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了解埃塞俄比亚的心理健康污名与歧视:一项定性研究。

Understanding mental health stigma and discrimination in Ethiopia: A qualitative study.

作者信息

Girma Eshetu, Ayele Bethel, Gronholm Petra C, Wahid Syed Shabab, Hailemariam Ariam, Thornicroft Graham, Hanlon Charlotte, Kohrt Brandon

机构信息

Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.

Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychology, Psychiatry & Neuroscience, King's College London, London, UK.

出版信息

Glob Ment Health (Camb). 2024 Apr 30;11:e58. doi: 10.1017/gmh.2024.55. eCollection 2024.

Abstract

BACKGROUND

Stigma is significantly impacted by cultural and contextual value systems. People with mental health conditions frequently have to deal with the condition itself and the associated stigma and discrimination. Contextual understanding is essential to design measures and interventions.

OBJECTIVE

This study aimed to explore the experiences and perceptions of people with mental health conditions, their families and key stakeholders.

METHOD

A qualitative method used to understand mental health-related stigma and its local contexts. Sixteen participants, including service users, caregivers, service providers and health service administrators, were interviewed.

RESULT

People with mental health conditions and their caregivers experienced various forms of stigmatization which is linked to attributions about the causality of the illness, overt manifestations of mental health condition leading to easy identification and functional impairments that adversely affect participation. Social contact, lived experiences sharing and training of service providers are relevant intervention strategy to address stigma.

IMPLICATION

Stigma and exclusion are prominent in the experiences of people with mental health conditions and their caregivers in this rural Ethiopian setting. Measurement of stigma and the development of interventions should consider how stigma is socially constructed. Anti-stigma interventions need to be implemented alongside expanded local access to mental healthcare.

摘要

背景

耻辱感受到文化和情境价值体系的显著影响。患有精神疾病的人经常要应对疾病本身以及相关的耻辱感和歧视。情境理解对于设计措施和干预手段至关重要。

目的

本研究旨在探索患有精神疾病的人、他们的家人以及关键利益相关者的经历和看法。

方法

采用定性方法来了解与心理健康相关的耻辱感及其当地情境。对16名参与者进行了访谈,包括服务使用者、照顾者、服务提供者和卫生服务管理人员。

结果

患有精神疾病的人及其照顾者经历了各种形式的耻辱化,这与对疾病因果关系的归因、精神健康状况的明显表现导致易于识别以及对参与产生不利影响的功能障碍有关。社会接触、分享生活经历以及对服务提供者的培训是解决耻辱感的相关干预策略。

启示

在这个埃塞俄比亚农村地区,耻辱感和排斥在患有精神疾病的人及其照顾者的经历中很突出。耻辱感的衡量和干预措施的制定应考虑耻辱感是如何在社会中构建的。反耻辱干预措施需要与扩大当地获得精神卫生保健的机会同时实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9199/11362999/f3cc15ab5299/S2054425124000554_fig1.jpg

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