Petrus Chiara Francine, Mohd Salleh Sahimi Hajar, Midin Marhani, Lim Jane Tze Yn
Department of Psychiatry, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia.
Department of Psychiatry, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Front Psychiatry. 2023 Oct 23;14:1243015. doi: 10.3389/fpsyt.2023.1243015. eCollection 2023.
Mental health stigma (MHS) has been a pervasive social issue and a significant barrier to treatment seeking behavior. The treatment pathways and outcomes for people with mental illness, specifically those with recurrent suicidal ideations and attempts have been influenced by how MHS was experienced in clinical practice.
We reported a case of a young lady diagnosed with bipolar II disorder, obsessive-compulsive disorder and borderline personality disorder who had recurrent visits to various emergency departments (ED) of tertiary hospitals in Malaysia for suicidality; each time presenting with increased mortality risk and escalating near-lethal outcomes. Among the multiple ED visits after her alleged overdoses of psychotropic medications, thrice she was near-unconscious and had to be intubated for airway protection, subsequently requiring ventilatory support and ICU care. These near-lethal presentations in ED were due to her delays in seeking treatment for fear of re-experiencing the stigmatizing environment among healthcare staff and professionals in the ED.
The impact of MHS is detrimental. Effective interventions at various levels in the clinical setting is of utmost importance to prevent the negative consequences of suicidality against MHS.
心理健康污名化(MHS)一直是一个普遍存在的社会问题,也是寻求治疗行为的重大障碍。精神疾病患者,特别是那些有反复自杀意念和自杀企图的患者的治疗途径和结果,受到临床实践中MHS体验方式的影响。
我们报告了一例年轻女性病例,她被诊断为双相II型障碍、强迫症和边缘性人格障碍,因自杀倾向多次前往马来西亚三级医院的急诊科就诊;每次就诊时死亡风险增加,近乎致命的后果不断升级。在她据称过量服用精神药物后的多次急诊科就诊中,有三次她几乎失去意识,不得不插管以保护气道,随后需要通气支持和重症监护病房护理。急诊科这些近乎致命的情况是由于她因担心在急诊科医护人员和专业人员中再次经历污名化环境而延迟寻求治疗。
MHS的影响是有害的。在临床环境的各个层面进行有效干预对于预防自杀倾向对MHS的负面后果至关重要。