“Making People Aware and Taking the Stigma Away”: Alleviating Stigma and Discrimination through Trialogue

Simon Dunne, L. Macgabhann, M. Amering, Paddy Mcgowan
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引用次数: 5

Abstract

Mental health stigma and discrimination is a major societal issue. Participatory approaches such as Open Dialogue may be effective in bringing about changes in such stigma and discrimination. Trialogue is an extension of such approaches to three or more sets of stakeholders in mental health systems. The current study explores stakeholders’ evolving discourse concerning mental health stigma and discrimination over time through this approach and whether this approach may alleviate mental health stigma and discrimination. Through a prospective qualitative research design, individuals from seven participating communities throughout Ireland took part in interviews (n=42), focus groups (n=28) or Open Dialogue discussions (n=86) across three cycles of research. Thematic content relating to stigma/discrimination of individuals with mental health issues was purposefully analysed at each cycle using thematic analysis. The findings document the prevalence of avoidant approaches towards individuals with mental illness and their families in Irish society, resulting in negative effects of stigma and discrimination such as lowered levels of self-esteem, lower help-seeking behaviours, difficult interpersonal relations and fewer employment/educational opportunities. Trialogue Meetings evolved into a forum where myths surrounding mental illness were dispelled and more humane views of service users and service providers were established among relevant stakeholders and their social networks. The findings indicate that Trialogue Meetings may go some way to tackling stigma and discrimination through positive social contact, dialogue and education for relevant stakeholders in mental health systems. The findings also elucidate a culture of concealment of mental health issues in Ireland, leading to subsequent stigma and discrimination.
“让人们意识到并消除耻辱”:通过三方对话减轻耻辱和歧视
心理健康的耻辱和歧视是一个重大的社会问题。公开对话等参与性办法可能有效地改变这种耻辱和歧视。“三方对话”是将这种方法扩展到精神卫生系统中的三组或更多利益攸关方。本研究通过这种方法探讨了利益相关者关于心理健康耻辱和歧视的演变话语,以及这种方法是否可以减轻心理健康耻辱和歧视。通过前瞻性定性研究设计,来自爱尔兰七个参与社区的个人参加了三个研究周期的访谈(n=42)、焦点小组(n=28)或公开对话讨论(n=86)。在每个周期中,利用专题分析有目的地分析了与有精神健康问题的个人遭受耻辱/歧视有关的专题内容。调查结果表明,在爱尔兰社会中,对精神疾病患者及其家庭的回避态度普遍存在,导致了耻辱和歧视的负面影响,如自尊水平降低,寻求帮助的行为减少,人际关系困难,就业/教育机会减少。三方对话会议发展成为一个论坛,在这里消除了围绕精神疾病的神话,并在相关利益攸关方及其社会网络中建立了对服务使用者和服务提供者更人道的看法。研究结果表明,通过积极的社会接触、对话和对精神卫生系统中相关利益攸关方的教育,三方对话会议可能在一定程度上解决耻辱和歧视问题。调查结果还阐明了爱尔兰隐瞒心理健康问题的文化,导致随后的耻辱和歧视。
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