Office of Transformative Global Health, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Ontario, Canada.
Departments of Public Health and Family Medicine, Faculty of Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
J Community Health. 2019 Dec;44(6):1204-1213. doi: 10.1007/s10900-019-00706-w.
Healthcare environments are not exempt from the impact of stigma against mental illness and addiction, which contributes to barriers to client access and appropriate treatment. To address this concern, healthcare organizations have a growing interest in mental illness and addiction anti-stigma anti-discrimination programming as part of their staff-wide professional development. Though standard interventions demonstrate effectiveness in the short and mid-term, the evidence for long-term change is inconclusive. A flexible, innovative intervention was developed in collaboration with community health care centres to reduce mental illness and addiction stigma and discrimination at an organizational level. A mixed methods approach was utilized to develop the intervention design and evaluate the effectiveness of the intervention. 137 people participated in the survey component of the study and five senior management staff in interviews. Quantitative results showed that the intervention was effective in changing attitudes toward mental illness (e.g. 5,9% improvement in OMS-HC score, p < 0,05) and substance use problems (e.g. 8.4% reduction in social distance for heroin dependence, p < 0.05). Qualitative findings were positive for indicators of observed improvement in mental health knowledge and behaviour. The implications for future research that allows for the further evaluation of multicomponent anti-stigma interventions in healthcare settings are discussed.
医疗环境也不能免受对精神疾病和成瘾的污名化的影响,这导致了患者获得服务和适当治疗的障碍。为了解决这一问题,医疗机构越来越关注精神疾病和成瘾反污名反歧视计划,将其作为员工全面专业发展的一部分。虽然标准干预措施在短期和中期内显示出有效性,但长期变化的证据尚无定论。为了在组织层面减少精神疾病和成瘾的污名化和歧视,与社区医疗中心合作开发了一种灵活、创新的干预措施。采用混合方法来制定干预设计并评估干预措施的有效性。137 人参加了研究的调查部分,5 名高级管理人员参加了访谈。定量结果表明,该干预措施在改变对精神疾病(例如,OMS-HC 评分提高 5.9%,p<0.05)和物质使用问题(例如,对海洛因依赖的社会距离减少 8.4%,p<0.05)的态度方面是有效的。定性结果表明,心理健康知识和行为的观察到的改善指标是积极的。讨论了未来研究的意义,这些研究允许在医疗环境中进一步评估多成分反污名化干预措施。