Imagining mental healthcare: engaging underserved local communities in Kent (INTERACT)

英国正面临两大危机：经济和健康，这对每个人的心理健康和福祉都有影响。此外，近年来，公共服务的体验有所恶化，经常达不到人们的预期：日益严重的预算约束导致医疗资金削减。这些反过来又导致医疗服务的可及性和可获得性降低，等待名单空前冗长。因此，人们不得不重新评估他们对医疗体系的期望，将自己和日常生活重新定位为越来越不稳定的未来。尽管对医疗服务的满意度很低，但绝大多数英国人仍然坚定不移地支持国家医疗服务体系(NHS)。为了捕捉人们的情绪并重新想象未来的NHS可能是什么样子，我们建议InterAct，一种以艺术为基础的、创造性的方法论为基础的民族志调查，具有真正的协作精神和包容的跨学科方法，以共同产生关于精神卫生保健的知识。InterAct将通过放大那些在研究中很难接触到的人的声音，将精神卫生保健的创造性、科学性和应用性的观点协同起来。由医学人类学家迪科米蒂斯领导的跨学科InterAct团队由1名创造性人种学方法方面的医学人类学家专家(Bonanno)、3名精神病学家(Rodda、Shergill和Tracy)、1名媒体学者(Declercq)、2名在肯特精神健康服务部门工作的创意艺术治疗师(Le Fleuve和Richardson)以及2个项目合作伙伴(Turner当代和肯特社区精神健康信托基金KMPT)组成。在InterAct中，肯特当地社区将在研究对话中拥有平等的发言权。因此，互动公共参与活动旨在最大限度地让精神卫生保健服务的接受者参与，并从自下而上的社区参与方法中受益。互动研究人员将让面临系统性精神健康挑战的服务不足社区的成员参与进来。我们的地理焦点是肯特郡，它面临着贫困和获得公共医疗服务机会有限的特殊挑战。应对这些挑战是InterAct团队所在的新肯特和梅德韦医学院愿景声明的核心。我们将与四个不同的社区合作，从不同的人口背景和生命历程提供观点，即1)年轻人；2)新妈妈；3)老年人；4)移民。通过在心理健康服务领域工作的戏剧治疗师领导的一系列创造性研讨会，InterAct将利用人种学方法吸引4个团体，来自这些服务不足的社区的10名代表记录他们的生活经历。通过这些活动，服务不足的社区将成为有意义的利益相关者，通过沟通他们对肯特郡精神卫生保健未来的需求和兴趣。参与者将根据患者和公众参与(PPI)的最佳实践，为他们的参与时间支付报酬，并将通过肯特郡社区精神健康信托基金、肯特和梅德韦NHS和社会护理伙伴信托基金(KMPT)的PPI团队招募。研讨会将在马尔盖特的特纳当代画廊举办，该画廊在社会参与的艺术实践方面有着良好的记录，并一直是东肯特地区复兴的推动力。讲习班的见解将通过巡回展览、公开演讲、图形媒体(杂志)、播客、Tik-Tok视频和InterAct社区使用的其他社交媒体、政策简报和期刊文章来传播。

The UK is facing two major crises: economic and health, which impact on the mental health and wellbeing of everyone. Adding to this, experiences of public services have worsened in recent years and regularly fall short of people's expectations: increasing budget constraints have resulted in cuts to healthcare funding. These, in turn, led to reduced accessibility and availability of healthcare with unprecedentedly lengthy waiting lists. Consequently, people have had to reassess their expectations of their healthcare system, reorienting themselves and their everyday life towards more and more precarious futures. Despite low satisfaction with healthcare services, an overwhelming majority of the UK population still expresses unwavering support for a national health service (NHS). To capture people's emotions and re-imaginations of what the future NHS might look like, we propose INTERACT, an ethnographic enquiry underpinned by arts-based, creatives methodologies, with a genuine collaborative ethos and an inclusive interdisciplinary approach to co-producing knowledge around mental healthcare. INTERACT will synergise creative, scientific and applied perspectives of mental healthcare by amplifying the voices of those hardly reached in research. The interdisciplinary INTERACT team, led by Dikomitis, a medical anthropologist, is comprised of 1 medical anthropologist expert in creative ethnographic methods (Bonanno), 3 psychiatrists (Rodda, Shergill and Tracy), 1 media scholar (Declercq), 2 creative arts therapists working in Kent mental health services (Le Fleuve and Richardson) and 2 project partners (Turner Contemporary and the Kent-wide community mental health trust, KMPT).In INTERACT, Kent local communities will have an equal voice in the conversation of research. As such, INTERACT public engagement activities are designed to maximise the involvement of mental healthcare services' recipients and benefit from a bottom-up approach to community involvement. INTERACT researchers will engage members from underserved communities who face systemic mental health challenges. Our geographic focus is Kent, which faces particular challenges of deprivation and limited access to public healthcare services. Addressing these challenges are at the heart of the vision statement of new Kent and Medway Medical School, where the INTERACT team is located.We will work with four distinct communities, offering perspectives across the life course and from different demographic backgrounds, i.e., 1) young people; 2) new mothers; 3) older adults; and 4) migrants. Through a series of creative workshops, led by drama therapists working in mental health services, and using ethnographic methods, INTERACT will engage 4 groups, with 10 representatives from these underserved communities to capture their lived experiences. Through these activities, underserved communities will become meaningful stakeholders by communicating their needs and interests for the future of mental healthcare in Kent. Participants will be paid for their time involvement, following best practice in patient and public involvement (PPI), and will be recruited through the PPI team at the Kent-wide community mental health trust, the Kent and Medway NHS and Social Care Partnership Trust (KMPT). The workshops will be hosted in the Turner Contemporary Gallery in Margate, which has a track record of socially-engaged arts-based practice, and has been a driving force in the regeneration of the East Kent area. Insights from the workshops will be disseminated through a touring exhibitions, public talks, graphic media (zine), podcasts, Tik-Tok videos and other social media used by the INTERACT communities, a policy brief and a journal article.