

Abstract

Despite the high burden and poor rates of treatment associated with mental illness and substance use disorders, public support for allocating resources to improving treatment for these disorders is low. A growing body of research suggests that effective policy communication strategies can increase public support for policies benefiting people with these conditions. In October 2015, the Center for Mental Health and Addiction Policy Research at Johns Hopkins University convened an expert forum to identify what is currently known about the effectiveness of such policy communication strategies and produce recommendations for future research. One of the key conclusions of the forum was that communication strategies using personal narratives to engage audiences have the potential to increase public support for policies benefiting persons with mental illness or substance use disorders. Specifically, narratives combining personal stories with depictions of structural barriers to mental illness and substance use disorder treatment can increase the public's willingness to invest in the treatment system. Depictions of mental illness and violence significantly increase public stigma toward people with mental illness and are no more effective in increasing willingness to invest in mental health services than nonstigmatizing messages about structural barriers to treatment. Future research should prioritize development and evaluation of communication strategies to increase public support for evidence-based substance use disorder policies, including harm reduction policies-such as needle exchange programs-and policies expanding treatment.

摘要

尽管精神疾病和物质使用障碍相关的负担高且治疗率低,但公众对为改善这些障碍的治疗提供资源的支持率较低。越来越多的研究表明,有效的政策传播策略可以提高公众对有利于这些人群的政策的支持率。2015 年 10 月,约翰霍普金斯大学心理健康和成瘾政策研究中心召集了一次专家论坛,以确定目前已知的此类政策传播策略的有效性,并为未来的研究提出建议。论坛的一个关键结论是,使用个人叙事来吸引受众的沟通策略有可能提高公众对有利于精神疾病或物质使用障碍患者的政策的支持。具体来说,将个人故事与精神疾病和物质使用障碍治疗的结构障碍描述相结合的叙述,可以增加公众对治疗系统投资的意愿。对精神疾病和暴力的描述会显著增加公众对精神疾病患者的污名化,并且在增加对精神健康服务投资的意愿方面,并不比关于治疗障碍的非污名化信息更有效。未来的研究应优先制定和评估沟通策略,以提高公众对基于证据的物质使用障碍政策的支持,包括减少伤害政策,如针具交换计划,以及扩大治疗范围的政策。

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