Aftab Awais, Collings Shira, Jones Nev
Department of Psychiatry, Case Western Reserve University, Cleveland (Aftab); private practice, Philadelphia (Collings); School of Social Work, University of Pittsburgh, Pittsburgh (Jones).
Psychiatr Serv. 2023 Feb 1;74(2):112-118. doi: 10.1176/appi.ps.20220078. Epub 2022 Jul 14.
In this article, the authors used data from a national survey of mental health activists and advocates (MHAAs) with lived experience of psychiatric disabilities to investigate attitudes toward psychiatric care.
The authors distributed a survey, developed by a team led by researchers who were also service users, to both mainstream and more critical advocacy groups and networks (N=547 participants), and they analyzed the data by using latent class analysis (LCA). Four survey variables regarding beliefs about involuntary hospitalization, assisted outpatient treatment, medication, and diagnosis were used to generate latent subgroups. The authors explored associations between key survey variables and latent classes with chi-square tests and analysis of variance.
LCA indicated an optimal six-class solution. The classes existed on a spectrum of positions, ranging from highly favorable views of traditional psychiatric practices to highly critical views, with classes in the middle representing distinct profiles of attitudes toward treatment and diagnosis. Significant between-group differences were found for participants' psychiatric treatment histories, motivations to engage in activism and advocacy, and views about mental health care and advocacy priorities.
Findings reveal considerable heterogeneity among MHAAs and challenge binary narratives of mental health advocacy.
在本文中，作者使用了一项针对有精神疾病生活经历的心理健康活动家及倡导者（MHAAs）的全国性调查数据，以调查他们对精神科护理的态度。
作者向主流及更具批判性的倡导团体和网络（N = 547名参与者）分发了一份由研究人员团队（其中也包括服务使用者）编制的调查问卷，并使用潜在类别分析（LCA）对数据进行分析。使用四个关于非自愿住院、辅助门诊治疗、药物治疗和诊断信念的调查变量来生成潜在亚组。作者通过卡方检验和方差分析探索关键调查变量与潜在类别的关联。
潜在类别分析表明最优的六类别解决方案。这些类别存在于一系列立场上，从对传统精神科实践的高度赞同观点到高度批判观点，中间的类别代表了对治疗和诊断的不同态度。在参与者的精神科治疗史、参与维权行动的动机以及对精神卫生保健和维权优先事项的看法方面，发现了显著的组间差异。
研究结果揭示了MHAAs之间存在相当大的异质性，并挑战了精神卫生维权的二元叙事。
