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建立文化能力导向的心理健康服务证据:一项混合方法研究方案。

Establishing evidence to inform culturally competent mental health services: A mixed methods study protocol.

机构信息

Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom.

NIHR Applied Research Collaborative North East and North Cumbria, Cumbria, Northumberland and Tyne and Wear NHS Foundation Trust, Gosforth, Newcastle upon Tyne, United Kingdom.

出版信息

PLoS One. 2023 Mar 14;18(3):e0282445. doi: 10.1371/journal.pone.0282445. eCollection 2023.

Abstract

BACKGROUND

COVID-19 has exacerbated the significant and longstanding mental health inequalities for ethnic minorities, who were less likely to access mental health support in primary care but more likely to end up in crisis care compared to the majority ethnic group. Services were poorly offered and accessed to respond to the increased mental health challenges.

AIM

To 1) establish evidence on which changes to mental health services provided in response to COVID-19 are beneficial for ethnic minorities who experience mental health difficulties in the North of England, and 2) to inform what and how culturally competent mental health services should be routinely provided.

METHODS

A mixed methods approach comprising 1) a rapid review to map services and models of care designed or adjusted for mental health during the pandemic, 2) an observational study of retrospective routine data to assess changes to mental health services and associated outcomes, 3) qualitative interviews to understand experiences of seeking care and factors associated with high-quality service provision, and 4) a Delphi study to establish consensus on key features of culturally competent services. From the selected areas in the North of England, adults from ethnic minorities who experience mental health difficulties will be identified from the primary, community and secondary care services and local ethnic minority communities.

DISCUSSION

This study will identify ways to tackle health inequalities and contribute to mental health service recovery post pandemic by providing practice recommendations on equitable and effective services to ensure culturally competent and high-quality care. A list of services and features on what and how mental health services will be provided. Working with study collaborators and public and patient involvement partners, the study findings will be widely disseminated through presentations, conferences and publications and will inform the subsequent funding application for intervention development and evaluation.

摘要

背景

COVID-19 加剧了少数民族的严重且长期存在的心理健康不平等现象,与多数族裔相比,少数民族在初级保健中获得心理健康支持的可能性较小,但最终更有可能进入危机护理。服务提供和获取情况不佳,无法应对日益增加的心理健康挑战。

目的

1)确定针对在英格兰北部经历心理健康困难的少数民族提供的心理健康服务的哪些变化是有益的,以及 2)了解如何常规提供文化上胜任的心理健康服务。

方法

采用混合方法,包括 1)快速审查以绘制在大流行期间为心理健康设计或调整的服务和护理模式,2)对回顾性常规数据进行观察性研究,以评估心理健康服务的变化及其相关结果,3)定性访谈以了解寻求护理的经验以及与高质量服务提供相关的因素,以及 4)德尔菲研究以确定文化上胜任的服务的关键特征达成共识。从英格兰北部选定的地区,将从初级、社区和二级保健服务以及当地少数民族社区中确定经历心理健康困难的少数民族成年人。

讨论

这项研究将通过提供关于公平和有效的服务的实践建议来确定解决健康不平等问题和为大流行后心理健康服务恢复做出贡献的方法,以确保提供文化上胜任和高质量的护理。服务列表以及有关如何提供心理健康服务的信息。与研究合作者以及公众和患者参与伙伴合作,将通过演讲、会议和出版物广泛传播研究结果,并为随后的干预措施开发和评估申请提供信息。

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