Rüsch Nicolas, Oexle Nathalie, Reichhardt Lea, Ventling Stephanie
Klinik für Psychiatrie und Psychotherapie II der Universität Ulm am BKH Günzburg.
Freiberufliche Peer Support Specialist, Zürich, Schweiz.
Psychiatr Prax. 2019 Mar;46(2):97-102. doi: 10.1055/a-0800-3695. Epub 2018 Dec 3.
Due to the stigma associated with mental disorders, many people with mental illness face the difficult choice whether to disclose their illness to others. (Non-)Disclosure is a key reaction in coping with stigma. Disclosure as well as non-disclosure have risks and benefits, depending on the environment and the individual.
"Honest, Open, Proud" (HOP; German: "In Würde zu sich stehen"/IWS) is a peer-led group program to support people with mental illness in their disclosure decisions. It is not HOP's aim to make participants disclose, but to support a well-informed and empowered decision.
Currently three RCTs, with several others underway, show HOP's positive effects in terms of reductions in stigma stress, disclosure distress, self-stigma, or depressive symptoms. Adolescent participants reported better quality of life, recovery, and attitudes to help-seeking. Adaptations for different diagnoses and age groups have been developed.
HOP appears to be a feasible and effective program to support people with mental illness in their disclosure decisions and in their coping with stigma. Future developments and public health implications are discussed.
由于与精神障碍相关的污名,许多患有精神疾病的人面临着是否向他人透露自己病情的艰难选择。(不)透露是应对污名的关键反应。根据环境和个人情况,透露和不透露都有风险和益处。
“诚实、开放、自豪”(HOP;德语:“In Würde zu sich stehen”/IWS)是一个由同伴主导的团体项目,旨在支持患有精神疾病的人做出透露病情的决定。HOP的目的不是让参与者透露病情,而是支持他们做出明智且自主的决定。
目前有三项随机对照试验,还有其他几项正在进行中,这些试验表明HOP在减轻污名压力、透露痛苦、自我污名或抑郁症状方面具有积极效果。青少年参与者报告说生活质量、康复情况以及对寻求帮助的态度有所改善。已经针对不同诊断和年龄组进行了调整。
HOP似乎是一个可行且有效的项目,可支持患有精神疾病的人做出透露病情的决定并应对污名。文中讨论了未来的发展以及对公共卫生的影响。