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，并将利用创造性渠道作为有心理健康问题的个人形成叙述的媒介。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验，在对内在的耻辱感产生积极影响的总体目标。心理健康污名在全球范围内普遍存在，特别是在低收入环境中，阻碍了获得和参与心理健康护理和治疗。关于心理健康的根深蒂固的传统观念与津巴布韦环境中经历的耻辱和歧视有关。有大量证据表明，减少污名化的技术越来越多，但其中大部分发生在高收入国家和白色人群中，因此对其他环境无效。创造力（在“健康人文”范围内）在精神卫生保健中显示出多种益处，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，在修纳文化（津巴布韦），虽然心理健康疾病有负面的文化内涵（与邪恶的精神），创造力与“好精神”，因此，创造性的战略，减少心理健康的耻辱是一个适当的主题，探讨在这种情况下。这项研究将增加对非洲背景下适当的减少耻辱技术的有限理解，以及对津巴布韦文化中心理健康的健康人文方法的使用。一个共同生产的模型将被用来进行这种混合方法的研究，与定性方面的重点，探讨以下问题：-如何表现在津巴布韦文化的耻辱？污名化对有心理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与他人分享故事的能力？这是否会影响内部的耻辱感？个人对通过创造性表达分享他们的心理健康经验的看法是什么？一系列焦点小组和创意研讨会将与Tariro Negitare合作，他是津巴布韦音乐家，在当地社区经营创意艺术中心，并在最近与艾滋病毒诊断年轻人的研究背景下成功地做到了这一点。该研究的目标是招募30名参与者，通过焦点小组开展以下工作：探索绍纳文化中心理健康污名的性质（将用于创建定量评估工具）;规划和提供创意表达展示;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。定性访谈将被用来考虑的影响，展示对内化的耻辱，通过个人的前和后半结构化访谈的参与者参与的焦点小组和展示。评估工具将在衡量污名的展示活动前后使用。

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.