Section of Personality, Assessment and Psychological Treatment, Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, 08035 Barcelona, Spain.
First-Person Research Group, Veus, Catalan Federation of 1st Person Mental Health Organisations, 08035 Barcelona, Spain.
Int J Environ Res Public Health. 2021 Jan 29;18(3):1214. doi: 10.3390/ijerph18031214.
Although it may seem paradoxical, primary care and mental health professionals develop prejudices and discriminatory attitudes towards people with mental health problems in a very similar way to the rest of the population. The main objective of this project was to design, implement and evaluate two awareness-raising interventions respectively tailored to reduce stigmatising beliefs and attitudes towards persons with a mental health diagnosis among primary care (PC) and mental health (MH) professionals. These interventions were developed by Obertament, the Catalan alliance against stigma and discrimination in mental health. Activists from this organisation with lived experience of mental health diagnosis carried out awareness-raising interventions in PC and MH health centres. The Targeted, Local, Credible, Continuous Contact (TLC3) methodology was adapted to the Catalan healthcare context. The efficacy of these interventions was evaluated using two prospective double-blind cluster-randomised-controlled trials. Stigmatizing beliefs and behaviours were measured with the Opening Minds Stigma Scale for Health Care Providers in PC centres and with the Beliefs and Attitudes towards Mental Health Service users' rights in MH centres. Reductions in both PC and MH professionals' stigmatising beliefs and attitudes were found in the 1-month follow-up, although a 'rebound effect' at the 3-month follow up was detected. This emphasizes the importance of the continuity of the presence of anti-stigma activities and messages. Attrition rates were high, which can hamper the reliability of the results. Further follow-up studies should enquiry effects of long-term interventions aimed at reducing stigmatising beliefs and attitudes among primary care and mental health professionals using assessment systems that include the measurement of knowledge acquired and actual behavioural change.
尽管这似乎有些矛盾，但初级保健和心理健康专业人员对有心理健康问题的人产生偏见和歧视态度的方式与其他人非常相似。本项目的主要目的是设计、实施和评估两种提高认识的干预措施，分别针对减少初级保健（PC）和心理健康（MH）专业人员对有精神健康诊断的人的污名化信念和态度。这些干预措施是由奥伯特门特（Obertament）开发的，这是一个反对精神健康领域污名化和歧视的加泰罗尼亚联盟。该组织的具有精神健康诊断经验的活动家在 PC 和 MH 保健中心开展了提高认识的干预措施。针对当地的、可信的、持续的、有针对性的接触（TLC3）方法被适用于加泰罗尼亚医疗保健环境。这些干预措施的效果通过两项前瞻性的、双盲、集群随机对照试验进行了评估。使用初级保健中心的《开放思想医疗保健提供者污名量表》和心理健康中心的《对心理健康服务使用者权利的信念和态度》来衡量污名化的信念和行为。在 1 个月的随访中，发现 PC 和 MH 专业人员的污名化信念和态度都有所减少，尽管在 3 个月的随访中发现了“反弹效应”。这强调了连续性存在反污名活动和信息的重要性。脱落率很高，这可能会影响结果的可靠性。进一步的随访研究应该调查旨在减少初级保健和心理健康专业人员污名化信念和态度的长期干预措施的效果，使用包括测量所获得的知识和实际行为改变的评估系统。
