阿富汗的心理健康与社会心理福祉：对四十年来研究与干预措施的主题综述
Afghan mental health and psychosocial well-being: thematic review of four decades of research and interventions.
作者信息
Alemi Qais, Panter-Brick Catherine, Oriya Spozhmay, Ahmady Mariam, Alimi Abdul Qawi, Faiz Hafizullah, Hakim Nadia, Sami Hashemi Sayed A, Manaly Muhammad Amin, Naseri Roman, Parwiz Khesraw, Sadat Sayed Javid, Sharifi Mohammad Zahid, Shinwari Zalmai, Ahmadi Sayed Jafar, Amin Rohullah, Azimi Sayed, Hewad Atal, Musavi Zeinab, Siddiqi Abdul Majeed, Bragin Martha, Kashino Wataru, Lavdas Michalis, Miller Kenneth E, Missmahl Inge, Omidian Patricia A, Trani Jean-Francois, van der Walt Sarah Kate, Silove Derrick, Ventevogel Peter
机构信息
School of Behavioral Health, Loma Linda University, California, USA.
Jackson Institute for Global Affairs and Department of Anthropology, Yale University, Connecticut, USA.
出版信息
BJPsych Open. 2023 Jul 10;9(4):e125. doi: 10.1192/bjo.2023.502.
BACKGROUND
Four decades of war, political upheaval, economic deprivation and forced displacement have profoundly affected both in-country and refugee Afghan populations.
AIMS
We reviewed literature on mental health and psychosocial well-being, to assess the current evidence and describe mental healthcare systems, including government programmes and community-based interventions.
METHOD
In 2022, we conducted a systematic search in Google Scholar, PTSDpubs, PubMed and PsycINFO, and a hand search of grey literature ( = 214 papers). We identified the main factors driving the epidemiology of mental health problems, culturally salient understandings of psychological distress, coping strategies and help-seeking behaviours, and interventions for mental health and psychosocial support.
RESULTS
Mental health problems and psychological distress show higher risks for women, ethnic minorities, people with disabilities and youth. Issues of suicidality and drug use are emerging problems that are understudied. Afghans use specific vocabulary to convey psychological distress, drawing on culturally relevant concepts of body-mind relationships. Coping strategies are largely embedded in one's faith and family. Over the past two decades, concerted efforts were made to integrate mental health into the nation's healthcare system, train cadres of psychosocial counsellors, and develop community-based psychosocial initiatives with the help of non-governmental organisations. A small but growing body of research is emerging around psychological interventions adapted to Afghan contexts and culture.
CONCLUSIONS
We make four recommendations to promote health equity and sustainable systems of care. Interventions must build cultural relevance, invest in community-based psychosocial support and evidence-based psychological interventions, maintain core mental health services at logical points of access and foster integrated systems of care.
背景
四十年的战争、政治动荡、经济贫困和被迫流离失所对阿富汗国内人口和难民都产生了深远影响。
目的
我们回顾了关于心理健康和社会心理福祉的文献，以评估当前证据并描述精神卫生保健系统，包括政府项目和基于社区的干预措施。
方法
2022年，我们在谷歌学术、创伤后应激障碍文献数据库、PubMed和PsycINFO中进行了系统检索，并手工检索了灰色文献（共214篇论文）。我们确定了推动心理健康问题流行病学的主要因素、对心理困扰的文化显著理解、应对策略和求助行为，以及心理健康和社会心理支持的干预措施。
结果
心理健康问题和心理困扰在女性、少数民族、残疾人和青年中显示出更高的风险。自杀和药物使用问题是正在出现但研究不足的问题。阿富汗人使用特定词汇来表达心理困扰，借鉴了与身心关系相关的文化概念。应对策略很大程度上植根于个人的信仰和家庭。在过去二十年中，人们齐心协力将心理健康纳入国家医疗保健系统，培训社会心理辅导员干部，并在非政府组织的帮助下开展基于社区的社会心理倡议。围绕适应阿富汗背景和文化的心理干预措施，正在出现少量但不断增加的研究。
结论
我们提出四项建议以促进健康公平和可持续的护理系统。干预措施必须建立文化相关性，投资于基于社区的社会心理支持和循证心理干预，在合理的接入点维持核心心理健康服务，并促进综合护理系统。
Zotero 插件