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在社区强化治疗团队中具有严重和持久精神疾病个体的污名化和歧视:家庭和医疗保健专业人员的看法。

Stigma and discrimination in individuals with severe and persistent mental illness in an assertive community treatment team: Perceptions of families and healthcare professionals.

机构信息

1 Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.

2 Lower North Shore Assertive Outreach Team, North Shore Ryde Mental Health Service, Northern Sydney Local Health District, St Leonards, NSW, Australia.

出版信息

Int J Soc Psychiatry. 2019 Nov;65(7-8):570-579. doi: 10.1177/0020764019867358. Epub 2019 Aug 3.

Abstract

AIM

To explore family member and staff perceptions of clients' experiences of stigma and discrimination, in those living with severe and persistent mental illness in an Assertive Community Treatment Team.

METHOD

This qualitative study used the Discrimination and Stigma Scale to conduct structured face-to-face and telephone interviews of family members and healthcare professionals, working with the Assertive Outreach Team (AOT) (an Assertive Community Treatment Team) of a northern inner suburban catchment of Sydney, New South Wales, Australia.

RESULTS

Forty-one people participated in the study (23 AOT clinical staff members and 18 family members). Family and clinical staff commonly reported stigma and discrimination amongst their relatives and clients, respectively. Four overarching themes emerged from the data: (1) appearance and behaviour, (2) avoidance and being shunned, (3) key areas of life affected by discrimination and (4) impacts of discrimination and skills to cope with discrimination.

CONCLUSION

Reports of stigma and discrimination were common, yet varied between groups with clinical staff commonly witnessing experiences and impacts of discrimination in everyday life, with families' reports being substantially less. Due to the strong advocacy and support provided by the AOT model, clinical staff often buffered experiences of stigma and discrimination. Further research is needed to explore effective interventions to reduce experiences of discrimination in this population group.

摘要

目的

探索在一个积极社区治疗团队中,生活在严重和持续精神疾病中的患者的家属和工作人员对其遭受污名化和歧视的看法。

方法

这项定性研究使用歧视和污名量表,对澳大利亚新南威尔士州悉尼北部内郊区一个积极外展团队(AOT)(一个积极社区治疗团队)的家属和医疗保健专业人员进行了面对面和电话访谈。

结果

共有 41 人参与了研究(23 名 AOT 临床工作人员和 18 名家属)。家属和临床工作人员分别报告了他们的亲属和患者中普遍存在的污名化和歧视现象。从数据中得出了四个主要主题:(1)外貌和行为,(2)回避和被排斥,(3)受歧视影响的主要生活领域,以及(4)歧视的影响和应对歧视的技能。

结论

污名化和歧视的报告很常见,但在不同群体之间存在差异,临床工作人员通常在日常生活中见证歧视的经历和影响,而家属的报告则要少得多。由于 AOT 模式的大力倡导和支持,临床工作人员通常会缓冲污名化和歧视的经历。需要进一步研究探索有效的干预措施,以减少这一人群的歧视经历。

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