Doctors accessing mental-health services: an exploratory study
Doctors accessing mental-health services: an exploratory study
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DOI：
10.1136/bmjopen-2010-000017
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发表时间：
2011-01-01
期刊：
影响因子：
2.9
通讯作者：
Randal, Patte
中科院分区：
文献类型：
--
作者：
Stanton, Josephine;Randal, Patte
目的：从医生自身和在此过程中接触的人的角度，更深入地了解医生是如何获得和不获得精神卫生保健的。设计：采用定性方法，采用扎根理论对半结构化访谈进行记录和分析。参与者是11名有精神科病人经验的医生，4名医生和4名非医生个人联系人（朋友、家人和同事），以及8名治疗精神科医生。结果：参与者描述了不现实的期望和恶劣的工作环境，自我照顾能力差，否认和最小化心理健康问题的迹象。与医生接触的人说，在对需要心理保健的医生朋友、家人和同事作出有效回应方面特别困难。相比之下，非医生的个人接触更能够识别和谈论担忧，但不一定能够获得适当的心理健康服务。结论：在支持医生获得适当的医疗保健方面，已经确定了三个有潜力解决的领域：(1)使医生能够在减少最小化和拒绝使用的情况下保持高标准的工作流程；(2)提高医师之间关于心理健康问题的非正式对话的质量和效果；(3)非医生支持人员在识别医生心理健康需求并使其获得心理健康服务中的作用。所有这些领域的进一步研究都有可能有助于改善医生获得适当精神保健的机会，并可能对一般人群有价值。
Objective: To develop a more in-depth understanding of how doctors do and do not access mental healthcare from the perspectives of doctors themselves and people they have contact with through the process.Design: Qualitative methodology was used with semistructured interviews transcribed and analysed using Grounded Theory. Participants were 11 doctors with experience as patients of psychiatrists, four doctor and four non-doctor personal contacts (friends, family and colleagues) and eight treating psychiatrists.Results: Participants described experiencing unrealistic expectations and a harsh work environment with poor self care and denial and minimisation of signs of mental health difficulties. Doctor contacts described particular difficulty in responding effectively to doctor friends, family and colleagues in need of mental healthcare. In contrast, non-doctor personal contacts were more able to identify and speak about concerns but not necessarily to enable accessing adequate mental-health services.Conclusions: Three areas with potential to address in supporting doctors' accessing of appropriate healthcare have been identified: (1) processes to enable doctors to maintain high standards of functioning with less use of minimisation and denial; (2) improving the quality and effectiveness of informal doctor-to-doctor conversations about mental-health issues among themselves; (3) role of non-doctor support people in identifying doctors' mental-health needs and enabling their access to mental healthcare. Further research in all these areas has the potential to contribute to improving doctors' access to appropriate mental healthcare and may be of value for the general population.