Gudyanga Denford, Palmer Tamaryn, Wright Nicola, O'Regan Eileen, Shonai Charity, Mlambo Nefasi, Maremera Melody, Mangezi Walter
Zimbabwe Early Intervention in Psychosis Project (Together We Thrive Trust), Harare, Zimbabwe.
Department of Psychiatry, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Wellcome Open Res. 2021 Feb 8;6:26. doi: 10.12688/wellcomeopenres.16262.1. eCollection 2021.
Mental health is slowly gaining global significance as a key health issue, yet the stigma attached to psychosis is still a major problem. There has been little in-depth exploration of sustainable, cost-effective, and replicable community engagement strategies that address mental health myths and stigma, which are major barriers to early health-seeking behaviours. In low-income countries such as Zimbabwe, cultural and spiritual beliefs are at the centre of most mental health explanatory models, perpetuating an environment where mental health conversations are a cultural taboo. Mental health interventions should be accompanied by creative, evidence-based community engagement, ensuring that interventions are suitable for local settings and giving communities a voice in directing their health initiatives. Z Factor aimed to engage young adults and their support networks across a variety of socioeconomic groups in a rural district of Zimbabwe through their participation in an inter-ward five-staged drama competition. The focus was on psychosis, with subcategories of initial presentation/detection, seeking help/pathway to care, and the road to recovery/treatment. Each drama group's composition included a young adult and a typical support network seeking treatment from the service provider of choice. Dramas were to act as discussion starters, paving the way toward broader and deeper psychosis treatment discussions among rural communities and gaining insight into service user expectations from health research. Outcomes of the pilot community engagement project will be instrumental in improving understanding community perceptions about psychosis treatment and recovery in rural Zimbabwe and increasing community awareness about psychosis, as well as paving the way for initiating service provider collaboration to promote early detection and encouraging early health-seeking behaviours. The above outcomes will also inform the design of models for more responsive community and public engagement initiatives in similar low resource settings in Zimbabwe and beyond.
作为一个关键的健康问题，心理健康正逐渐在全球范围内受到重视，但与精神病相关的污名化仍然是一个主要问题。对于解决心理健康误解和污名化的可持续、具有成本效益且可复制的社区参与策略，目前几乎没有深入的探索，而这些误解和污名化是早期寻求医疗行为的主要障碍。在津巴布韦等低收入国家，文化和精神信仰是大多数心理健康解释模型的核心，这使得心理健康对话成为文化禁忌的环境长期存在。心理健康干预应伴随着富有创造性、基于证据的社区参与，确保干预措施适合当地情况，并让社区在指导其健康倡议方面有发言权。Z因素旨在通过参与一场跨病房的五阶段戏剧比赛，让津巴布韦一个农村地区不同社会经济群体的年轻人及其支持网络参与进来。重点是精神病，包括初始表现/检测、寻求帮助/护理途径以及康复/治疗之路等子类别。每个戏剧小组的组成包括一名年轻人和一个向选定服务提供者寻求治疗的典型支持网络。戏剧将作为讨论的起点，为农村社区更广泛、更深入地讨论精神病治疗铺平道路，并深入了解服务使用者对健康研究的期望。试点社区参与项目的成果将有助于增进对津巴布韦农村地区社区对精神病治疗和康复看法的理解，提高社区对精神病的认识，为启动服务提供者合作以促进早期发现和鼓励早期寻求医疗行为铺平道路。上述成果还将为在津巴布韦及其他类似资源匮乏地区设计更具响应性的社区和公众参与倡议模式提供参考。
