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Stigma and poor mental health literacy as barriers to service use among unemployed people with mental illness

耻辱感和心理健康素养差是患有精神疾病的失业人员使用服务的障碍

基本信息

批准号：
252345792
负责人：
Professor Dr. Nicolas Rüsch
金额：
--
依托单位：
Sektion Public Mental Health
依托单位国家：
德国
项目类别：
Research Grants
财政年份：
2014
资助国家：
德国
起止时间：
2013-12-31 至 2017-12-31
项目状态：
已结题

来源：
https://gepris.dfg.de/gepris/projekt/252345792?language=en
关键词：
Stigma poor mental health literacy

项目摘要

People with mental illness often choose not to use mental health services and therefore do not benefit from available psychopharmacological and psychosocial therapies. The resulting treatment gap has harmful consequences for individuals, their families and society, such as poor clinical outcomes, unemployment and productivity losses. Because individuals outside the healthcare system are a hard-to-reach population, barriers to use mental health services are poorly understood. Two factors likely reduce service use: (i) to avoid being stigmatised by others as mentally ill due to help-seeking (public stigma) and to internalise negative stereotypes and give up life goals (self-stigma); (ii) poor knowledge about mental illnesses and available treatments (mental health literacy).The aim of this study is to examine stigma- and knowledge-related facilitators and barriers to service use. Since it is not efficient to address the treatment gap and its consequences in the general population, we chose a more targeted approach. We will focus on a group in which untreated mental illness impairs vocational functioning, with significant socioeconomic and public health impact: unemployed individuals with high rates of mental illness and unmet mental healthcare needs that prolong unemployment.In a first qualitative phase, we will collect information on facilitators and barriers to service use. In the subsequent quantitative study, participants will be recruited using a screening followed by face-to-face interviews. We prospectively assess predictors of service use at baseline with standardised self-report measures, focussing on stigma and mental health literacy. In line with recent health behaviour models, we complement this approach with indirect measures of implicit attitudes to treatment (Brief Implicit Association Test) and with shame and anxiety as emotional barriers to service use. At six-month follow-up, mental health service use after baseline will be assessed.This study will fill the knowledge gap regarding barriers to service use and thus provide the empirical basis for subsequent development and randomised trials of interventions that aim to increase mental health service use. Furthermore, our study will provide insights into effective recruitment strategies for people with mental illness outside the healthcare system that can later be used to access such hard-to-reach individuals. Therefore this project is a vital step towards addressing the treatment gap and its harmful impact on individuals and society.

精神疾病患者往往选择不使用精神卫生服务，因此无法从现有的精神药理学和心理社会疗法中获益。由此产生的治疗差距对个人、其家庭和社会造成有害后果，如临床结果不佳、失业和生产力损失。由于医疗保健系统之外的个人是难以接触的人群，因此人们对使用心理健康服务的障碍知之甚少。两个因素可能会减少服务的用途：（一）避免被他人污名化为精神病患者，由于寻求帮助（公共耻辱）和内化负面的刻板印象，放弃生活目标（自我耻辱）;（二）对精神疾病和可用的治疗知识贫乏（心理健康素养）。由于在一般人群中解决治疗差距及其后果并不有效，我们选择了一种更有针对性的方法。我们将重点关注未经治疗的精神疾病会损害职业功能、产生重大社会经济和公共卫生影响的群体：精神疾病发病率高、精神保健需求未得到满足、导致失业时间延长的失业人员。在第一个定性阶段，我们将收集有关服务使用的促进者和障碍的信息。在随后的定量研究中，将通过筛选和面对面访谈招募参与者。我们前瞻性地评估了基线服务使用的预测因素，采用标准化的自我报告措施，重点关注耻辱感和心理健康素养。在最近的健康行为模式，我们补充这种方法与间接措施的内隐态度的治疗（简短的内隐联想测试）和羞耻和焦虑的情感障碍，服务使用。在六个月的随访中，将评估基线后的精神卫生服务使用情况，这项研究将填补有关服务使用障碍的知识空白，从而为后续旨在增加精神卫生服务使用的干预措施的开发和随机试验提供经验基础。此外，我们的研究将为医疗保健系统之外的精神疾病患者提供有效的招聘策略，这些策略可以在以后用于访问这些难以接触的个人。因此，该项目是解决治疗差距及其对个人和社会的有害影响的重要一步。

项目成果

期刊论文数量（5）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Attitudes Toward Disclosing a Mental Health Problem and Reemployment: A Longitudinal Study

对披露心理健康问题和再就业的态度：一项纵向研究

DOI：
10.1097/nmd.0000000000000810
发表时间：
2018
期刊：
The Journal of Nervous and Mental Disease
影响因子：
0
作者：
Rüsch N;Corrigan PW;Waldmann T;Staiger T;Bahemann A;Oexle N;Wigand M;Becker T
通讯作者：
Becker T

Mental illness stigma and suicidality: the role of public and individual stigma