Hansen Hege, Stige Signe Hjelen, Moltu Christian, Johannessen Jan Olav, Joa Inge, Dybvig Sveinung, Veseth Marius
1Department of Welfare and Participation, Western Norway University of Applied Sciences, Postbox 7030, 5020 Bergen, Norway.
2Department of Clinical Psychology, University of Bergen, Bergen, Norway.
Int J Ment Health Syst. 2019 May 9;13:32. doi: 10.1186/s13033-019-0289-4. eCollection 2019.
Intervening at an early stage of psychosis improves the chances of recovery from first-episode psychosis. However, people who are experiencing distress and early psychotic symptoms generally seem to delay seeking help. Therefore, multifaced information campaigns targeting help-seeking behavior of potential patients and their network are considered important tools within early detection and intervention strategies. In this study, we aimed to explore which discursive meaning content, including roles and actors, such information campaigns build on and construct. Our intention was not to provide objective answers, but to contribute to a discursive debate about potential conflicts in messages conveyed in such campaigns.
A broad sample of information material utilized by TIPS Stavanger University Hospital (Norway) was examined. The material consisted of posters, booklets and brochures, newspaper ads, Facebook ads, and TIPS Info's website, representing various campaigns from 1996 to April 2018. A narrative discursive approach was applied at an epistemological level. At a practical level, a team-based thematic analysis was utilized to identify patterns across data.
Diversity and several changes in strategy were recognized throughout the information material. Furthermore, three main themes and four subthemes were found to constitute the meaning content built in the information campaigns: knowledge is key; (almost) an illness among illnesses; and we all have a responsibility (comprising of the subthemes; to respond quickly; to step in; to provide an answer; and to tag along).
Our findings pointed to common dilemmas in mental health services: How to combine professional expert knowledge with collaborative practices that emphasize shared decision-making and active roles on behalf of patients? How to combine a focus on symptoms and illness and simultaneously express the importance of addressing patients' recourses? And how can we ask for societal responsibility in help-seeking when professionals are placed in expert positions which may not be optimal for dialogue with potential patients or their network? We discuss whether highlighting practices with more weight on resources and active roles for patients and their surroundings in information campaigns could promote earlier help-seeking.
在精神病早期进行干预可提高首次发作精神病康复的几率。然而，正经历痛苦和早期精神病症状的人通常似乎会延迟寻求帮助。因此，针对潜在患者及其社交网络的求助行为开展多方面的宣传活动被视为早期检测和干预策略中的重要工具。在本研究中，我们旨在探讨此类宣传活动所基于和构建的话语意义内容，包括角色和行为主体。我们的目的不是提供客观答案，而是为关于此类活动所传达信息中潜在冲突的话语辩论做出贡献。
对挪威斯塔万格大学医院TIPS所使用的广泛信息材料样本进行了检查。这些材料包括海报、小册子和宣传册、报纸广告、脸书广告以及TIPS信息网站，代表了1996年至2018年4月期间的各种活动。在认识论层面采用了叙事话语方法。在实践层面，利用基于团队的主题分析来识别数据中的模式。
在整个信息材料中发现了策略的多样性和若干变化。此外，发现三个主要主题和四个子主题构成了信息活动中构建的意义内容：知识是关键；（几乎）是疾病中的一种疾病；以及我们都有责任（包括子主题：迅速做出反应；介入；提供答案；以及陪伴）。
我们的研究结果指出了心理健康服务中的常见困境：如何将专业专家知识与强调共同决策和患者积极作用的协作实践相结合？如何在关注症状和疾病的同时，表达解决患者资源问题的重要性？当专业人员处于可能不利于与潜在患者或其社交网络对话的专家位置时，我们如何在求助方面要求社会责任？我们讨论了在信息活动中更加强调患者及其周围环境的资源和积极作用的做法是否可以促进更早地寻求帮助。
