有效干预措施减少与心理健康相关的耻辱和歧视的证据
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
概括
有效的干预措施减少精神疾病的耻辱感, 然而,低收入国家的长期影响和研究仍然有限, 需要进行更强大的研究.
科学领域:
- 心理健康研究
- 公共卫生干预措施
- 社会心理学
背景情况:
- 心理疾病的耻辱和歧视带来严重的后果,
- 现有研究主要描述了人们对精神疾病的态度,而不是关注有效的耻辱化措施.
- 需要对应精神疾病污名的干预措施进行全球概述, 以指导未来的研究和政策.
研究的目的:
- 系统地审查和总结有关有效干预措施的全球证据,以减少与精神疾病相关的耻辱和歧视.
- 确定不同干预类型和目标人群的有效性模式.
- 突出目前研究的差距,包括方法上的局限性和代表性不足的地区.
主要方法:
- 一个叙述性综述,综合了已发表的系统综述和关于反耻辱干预的初级数据.
- 分析与态度变化,知识改善和行为变化相关的干预结果.
- 评估研究设计,样本大小,目标群体和地理位置.
主要成果:
- 人口层面的干预显示出持续的短期积极态度变化,有证据表明知识有所改善.
- 对于患有精神疾病的个人来说,群体层面的干预是有前途的,需要进一步评估.
- 基于社交接触的干预措施在学生等特定群体中产生短期的态度改善,但长期的好处和知识获取不那么明显.
- 研究的特点是异质性,有限的强大研究设计,以及来自低收入和中等收入国家的研究显著缺失.
- 很少有研究涉及到服务用户的观点或行为变化方面的耻辱.
结论:
- 社交接触干预措施对心理疾病耻辱的短期态度和知识改善是有效的,但它们的长期有效性得到了微弱的支持.
- 方法论的严谨性,长期的跟进和来自全球不同背景的研究对于该领域的发展至关重要.
- 为了制定和实施有效的,基于证据的应对心理健康污名和歧视的战略,需要对方法上健全的研究进行大量投资.
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