The psychological toll of slum living in Mumbai, India: a mixed methods study.
The psychological toll of slum living in Mumbai, India: a mixed methods study.
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DOI：
10.1016/j.socscimed.2014.08.021
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发表时间：
2014-10
影响因子：
5.4
通讯作者：
Patil-Deshmukh, Anita
中科院分区：
文献类型：
--
作者：
Subbaraman, Ramnath;Nolan, Laura;Shitole, Tejal;Sawant, Kiran;Shitole, Shrutika;Sood, Kunal;Nanarkar, Mahesh;Ghannam, Jess;Betancourt, Theresa S.;Bloom, David E.;Patil-Deshmukh, Anita
在印度，“未通知”的贫民窟没有得到市政府的正式承认;与“通知”（政府承认）的贫民窟相比，这些贫民窟的保有权没有保障，获得基本服务的机会也更少。我们在孟买一个约12,000人的未通知贫民窟进行了一项研究，以确定患有常见精神障碍（即，抑郁症和焦虑症），以确定心理健康对功能障碍负担的影响，并评估贫民窟环境对心理健康的影响。我们收集了定性数据（2011年7月至11月的6次焦点小组讨论和40次个人访谈），有目的地抽样参与者，以及定量数据（2012年2月的521次结构化调查），使用社区水平随机抽样选择受访者。对于这些调查，我们使用一般健康问卷-12（GHQ）来筛查常见精神障碍（CMD），使用WHO残疾评估量表2.0（WHO DAS）来筛查功能障碍，以及贫民窟逆境问卷，我们使用该问卷来创建复合贫民窟逆境指数（SAI）评分。23%的人GHQ评分≥5，表明他们患有CMD的风险很高。心理困扰是贫民窟功能障碍总体负担的主要原因。在多变量逻辑回归模型中，家庭收入、贫困相关因素和SAI评分都与CMD风险有很强的独立关联。定性研究结果表明，非通知状态在创造心理困扰中发挥着核心作用，通过创造和加剧作为压力来源的剥夺，通过将贫民窟居民与政府的内在对立关系，通过刑事定罪的基本需求，并通过塑造一个社区的身份建立在一种社会排斥的感觉，从城市的其他部分。
In India, “non-notified” slums are not officially recognized by city governments; they suffer from insecure tenure and poorer access to basic services than “notified” (government-recognized) slums. We conducted a study in a non-notified slum of about 12,000 people in Mumbai to determine the prevalence of individuals at high risk for having a common mental disorder (i.e., depression and anxiety), to ascertain the impact of mental health on the burden of functional impairment, and to assess the influence of the slum environment on mental health. We gathered qualitative data (six focus group discussions and 40 individual interviews in July-November 2011), with purposively sampled participants, and quantitative data (521 structured surveys in February 2012), with respondents selected using community-level random sampling. For the surveys, we administered the General Health Questionnaire-12 (GHQ) to screen for common mental disorders (CMDs), the WHO Disability Assessment Schedule 2.0 (WHO DAS) to screen for functional impairment, and a slum adversity questionnaire, which we used to create a composite Slum Adversity Index (SAI) score. Twenty-three percent of individuals have a GHQ score ≥5, suggesting they are at high risk for having a CMD. Psychological distress is a major contributor to the slum’s overall burden of functional impairment. In a multivariable logistic regression model, household income, poverty-related factors, and the SAI score all have strong independent associations with CMD risk. The qualitative findings suggest that non-notified status plays a central role in creating psychological distress—by creating and exacerbating deprivations that serve as sources of stress, by placing slum residents in an inherently antagonistic relationship with the government through the criminalization of basic needs, and by shaping a community identity built on a feeling of social exclusion from the rest of the city.
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影响因子：
3.7
作者：
KISH, L
通讯作者：
KISH, L
影响因子：
3.7
作者：
Appadurai, A
通讯作者：
Appadurai, A
影响因子：
6.9
作者：
Patel, V.;Araya, R.;Weiss, H. A.
通讯作者：
Weiss, H. A.
影响因子：
3.7
作者：
Poongothai, Subramani;Pradeepa, Rajendra;Mohan, Viswanathan
通讯作者：
Mohan, Viswanathan
影响因子：
5.4
作者：
Das, Jishnu;Do, Quy-Toan;Scott, Kinnon
通讯作者：
Scott, Kinnon