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新冠疫情期间的精神困扰与人权侵犯:关于弱势群体权利、心理健康需求及公共政策的证据快速回顾

Mental Distress and Human Rights Violations During COVID-19: A Rapid Review of the Evidence Informing Rights, Mental Health Needs, and Public Policy Around Vulnerable Populations.

作者信息

Rahman Muhammad, Ahmed Rabab, Moitra Modhurima, Damschroder Laura, Brownson Ross, Chorpita Bruce, Idele Priscilla, Gohar Fatima, Huang Keng Yen, Saxena Shekhar, Lai Joanna, Peterson Stefan Swartling, Harper Gary, McKay Mary, Amugune Beatrice, Esho Tammary, Ronen Keshet, Othieno Caleb, Kumar Manasi

机构信息

University of Washington, Seattle, WA, United States.

Washington University, St. Louis, MO, United States.

出版信息

Front Psychiatry. 2021 Jan 8;11:603875. doi: 10.3389/fpsyt.2020.603875. eCollection 2020.

Abstract

COVID-19 prevention and mitigation efforts were abrupt and challenging for most countries with the protracted lockdown straining socioeconomic activities. Marginalized groups and individuals are particularly vulnerable to adverse effects of the pandemic such as human rights abuses and violations which can lead to psychological distress. In this review, we focus on mental distress and disturbances that have emanated due to human rights restrictions and violations amidst the pandemic. We underscore how mental health is both directly impacted by the force of pandemic and by prevention and mitigation structures put in place to combat the disease. We conducted a review of relevant studies examining human rights violations in COVID-19 response, with a focus on vulnerable populations, and its association with mental health and psychological well-being. We searched PubMed and Embase databases for studies between December 2019 to July 2020. Three reviewers evaluated the eligibility criteria and extracted data. Twenty-four studies were included in the systematic inquiry reporting on distress due to human rights violations. Unanimously, the studies found vulnerable populations to be at a high risk for mental distress. Limited mobility rights disproportionately harmed psychiatric patients, low-income individuals, and minorities who were at higher risk for self-harm and worsening mental health. Healthcare workers suffered negative mental health consequences due to stigma and lack of personal protective equipment and stigma. Other vulnerable groups such as the elderly, children, and refugees also experienced negative consequences. This review emphasizes the need to uphold human rights and address long term mental health needs of populations that have suffered disproportionately during the pandemic. Countries can embed a proactive psychosocial response to medical management as well as in existing prevention strategies. International human rights guidelines are useful in this direction but an emphasis should be placed on strengthening rights informed psychosocial response with specific strategies to enhance mental health in the long-term. We underscore that various fundamental human rights are interdependent and therefore undermining one leads to a poor impact on the others. We strongly recommend global efforts toward focusing both on minimizing fatalities, protecting human rights, and promoting long term mental well-being.

摘要

对大多数国家来说,新冠疫情防控措施实施得很突然,且颇具挑战性,长期封锁给社会经济活动带来了压力。边缘化群体和个人尤其容易受到疫情不利影响,比如侵犯人权行为,这可能导致心理困扰。在本综述中,我们关注疫情期间因人权限制和侵犯而产生的心理困扰和障碍。我们强调心理健康如何既受到疫情本身的直接影响,也受到为抗击疫情而采取的防控措施的影响。我们对相关研究进行了综述,这些研究考察了新冠疫情应对中的侵犯人权行为,重点关注弱势群体,以及这些行为与心理健康和幸福感的关联。我们在PubMed和Embase数据库中搜索了从2019年12月到2020年7月的研究。三位评审员评估了纳入标准并提取了数据。系统检索纳入了24项关于因侵犯人权而产生困扰的研究。这些研究一致发现弱势群体面临心理困扰的高风险。行动权利受限对精神病患者、低收入个体和少数族裔造成了不成比例的伤害,这些人群有更高的自我伤害风险和心理健康恶化风险。医护人员由于耻辱感、缺乏个人防护装备以及耻辱感而出现了负面心理健康后果。其他弱势群体,如老年人、儿童和难民也经历了负面后果。本综述强调了维护人权以及满足在疫情期间遭受不成比例痛苦的人群长期心理健康需求的必要性。各国可以在医疗管理以及现有预防策略中融入积极的社会心理应对措施。国际人权准则在这方面很有用,但应强调通过具体策略加强基于权利的社会心理应对措施,以长期改善心理健康。我们强调各种基本人权是相互依存的,因此损害其中一项会对其他权利产生不良影响。我们强烈建议全球共同努力,既要尽量减少死亡人数、保护人权,又要促进长期的心理健康。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89ee/7820171/27d436f7d6dd/fpsyt-11-603875-g0001.jpg

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