Mental health stigma and discrimination in Ethiopia: evidence synthesis to inform stigma reduction interventions.
Mental health stigma and discrimination in Ethiopia: evidence synthesis to inform stigma reduction interventions.
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DOI：
10.1186/s13033-022-00540-z
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发表时间：
2022-06-23
影响因子：
3.6
通讯作者：
Thornicroft, Graham
中科院分区：
文献类型：
--
作者：
Girma, Eshetu;Ketema, Bezawit;Mulatu, Tesfahun;Kohrt, Brandon A.;Wahid, Syed Shabab;Heim, Eva;Gronholm, Petra C.;Hanlon, Charlotte;Thornicroft, Graham
精神疾病患者遭受侵犯人权、羞辱和歧视的风险更大。尽管心理健康污名化和歧视普遍存在，但中低收入国家的负担似乎更重。反污名干预措施需要以当地证据为基础。本文的目的是综合埃塞俄比亚心理健康污名化和歧视的证据，为制定反污名化干预措施提供信息。这一证据综合是作为歧视和污名结果国际研究（靛蓝）伙伴关系研究计划的形成工作的一部分进行的。使用PubMed对科学文章进行电子检索，使用Google搜索和Google Scholar对灰色文献进行检索。选择符合资格标准的记录进行证据合成。研究结果综合使用一个框架，旨在捕捉心理健康的耻辱的特点，告知反耻辱干预的文化适应。证据合成中共纳入37条记录（2篇灰色文献和35篇科学文章）。根据综合报告的主题，其中一些记录被不止一次地描述。这些记录被归纳为以下主题：污名的解释模型（3条关于标签的记录和4条关于症状和原因的记录）、感知和体验的污名形式（7条关于公共污名的记录、6条关于结构性污名的记录、2条关于礼貌污名的记录和4条关于自我污名的记录）、污名对求助的影响（6条记录）和减少污名的干预措施（12条记录）。只有两项干预研究评估了减少耻辱感的情况-一项研究表明，由于获得有效精神保健的机会增加，歧视减少，而另一项研究没有发现基于社区的康复干预与基于设施的护理相结合后歧视减少的证据。埃塞俄比亚普遍存在污名化和歧视现象，导致该国现有精神卫生服务利用不足。这一问题应通过根据具体情况设计的有效减少污名化干预措施加以解决，让利益攸关方（服务使用者、服务提供者、社区代表和服务开发者及决策者）参与，以便在埃塞俄比亚实现联合国精神健康全民医保目标。在线版本包含补充材料，可通过10.1186/s13033-022-00540-z获得。
People with mental illnesses are at an increased risk of experiencing human rights violations, stigma and discrimination. Even though mental health stigma and discrimination are universal, there appears to be a higher burden in low- and middle-income countries. Anti-stigma interventions need to be grounded in local evidence. The aim of this paper was to synthesize evidence on mental health stigma and discrimination in Ethiopia to inform the development of anti-stigma interventions. This evidence synthesis was conducted as a part of formative work for the International Study of Discrimination and Stigma Outcomes (INDIGO) Partnership research program. Electronic searches were conducted using PubMed for scientific articles, and Google Search and Google Scholar were used for grey literature. Records fulfilling eligibility criteria were selected for the evidence synthesis. The findings were synthesized using a framework designed to capture features of mental health stigma to inform cultural adaptation of anti-stigma interventions. A total of 37 records (2 grey literature and 35 scientific articles) were included in the evidence synthesis. Some of these records were described more than once depending on themes of the synthesis. The records were synthesized under the themes of explanatory models of stigma (3 records on labels and 4 records on symptoms and causes), perceived and experienced forms of stigma (7 records on public stigma, 6 records on structural stigma, 2 records on courtesy stigma and 4 records on self-stigma), impact of stigma on help-seeking (6 records) and interventions to reduce stigma (12 records). Only two intervention studies assessed stigma reduction— one study showed reduced discrimination due to improved access to effective mental health care, whereas the other study did not find evidence on reduction of discrimination following a community-based rehabilitation intervention in combination with facility-based care. There is widespread stigma and discrimination in Ethiopia which has contributed to under-utilization of available mental health services in the country. This should be addressed with contextually designed and effective stigma reduction interventions that engage stakeholders (service users, service providers, community representatives and service developers and policy makers) so that the United Nations universal health coverage goal for mental health can be achieved in Ethiopia. The online version contains supplementary material available at 10.1186/s13033-022-00540-z.
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影响因子：
4.4
作者：
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