Clinical ethnography in severe mental illness: a clinical method to tackle social determinants and structural racism in personalised care.
Clinical ethnography in severe mental illness: a clinical method to tackle social determinants and structural racism in personalised care.
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DOI：
10.1192/bjo.2021.38
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发表时间：
2021-04-12
期刊：
影响因子：
5.4
通讯作者：
Pope C
中科院分区：
文献类型：
--
作者：
Bhui K;Dein S;Pope C
在严重精神疾病的经历和结果方面，种族不平等是众所周知的。其中包括严重精神疾病（精神病）的发病率较高、进入和通过护理的不利途径，包括危机护理、警察和刑事司法系统的参与以及《精神卫生法》权力下的护理。尽管人们已经意识到这一情况，但这种情况仍然持续存在，其原因是健康状况不佳、社会劣势和结构性种族主义等社会决定因素，以及与护理系统的相互冲突，而护理系统本身的配置方式就维持或加深了这些不平等。尽管经常提出培训和教育，但这并没有显示出持续的效果。临床流程（访谈/评估/制定/干预）需要解决系统性影响并提高提供、组织和委托护理的文化精确度。我们讨论临床人种学，并提供其在满足不同社区的系统和个人护理需求方面的价值的证据。
Ethnic inequalities in the experiences and outcomes of severe mental illness are well established. These include a higher incidence of severe mental illnesses (psychoses), adverse pathways into and through care, including crisis care, police and criminal justice systems involvement, and care under the powers of the Mental Health Act. The situation persists despite awareness and is driven by a mixture of the social determinants of poor health, societal disadvantage and structural racism, as well as conflictual interactions with care systems, which themselves are configured in ways that sustain or deepen these inequalities. Although training and education are often proposed, this is not shown to have sustained effects. Clinical processes (interviewing/assessment/formulation/intervention) need to address systemic influences and improve the cultural precision with which care is delivered, organised and commissioned. We discuss clinical ethnography and present evidence of its value in addressing systemic as well as individual care needs for diverse communities.
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DOI：
10.1192/bjp.bp.114.158899
发表时间：
2015-08
期刊：
The British journal of psychiatry : the journal of mental science
影响因子：
--
作者：
Bhui KS;Aslam RW;Palinski A;McCabe R;Johnson MR;Weich S;Singh SP;Knapp M;Ardino V;Szczepura A
通讯作者：
Szczepura A
影响因子：
2.3
作者：
Onoma, Ato Kwamena
通讯作者：
Onoma, Ato Kwamena
影响因子：
3.8
作者：
Grote, Nancy K.;Swartz, Holly A.;Frank, Ellen
通讯作者：
Frank, Ellen
影响因子：
2.8
作者：
Bhui, Kamaldeep S.;Owiti, John A.;Ajaz, Ali
通讯作者：
Ajaz, Ali
影响因子：
3.1
作者：
Aggarwal, Neil K.;Desilva, Ravi;Lewis-Fernandez, Roberto
通讯作者：
Lewis-Fernandez, Roberto