Stakeholder perspectives of Community Mental Health Forums: a qualitative study in Sierra Leone
Stakeholder perspectives of Community Mental Health Forums: a qualitative study in Sierra Leone
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DOI：
10.1186/s13033-020-00382-7
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发表时间：
2020-07-10
影响因子：
3.6
通讯作者：
Eaton, Julian
中科院分区：
文献类型：
--
作者：
Adams, Ben;Vallieres, Frederique;Eaton, Julian
背景精神健康是世界范围内残疾的主要原因。在内战和埃博拉疫情爆发后，塞拉利昂在人类发展指数中排名最低（开发署）。《2015年人类发展报告》，致力于人类发展。联合国开发计划署，2015年）。世卫组织将塞拉利昂确定为试点精神卫生差距行动方案的优先国家之一。为了配合这些努力，CBM及其附属伙伴利用社区心理健康论坛，由心理健康护士提供便利，作为一种敏感和实用的方式，让主要社区利益攸关方参与讨论和解决心理健康问题。这项研究首先试图确定方案参与者所确定的影响成功实施CMHF的因素。第二，该研究旨在确定参与者认为发生了什么变化，由于他们参与CMHFs.Methods10 MHN和52论坛参与者特意选择参加关键线人访谈和焦点小组讨论，在塞拉利昂的8个地区进行。采访成绩单进行了分析，在四个回合的编码，使用演绎和归纳的混合approaches.ResultsResults确定了三个主题，传统信仰和文化;卫生系统;和包容性的方法，影响实施CMHF在他们的地区。参与者进一步认为，他们在社区心理健康论坛的参与导致了跨意识和信仰的主题发生的变化，对经历心理困扰的人的行为，并导致正式和非正式的心理健康practitioners.ConclusionsResults之间的更大的协作和合作的背景下，现存的文献和一个新的框架进行了讨论，提出了一个包含多个最佳实践建议和影响CMHF成功实施的因素的模型。
BackgroundMental health is the leading cause of disability worldwide. In the wake of both a civil war and an Ebola outbreak, Sierra Leone ranks as one of the lowest ranked countries on the Human Development Index (UNDP. Human Development Report 2015, Work for Human Development. The United Nations Development Programme; 2015). The WHO identified Sierra Leone among its priority countries for the piloting of its Mental Health Gap Action Programme (mhGAP). Aligned to these efforts, CBM and their affiliated partners employed the use of Community Mental Health Forums (CMHFs), facilitated by Mental Health Nurses (MHNs), as a sensitive and practical way of engaging key community stakeholders to discuss and address issues of mental health. This study sought firstly, to identify factors that affect the successful implementation of CMHFs, as identified by programme participants. Second, the study sought to identify what changes participants perceived as having taken place as a result of their participation in CMHFs.Methods10 MHNs and 52 forum participants were purposely selected to take part in key informant interviews and focus group discussions, conducted across eight districts in Sierra Leone. Interview transcripts were analysed across four rounds of coding, using a mixture of deductive and inductive approaches.ResultsResults identified three themes, Traditional Beliefs and Culture; Health System; and Inclusive Approaches as affecting the implementation of CMHFs in their districts. Participants further perceived that their participation in the Community Mental Health Forums resulted in changes taking place across the themes of Awareness and beliefs, Behaviours towards people experiencing psychological distress, and as leading to greater Collaboration and cooperation between formal and informal mental health practitioners.ConclusionsResults are discussed in the context of the extant literature and a novel framework, that incorporates multiple best practice recommendations and factors which influence the successful implementation of CMHFs is put forward.