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[坦诚、开放、自豪:一项由同伴主导的项目的概念与成效,该项目为披露决策及应对耻辱感提供支持]

[Honest, Open, Proud: Concept and Efficacy of a peer-led Program to Provide Support with Disclosure Decisions and Coping with Stigma].

作者信息

Rüsch Nicolas, Oexle Nathalie, Reichhardt Lea, Ventling Stephanie

机构信息

Klinik für Psychiatrie und Psychotherapie II der Universität Ulm am BKH Günzburg.

Freiberufliche Peer Support Specialist, Zürich, Schweiz.

出版信息

Psychiatr Prax. 2019 Mar;46(2):97-102. doi: 10.1055/a-0800-3695. Epub 2018 Dec 3.

Abstract

BACKGROUND

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.

METHODS

"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.

RESULTS

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.

CONCLUSIONS

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.

摘要

背景

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。

方法

“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。

结果

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。

结论

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。

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