Wagstaff C, Graham H, Salkeld R
Medical School, Nursing, University of Birmingham, Edgbaston, Birmingham, UK.
School of Psychology, University of Birmingham, Birmingham, UK.
J Psychiatr Ment Health Nurs. 2018 Mar;25(2):88-95. doi: 10.1111/jpm.12441. Epub 2017 Nov 27.
This study is a follow-on study to a study into the experiences of disengagement from mental health services for men who described their ethnic identity as "black." The aim of this study was to understand the same phenomenon from a clinician's perspective. WHAT IS KNOWN ON THE SUBJECT?: Literature highlights that people from ethnic minority backgrounds experience some difficulties engaging with mental health services; Disengagement from mental health services is a complex phenomenon that occurs for a variety of different reasons; Only one paper previously has investigated clinicians' perspective on disengagement from mental health services; WHAT THE STUDY ADDS TO EXISTING KNOWLEDGE?: This study demonstrates that clinicians are aware that stigma and medication impact upon engagement with mental health services, which were also important components of the patients experience. A finding of the former study was that patients' attitudes towards mental health services change over time, with patients engaging more as they get older, a finding was supported by wider literature. However, in this study, the participants were not certain that this was the case. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The implications for practice from this study are that staff should persist with efforts to reduce the stigma surrounding mental health, carefully consider the significance and impact of medication and have an awareness of how patients' attitudes towards mental illness and mental health services change and develop over time. Continued support for an AO approach to practice for people who find it difficult to engage with services, where a multidisciplinary "team" approach can focus on service user-centred recovery goals and a positive space for collaboration.
Introduction Engagement with services is often poor amongst people with severe mental health problems, yet key to improving clinical outcomes. Aims This study explores the perception of clinicians on patients with severe mental health problems, in particular the experiences of black men, who disengage from mental health services. Method Two focus groups consisting of a combined total of twelve, mainly white, experienced clinicians in the UK were recruited. Transcripts were analysed using interpretative phenomenological analysis. Results Clinicians understood that patients' awareness of stigma impacted upon engagement with mental health services. Clinicians were aware that medication negatively impacted on engagement. The passage of time was perceived as impacting upon engagement. Discussion The perspectives of the clinicians in this study and the experiences of the patients in a former study converged. The participants had an understanding of the complexities that black men faced when engaging with mental health services. Implications for practice This is the first study to highlight that AOT staff need to be aware of the key role that stigma plays in engagement in treatment, continue to focus on efforts to reduce the stigma surrounding mental health, consider the significance medication and be aware of how patients' attitudes towards mental health services develop over time.
本研究是一项后续研究，其前一项研究探讨了自认为族裔身份为“黑人”的男性脱离心理健康服务的经历。本研究的目的是从临床医生的角度理解同一现象。关于该主题已知的信息：文献强调少数族裔背景的人在参与心理健康服务方面存在一些困难；脱离心理健康服务是一个复杂的现象，其发生有多种不同原因；此前仅有一篇论文研究了临床医生对脱离心理健康服务的看法；本研究对现有知识的补充：本研究表明临床医生意识到耻辱感和药物治疗会影响参与心理健康服务的情况，而这也是患者经历的重要组成部分。前一项研究的一个发现是患者对心理健康服务的态度会随时间变化，随着年龄增长患者参与度更高，这一发现得到了更广泛文献的支持。然而，在本研究中，参与者并不确定情况是否如此。对实践的启示：本研究对实践的启示是工作人员应持续努力减少围绕心理健康的耻辱感，仔细考虑药物治疗的意义和影响，并了解患者对精神疾病和心理健康服务的态度如何随时间变化和发展。对于难以参与服务的人群，继续支持采用以患者为导向的实践方法，多学科“团队”方法可专注于以服务使用者为中心的康复目标以及营造积极的合作空间。
引言 严重心理健康问题患者参与服务的情况往往不佳，但这是改善临床结果的关键。目的 本研究探讨临床医生对严重心理健康问题患者的看法，特别是对脱离心理健康服务的黑人男性的经历的看法。方法 招募了两个焦点小组，总共十二名主要为白人的经验丰富的英国临床医生。使用解释现象学分析对访谈记录进行分析。结果 临床医生理解患者对耻辱感的认知会影响其参与心理健康服务。临床医生意识到药物治疗对参与有负面影响。时间的推移被认为会影响参与情况。讨论 本研究中临床医生的观点与前一项研究中患者的经历相契合。参与者理解黑人男性在参与心理健康服务时面临的复杂性。对实践的启示 这是第一项强调以患者为导向的工作人员需要意识到耻辱感在治疗参与中所起的关键作用、继续专注于减少围绕心理健康的耻辱感、考虑药物治疗的意义并了解患者对心理健康服务的态度如何随时间发展的研究。
