Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China.
Kwai Chung Hospital, Hong Kong, China.
Evid Based Ment Health. 2019 May;22(2):51-55. doi: 10.1136/ebmental-2018-300078. Epub 2019 Mar 28.
Health professionals including psychiatrists were reported to have stigmatising opinions on psychiatric patients. Their views may be affected by clinical, social and cultural factors.
This study explored the views of Chinese psychiatrists on stigmatisation of psychiatric patients.
Focus group discussions with psychiatrists were conducted in Hong Kong. Their views towards stigmatisation of psychiatric patients and strategies to reduce stigmatisation were discussed.
The psychiatrists perceived the clinical needs to classify the patients according to the diagnoses and they did not see it as stigmatisation. They believed that some mental illnesses are characterised with violence or deviance, and were not completely curable. Instead of trying to eliminate stigma, they managed in ways that took social expectations into consideration. They might offer a relative vague diagnostic label to save the 'face' of the patients and secure greater acceptance for the illness from the public. They tended to accept family members to make decisions on behalf of the patients. Reconciling public interest and patients' autonomy, they encouraged stable psychotic patients to live in the community but agreed to institutionalise those patients with violent behaviours.
While the psychiatrists argued that the diagnosis was not a form of stigma, they were sensitive enough and framed responses to patients in ways to minimise stigma. They tended to believe that stigma was inevitable given the nature of some psychotic disorders. Disguising the stigma appeared to be the common approach to deal with stigma in a Chinese context.
The psychiatrists, especially those practicing in a Chinese context, may consider a wider perspective of community mental health rehabilitation which is not limited to social stability but also social life.
据报道，包括精神科医生在内的卫生专业人员对精神科患者存在污名化的观点。他们的观点可能受到临床、社会和文化因素的影响。
本研究探讨了中国精神科医生对精神科患者污名化的看法。
在香港对精神科医生进行了焦点小组讨论。讨论了他们对精神科患者污名化的看法以及减少污名化的策略。
精神科医生认为根据诊断对患者进行分类是临床需要，他们并不认为这是污名化。他们认为，一些精神疾病具有暴力或偏差的特征，并且不能完全治愈。他们不是试图消除污名，而是采取考虑到社会期望的方式进行管理。他们可能会提供一个相对模糊的诊断标签，以维护患者的“面子”，并使公众更容易接受这种疾病。他们倾向于让家庭成员代表患者做出决定。在兼顾公众利益和患者自主权的情况下，他们鼓励稳定的精神病患者在社区生活，但同意将有暴力行为的患者住院治疗。
尽管精神科医生认为诊断不是一种污名化的形式，但他们足够敏感，并以尽量减少污名化的方式为患者制定应对措施。他们倾向于认为，鉴于某些精神病性障碍的性质，污名化是不可避免的。在中国背景下，掩饰污名似乎是处理污名的常见方法。
精神科医生，尤其是在中国背景下工作的精神科医生，可能需要考虑更广泛的社区精神卫生康复视角，不仅限于社会稳定，还包括社会生活。
