メンタルヘルスに関連する汚名と差別を減らすための効果的な介入の証拠
Graham Thornicroft1, Nisha Mehta2, Sarah Clement2
1Centre for Global Mental Health, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
Lancet (London, England)
|September 28, 2015
まとめ
精神疾患の汚名を減らすための効果的な介入は 短期的な利益をもたらします 特に社会的接触です しかし,低所得国における長期的な影響と研究は依然として限られており,より強力な研究が必要である.
科学分野:
- メンタルヘルスの研究
- 公衆衛生の介入
- 社会心理学
背景:
- 精神疾患の汚名と差別は 深刻な結果をもたらし しばしば 精神疾患そのものを上回ります
- 現存する研究では 精神疾患に対する態度が 主に記述されていて 効果的な汚名を減らす介入に 焦点を当てていません
- 精神疾患の汚名と闘うための介入のグローバルな概要は,将来の研究と政策を導くために必要です.
研究 の 目的:
- 精神疾患に関連する汚名と差別を減らすための効果的な介入に関する世界的な証拠を体系的に検討し,要約する.
- 異なる介入タイプとターゲット集団における有効性のパターンを特定する.
- 方法論的な限界や代表が不足している地域を含む現在の研究におけるギャップを強調する.
主な方法:
- 出版された系統的レビューと反汚名介入の原始データから得られた結果を統合した記述的レビューです.
- 態度の変化,知識の改善,行動の変化に関連する介入結果の分析.
- 研究デザイン,サンプルサイズ,ターゲットグループ,地理的分布の評価
主要な成果:
- 人口レベルでの介入は,短期的なポジティブな態度の変化を一貫して示し,知識の改善の証拠もあります.
- 集団レベルでの介入は 精神疾患の患者にとって有望であり,さらなる評価が必要である.
- 社会的接触に基づく介入は 学生などの特定のグループにおいて短期的な態度改善をもたらしますが 長期的な利益と知識の獲得はそれほど顕著ではありません
- 研究は異質性,限られた堅固な研究デザイン,低所得国および中所得国の研究が顕著に欠けていることが特徴です.
- サービス利用者の視点や ステグマの行動変化の側面を扱う研究はほとんどありません
結論:
- 社会的接触の介入は,精神疾患の汚名に関する短期的な態度と知識の改善に有効ですが,その長期的な有効性は弱く支持されています.
- 方法論的厳密さ,長期のフォローアップ,そして多様なグローバルな文脈からの研究は,この分野を前進させるために不可欠です.
- メンタルヘルスの汚名と差別と闘うために有効な証拠に基づいた戦略を開発し,実施するためには,方法論的に健全な研究に相当な投資が必要である.
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