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一项定性研究:精神健康问题患者的污名体验。

A qualitative study: experiences of stigma by people with mental health problems.

机构信息

Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK.

Stockport and District Mind, UK.

出版信息

Psychol Psychother. 2018 Sep;91(3):380-397. doi: 10.1111/papt.12167. Epub 2018 Jan 18.

Abstract

OBJECTIVES

Prior research has examined various components involved in the impact of public and internalized stigma on people with mental health problems. However, studies have not previously investigated the subjective experiences of mental health stigma by those affected in a non-statutory treatment-seeking population.

DESIGN

An in-depth qualitative study was conducted using thematic analysis to investigate the experiences of stigma in people with mental health problems.

METHODS

Eligible participants were recruited through a local mental health charity in the North West of England. The topic of stigma was examined using two focus groups of thirteen people with experience of mental health problems and stigma.

RESULTS

Two main themes and five subthemes were identified. Participants believed that (1) the 'hierarchy of labels' has a profound cyclical impact on several levels of society: people who experience mental health problems, their friends and family, and institutional stigma. Furthermore, participants suggested (2) ways in which they have developed psychological resilience towards mental health stigma.

CONCLUSIONS

It is essential to utilize the views and experiences gained in this study to aid understanding and, therefore, develop ways to reduce the negative impact of public and internal stigma.

PRACTITIONER POINTS

People referred to their mental health diagnosis as a label and associated that label with stigmatizing views. Promote awareness and develop improved strategies (e.g., training) to tackle the cyclical impact of the 'hierarchy of labels' on people with mental health problems, their friends and family, and institutional stigma. Ensure the implementation of clinical guidelines in providing peer support to help people to combat feeling stigmatized. Talking about mental health in psychological therapy or health care professional training helped people to take control and develop psychological resilience.

摘要

目的

先前的研究已经考察了公共和内化污名对心理健康问题患者的影响所涉及的各种因素。然而,之前的研究尚未调查非法定寻求治疗人群中受影响者对心理健康污名的主观体验。

设计

采用主题分析的深入定性研究,调查心理健康问题患者的污名体验。

方法

通过英格兰西北部的当地心理健康慈善机构招募合格参与者。使用两个有心理健康问题和污名经验的 13 人焦点小组来研究污名问题。

结果

确定了两个主要主题和五个子主题。参与者认为:(1)“标签等级”对社会的多个层面产生深远的循环影响:有心理健康问题的人、他们的朋友和家人以及机构污名。此外,参与者提出(2)他们对心理健康污名发展出心理弹性的方式。

结论

必须利用本研究中获得的观点和经验来帮助理解,从而开发出减少公共和内化污名负面影响的方法。

实践要点

人们将他们的心理健康诊断称为标签,并将该标签与污名化的观点联系起来。提高认识并制定改进策略(例如培训)来应对“标签等级”对心理健康问题患者、他们的朋友和家人以及机构污名的循环影响。确保在提供同伴支持以帮助人们克服被污名化的感觉时实施临床指南。在心理治疗或医疗保健专业人员培训中谈论心理健康有助于人们掌控局面并培养心理弹性。

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