Shifrer Dara, Pappas Fly Suzy, Springer Rachel, Dinh Xuan
Portland State University, Department of Sociology, 1721 SW Broadway Ave, Portland OR, 97201, USA.
Portland State University, Department of Psychology, 1825 SW Broadway Ave, Portland OR, 97201, USA.
SSM Qual Res Health. 2024 Dec;6. doi: 10.1016/j.ssmqr.2024.100503. Epub 2024 Nov 13.
The mental health of children, and especially adolescents, has been a global public health priority for decades. School-based health centers (SBHCs) are health clinics established in close proximity to elementary and secondary schools for the purpose of increasing access to medical, and particularly mental health services, for children and adolescents. Yet, like other health clinics, SBHCs struggle to overcome structural and interpersonal stigma related to mental health conditions and support. Then, the pandemic threatened the sustainability and efficacy of SBHCs just as youth's mental health needs skyrocketed. We use Stangl et al.'s (2019)framework for health-related stigma to analyze data from 36 interviews with SBHC Coordinators in Oregon and their Educator Partners to investigate: 1) What implications does mental health-related stigma have for SBHCs' delivery of mental health services to children and adolescents? 2) How did these factors change during the pandemic? Consistent with Stangl et al.'s (2019) framework for health-related stigma, mental-health-related stigma is evident in this study in terms of the secondary stigma youth are reported to experience from peers and families in terms of visiting a SBHC for mental health services, as well as in limitations in the quantity and quality of resources dedicated to providing mental health services. The pandemic had contradictory effects, both increasing and reducing stigma along two axes: cultural perceptions of mental health problems and telehealth.
几十年来，儿童尤其是青少年的心理健康一直是全球公共卫生的重点。学校健康中心（SBHCs）是在中小学附近设立的健康诊所，目的是增加儿童和青少年获得医疗服务，特别是心理健康服务的机会。然而，与其他健康诊所一样，SBHCs也在努力克服与心理健康状况及支持相关的结构性和人际耻辱感。然后，就在青少年心理健康需求激增之际，疫情威胁到了SBHCs的可持续性和有效性。我们使用斯坦格尔等人（2019年）的与健康相关耻辱感框架，分析了对俄勒冈州SBHC协调员及其教育伙伴进行的36次访谈数据，以调查：1）与心理健康相关的耻辱感对SBHCs为儿童和青少年提供心理健康服务有何影响？2） 在疫情期间这些因素发生了怎样的变化？与斯坦格尔等人（2019年）的与健康相关耻辱感框架一致，本研究中与心理健康相关的耻辱感体现在，据报道青少年在因心理健康服务前往SBHC时会受到同龄人和家人的继发性耻辱感，以及在用于提供心理健康服务的资源数量和质量方面的限制。疫情产生了矛盾的影响，在文化对心理健康问题的认知和远程医疗这两个轴线上，耻辱感既有增加也有减少。
