A qualitative investigation of self-stigma focussed music workshops for people with mental health disorders in urban Zimbabwe

该项目将探索津巴布韦创造力的过程和展示，并将利用创意渠道作为有精神健康问题的个人形成其叙述的媒介。希望这将发展他们的身份和信心，在一个安全的环境中表达他们的经历，在对内化耻辱产生积极影响的总体目标内。精神卫生污名在全球普遍存在，特别是在低收入环境中，这阻碍了获得和参与精神卫生保健和治疗。关于心理健康的根深蒂固的传统信念与津巴布韦环境中所经历的耻辱和歧视有关。越来越多的证据表明，减少耻辱感的技术是可行的，但这些技术大多发生在高收入国家和白人人群中，因此对其他环境无效。创造力（在“健康人文学科”范围内）在精神卫生保健中显示出多重益处，包括治疗效果、促进表达、社区凝聚力和积极的媒体报道。此外，在（津巴布韦的）绍纳文化中，虽然心理健康疾病在文化上具有负面含义（与恶灵有关），但创造力与“善灵”有关——因此，在这方面探讨减少心理健康耻辱的创造性战略是一个适当的主题。这项研究将增加对非洲背景下适当减少耻辱技术的有限理解，以及在津巴布韦文化中具体使用健康人文方法进行心理健康。将使用合作生产模型进行这种混合方法研究，以定性方面为重点，探讨以下问题：-耻辱如何在津巴布韦文化中表现出来？-污名对有精神健康问题的个人及其家庭有什么影响？-创意出口如何支持个人向他人分享他们的叙述的能力？这对内在化的耻辱有影响吗？-个人对通过创造性表达来分享他们的心理健康经历的看法是什么？将与Tariro Negitare合作举办一系列焦点小组和创意工作坊，Tariro Negitare是津巴布韦音乐家，他在当地社区经营一个创意艺术中心，最近在一项研究中成功地与被诊断患有艾滋病毒的年轻人合作。这项研究的目标是招募30名参与者。焦点小组将实现以下目标：探索绍纳文化中心理健康耻辱的性质（将用于创建一个定量评估工具）；创意表达展柜的策划与交付；并确定合适的创意形式。在焦点小组讨论期间，将支持参与者创造性地表达自己，并围绕他们的创作形成叙述。定性访谈将通过对焦点小组和展示的参与者进行个人前后半结构化访谈来考虑展示对内化污名的影响。然后，评估工具将在展示活动前后使用，以测量耻辱感。

This project will explore the process and showcase of creativity in Zimbabwe, and will use creative outlets as a medium for individuals with mental health issues to form their narratives. The hope is that this will develop their identity and confidence to express their experiences in a safe environment, within the overall aim of having a positive impact on internalised stigma. Mental health stigma is widespread globally, particularly in lower income settings, inhibiting access to, and engagement with, mental health care and treatment. Embedded traditional beliefs about mental health are linked to the stigma and discrimination experienced in a Zimbabwean setting. There has been a large body of evidence growing for stigma-reduction techniques, but most of this has taken place in high-income countries and within white populations, and is therefore ineffective and invalid for other settings.Creativity (within 'health humanities') has shown multiple benefits within mental health care, including therapeutic effect, enabling expression, community cohesion and positive media coverage. Furthermore, in the Shona culture (of Zimbabwe) though mental health illness has negative connotations culturally (linked with evil spirits), creativity is linked with 'good spirits' - therefore creative strategies in reducing mental health stigma is an appropriate theme to explore within this context. This research will add to the limited understanding of appropriate stigma-reduction techniques in an African context as well as the use of a health humanities approach for mental health in the Zimbabwean culture specifically. A coproduction model will be used to carry out this mixed method research, with the qualitative aspect being the focus, to explore the following questions:- How does stigma manifest itself in Zimbabwean culture?- What impact does stigma have on individuals with mental health issues and their families?- How does creative outlet support the individual's ability to share their narrative to others? Does this impact on internalised stigma?- What are the individual's perceptions toward sharing their experiences of mental health through creative expressions?A series of focus groups and creative workshops will be run in partnership with Tariro Negitare who, as well as being a Zimbabwean musician, runs a Creative Arts Hub in local communities and has successfully done this within a research context recently with young people with an HIV diagnosis. The study will aim to recruit 30 participants.Focus groups will enable the following: the exploration of the nature of mental health stigma in the Shona culture (which will be used to create a quantitative assessment tool); the planning and delivery of the creative expression showcase; and the identification of suitable creative formats. For the duration of the focus groups, participants will be supported to express themselves creatively and form a narrative around their creations. Qualitative interviews will be used to consider the impact of the showcase on internalised stigma, through individual pre and post semi-structured interviews with the participants involved in the focus groups and showcase. The assessment tool will then be used pre and post the showcase event for measuring stigma.