Kotera Yasuhiro, Rennick-Egglestone Stefan, Ng Fiona, Llewellyn-Beardsley Joy, Ali Yasmin, Newby Chris, Fox Caroline, Slade Emily, Bradstreet Simon, Harrison Julian, Franklin Donna, Todowede Olamide, Slade Mike
School of Health Sciences, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom.
School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, United Kingdom.
JMIR Ment Health. 2023 Apr 17;10:e44601. doi: 10.2196/44601.
Demand for digital health interventions is increasing in many countries. The use of recorded mental health recovery narratives in digital health interventions is becoming more widespread in clinical practice. Mental health recovery narratives are first-person lived experience accounts of recovery from mental health problems, including struggles and successes over time. Helpful impacts of recorded mental health recovery narratives include connectedness with the narrative and validation of experiences. Possible harms include feeling disconnected and excluded from others. Diverse narrative collections from many types of narrators and describing multiple ways to recover are important to maximize the opportunity for service users to benefit through connection and to minimize the likelihood of harm. Mental health clinicians need to know whether narrative collections are sufficiently diverse to recommend to service users. However, no method exists for assessing the diversity and inclusivity of existing or new narrative collections. We argue that assessing diversity and inclusivity is the next frontier in mental health recovery narrative research and practice. This is important, but methodologically and ethically complex. In this viewpoint, we propose and evaluate one diversity and two inclusivity assessment methods. The diversity assessment method involves use of the Simpson Diversity Index. The two inclusivity assessment methods are based on comparator demographic rates and arbitrary thresholds, respectively. These methods were applied to four narrative collections as a case study. Refinements are needed regarding a narrative assessment tool in terms of its practicality and cultural adaptation.
在许多国家，对数字健康干预措施的需求正在增加。在临床实践中，数字健康干预措施中使用记录的心理健康康复叙述正变得越来越普遍。心理健康康复叙述是关于从心理健康问题中康复的第一人称生活经历描述，包括随着时间推移的挣扎与成功。记录的心理健康康复叙述的有益影响包括与叙述产生联系以及对经历的认可。可能的危害包括感觉与他人脱节和被他人排斥。来自多种叙述者的多样化叙述集以及描述多种康复方式，对于最大限度地增加服务使用者通过联系受益的机会以及最小化伤害发生的可能性非常重要。心理健康临床医生需要知道叙述集是否足够多样化，以便推荐给服务使用者。然而，目前不存在评估现有或新的叙述集的多样性和包容性的方法。我们认为，评估多样性和包容性是心理健康康复叙述研究与实践的下一个前沿领域。这很重要，但在方法和伦理上都很复杂。在这一观点中，我们提出并评估了一种多样性评估方法和两种包容性评估方法。多样性评估方法涉及使用辛普森多样性指数。两种包容性评估方法分别基于比较人口统计率和任意阈值。这些方法作为案例研究应用于四个叙述集。在叙述评估工具的实用性和文化适应性方面还需要改进。
