Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, SE5 8AF, UK.
Department of Inflammation Biology, Centre for Rheumatic Diseases, School of Immunology and Microbial Sciences, King's College London, Weston Education, 10, Cutcombe Rd, London, SE5 9RJ, UK.
Soc Psychiatry Psychiatr Epidemiol. 2023 Nov;58(11):1687-1697. doi: 10.1007/s00127-023-02492-2. Epub 2023 May 27.
Building partnerships between mental health services and Black faith communities to co-produce culturally tailored interventions is an essential step towards improving access to services and reducing stigma among the Black population. Given that Black faith organisations are considered a primary source of emotional and psychological support they are well positioned as 'gatekeepers' for services, to overcome barriers to engagement and build trusting relationships with the Black community. The aim of this paper is to pilot a manualised mental health awareness and stigma reduction intervention for Black faith communities in the UK, and to make an initial assessment of feasibility, acceptability and outcomes.
This study employed a mixed methods pre-post-design, based upon the Medical Research Council Framework (MRC) for complex interventions, and the Implementation Science Research Development.
The qualitative assessments indicate that the intervention was found overall to be acceptable and feasible to the Black faith community population. This pilot study did not find statistically significant changes for the Mental Health Knowledge schedule (MAKS), Reported and Intended Behaviour Scale (RIBS), intended help-seeking or willingness to disclose (Attitudes to Mental Illness Survey) measures. However, the direction of all the non-significant changes in these measures suggests positive changes in mental health knowledge, a reduction in participants' desire for social distance, and greater willingness to disclose personal experiences of mental health problems. A statistically significant improvement in the Community Attitudes towards Mental Illness (CAMI) scale results indicated a lower level of stigmatising attitudes towards people with lived experience of mental health conditions (PWLE), and an increase in tolerance and support towards PWLE after the intervention. Significant improvement in the willingness to disclose measure suggests increased preparedness to seek help amongst participants, a lesser desire for social distance, and greater willingness to engage with PWLE after the intervention. Three key themes, including 9 subthemes were identified from the qualitative data analysis: (i) initial implementation and intention to adopt; (ii) perceived suitability and usefulness of intervention to address cultural issues relating to mental health in the Black community; and (iii) strengthening the capacity of faith leaders.
This ON TRAC pilot study shows that the intervention was feasible and acceptable, and that it has promising positive impacts and next requires larger scale evaluation. These results demonstrate that the intervention was a culturally acceptable way to potentially increase mental health awareness and reduce stigma in Black faith communities.
ISRCTN12253092.
在心理健康服务机构和黑人信仰社区之间建立伙伴关系,共同制定文化上合适的干预措施,是改善服务获取途径和减少黑人社区污名化的重要步骤。鉴于黑人信仰组织被认为是情感和心理支持的主要来源,他们作为服务的“把关人”,有能力克服参与障碍,与黑人社区建立信任关系。本文旨在为英国的黑人信仰社区试点一个针对心理健康意识和减少污名的手册化干预措施,并对可行性、可接受性和结果进行初步评估。
本研究采用基于医疗研究委员会框架(MRC)的复杂干预措施和实施科学研究发展的混合方法前后设计。
定性评估表明,该干预措施总体上被黑人信仰社区所接受和可行。这项试点研究没有发现心理健康知识量表(MAKS)、报告和意向行为量表(RIBS)、意向寻求帮助或愿意透露(精神疾病态度调查)测量的统计学显著变化。然而,所有这些非显著变化的措施表明,在心理健康知识方面有积极的变化,参与者对社会距离的渴望减少,以及更愿意透露个人心理健康问题的经历。社区对精神疾病态度量表(CAMI)结果的统计学显著改善表明,对有精神健康问题经历的人的污名化态度较低,并且在干预后对 PWLE 的容忍度和支持度增加。愿意透露测量的显著改善表明,参与者寻求帮助的准备程度提高,对社会距离的渴望减少,以及在干预后更愿意与 PWLE 接触。从定性数据分析中确定了三个关键主题,包括 9 个子主题:(i)初始实施和采用意向;(ii)干预措施对解决黑人社区与心理健康相关的文化问题的适宜性和有用性的看法;以及(iii)加强信仰领袖的能力。
这项 ON TRAC 试点研究表明,该干预措施是可行和可接受的,并且具有有希望的积极影响,下一步需要进行更大规模的评估。这些结果表明,该干预措施是一种文化上可接受的方式,可以潜在地提高黑人信仰社区的心理健康意识,减少污名化。
ISRCTN87136163。