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

英国正面临两大危机：经济和健康，这影响到每个人的心理健康和福祉。除此之外，近年来公共服务的情况恶化，经常达不到人们的期望：预算限制的增加导致医疗保健资金的削减。这些反过来又导致医疗保健的可及性和可用性降低，等待名单前所未有地长。因此，人们不得不重新评估他们对医疗保健系统的期望，重新定位自己和他们的日常生活，以适应越来越不稳定的未来。尽管对医疗保健服务的满意度很低，但绝大多数英国人仍然对国家医疗服务（NHS）表示坚定的支持。为了捕捉人们的情绪和对未来NHS可能是什么样子的重新想象，我们提出了INTERACT，这是一种以艺术为基础的、创造性的方法为基础的人种学调查，具有真正的协作精神和包容性的跨学科方法，以共同生产有关精神卫生保健的知识。INTERACT将通过放大那些在研究中难以触及的人的声音，将精神保健的创造性、科学和应用观点协同起来。跨学科的INTERACT团队由医学人类学家Dikomitis领导，由1名创造性民族志方法医学人类学家（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）和2个项目合作伙伴（Turner Contemporary和肯特全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，“青少年精神健康服务团”的公众参与活动旨在最大限度地让接受精神健康服务的人参与，并从自下而上的社区参与方式中获益。INTERACT的研究人员将吸引来自服务不足社区的成员，他们面临着系统性的心理健康挑战。我们的地理重点是肯特郡，那里面临着贫困和获得公共医疗服务的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，提供贯穿生命历程和不同人口背景的观点，即：1)年轻人；2)新妈妈；3)老年人；还有移民。通过一系列创意研讨会，由在精神卫生服务部门工作的戏剧治疗师领导，并使用人种学方法，INTERACT将吸引来自这些服务不足社区的4个小组和10名代表，以捕捉他们的生活经历。通过这些活动，服务不足的社区将通过沟通他们对肯特郡精神卫生保健未来的需求和兴趣，成为有意义的利益相关者。参与者将按照患者和公众参与（PPI）的最佳实践，按照他们参与的时间获得报酬，并将通过肯特郡社区精神卫生信托基金、肯特和梅德韦NHS和社会护理伙伴关系信托基金（KMPT）的PPI团队招募。讲习班将在马盖特的特纳当代画廊举办，该画廊拥有社会参与艺术实践的记录，并一直是东肯特地区复兴的推动力。研讨会的见解将通过巡回展览、公开演讲、平面媒体（zine）、播客、抖音视频和INTERACT社区使用的其他社交媒体、政策简报和期刊文章进行传播。

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.