Jacoby Sara F, Rich John A, Webster Jessica L, Richmond Therese S
Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA.
Penn Injury Science Center, University of Pennsylvania, Philadelphia, PA, USA.
Ethn Health. 2020 Aug;25(6):777-795. doi: 10.1080/13557858.2018.1455811. Epub 2018 Apr 1.
Psychological distress is common in survivors of traumatic injury, yet across United States' trauma systems, it is rare that standard injury care integrates psychological evaluation and professional mental healthcare. The purpose of this study was to explore help-seeking for psychological symptoms in injured Black men living in Philadelphia. A subset of a cohort of 551 injured Black men admitted to a Trauma Center in Philadelphia participated in qualitative interviews that explored their perceptions of psychological symptoms after injury and the factors that guided their decision to seek professional mental health help. Data from 32 participants were analyzed for narrative and thematic content. Three overarching themes emerged: (1) facilitators of help-seeking, (2) barriers to help-seeking, and (3) factors underlying the decision not to consider professional help. Five participants felt that their injury-related psychological distress was severe enough to merit professional help despite any perceived barriers. Seventeen participants identified systemic and interpersonal obstacles to professional help that prevented them from seeking this kind of care. These included: financial constraints, limited access to mental healthcare services, and fear of the judgments of mental healthcare professionals. Ten participants would not consider professional help; these men perceived a lack of need and sufficiency in their existing social support networks. Research is needed to inform or identify interventions that diminish the impact of barriers to care, and identify from whom, where, and how professional mental health help might be more effectively offered to injured Black men in recovery environments like Philadelphia.
心理困扰在创伤性损伤幸存者中很常见,但在美国各地的创伤系统中,标准的损伤护理很少纳入心理评估和专业心理健康护理。本研究的目的是探讨费城受伤黑人男性针对心理症状寻求帮助的情况。费城一家创伤中心收治的551名受伤黑人男性队列中的一部分人参与了定性访谈,这些访谈探讨了他们受伤后对心理症状的认知以及指导他们决定寻求专业心理健康帮助的因素。对32名参与者的数据进行了叙事和主题内容分析。出现了三个总体主题:(1)寻求帮助的促进因素,(2)寻求帮助的障碍,以及(3)不考虑专业帮助的决定背后的因素。五名参与者认为,尽管存在任何可感知的障碍,但他们与损伤相关的心理困扰严重到足以值得寻求专业帮助。17名参与者指出了寻求专业帮助存在的系统性和人际障碍,这些障碍使他们无法寻求此类护理。这些障碍包括:经济限制、获得心理健康护理服务的机会有限以及担心心理健康专业人员的评判。十名参与者不会考虑寻求专业帮助;这些男性认为他们现有的社会支持网络缺乏必要性和充分性。需要开展研究,为减少护理障碍的影响提供信息或确定干预措施,并确定在像费城这样的康复环境中,向受伤黑人男性更有效地提供专业心理健康帮助的对象、地点和方式。