撒哈拉以南非洲成年人获得精神卫生服务的障碍和促进因素:系统审查

Clement K. Komu, Michael Ngigi, Ambrose J. Melson
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引用次数: 0

摘要

在撒哈拉以南非洲,尽管精神卫生状况的患病率很高,但只有不到10%的精神疾病患者获得专业的精神卫生服务。本系统综述旨在识别、评估和综合在SSA进行的研究,旨在了解SSA成人获得MHS的障碍和促进因素。系统检索PsycINFO、MEDLINE和CINAHL数据库,使用关键术语(障碍、促进者、可及性、精神卫生服务和撒哈拉以南非洲),有16项研究符合纳入标准。根据文章的研究方法,使用关键评估技能计划(CASP)和乔安娜布里格斯研究所(JBI)关键评估工具对纳入研究的质量进行评估。采用标准化形式提取纳入研究的数据,并按来源细节、方法、参与者特征和主要发现进行分组。采用叙事综合法系统总结和评价纳入的研究。46个撒哈拉以南非洲国家中只有9个被纳入研究。障碍包括缺乏或很少了解精神障碍和专业服务;对精神卫生服务持消极态度;文化和宗教信仰导致过度依赖传统和精神干预;以及污名化的信念,包括自我污名化、来自家庭、社区和医疗保健提供者的污名化和歧视。促进获得精神健康服务的人比较有限,包括对精神障碍和所提供服务的认识;家庭成员和社区的社会支持和接受;以及社区精神卫生服务的可获得性。该系统综述确定了撒哈拉以南非洲地区知识有限、污名化和对传统干预措施的依赖等阻碍获得精神卫生服务的障碍。该区域的代表性有限,辅导员稀缺,这突出表明迫切需要有针对性的干预措施,以改善精神卫生的可及性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Barriers and Facilitators to Accessing Mental Health Services for Adults in Sub-Saharan Africa: A Systematic Review

Barriers and Facilitators to Accessing Mental Health Services for Adults in Sub-Saharan Africa: A Systematic Review

In Sub-Saharan Africa (SSA), despite a high prevalence of mental health conditions, less than 10% of those living with mental illness access professional mental health services (MHS). This systematic review aimed to identify, appraise, and synthesise studies conducted in SSA seeking to understand the barriers and facilitators to accessing MHS for adults in SSA. A systematic search of PsycINFO, MEDLINE, and CINAHL databases was conducted using key terms (Barriers, Facilitators, Access, Mental Health Services, and Sub-Saharan Africa) with 16 studies meeting the eligibility criteria for inclusion. The quality of the included studies was assessed using the Critical Appraisal Skills Programme (CASP) and Joanna Briggs Institute (JBI) Critical Appraisal tools based on the articles’ study methodology. Data from the included studies were extracted using a standardised proforma and grouped into source details, methodology, participants’ characteristics and the main finding(s). A narrative synthesis was adopted to systematically summarise and evaluate included studies. Only nine of 46 Sub-Saharan African countries were represented in the included studies. Barriers included lack of or little knowledge of mental disorders and professional services; negative attitudes held towards mental health services; cultural and religious beliefs leading to over-reliance on traditional and spiritual interventions; and stigmatising beliefs that included self-stigmatisation, stigma and discrimination from family, the community, and healthcare providers. Facilitators to accessing mental health services were more limited and included awareness of mental disorders and the services offered; social support and acceptance by family members and the community; and the availability of community-based mental health services. This systematic review identified barriers such as limited knowledge, stigma, and reliance on traditional interventions inhibiting access to mental health services in Sub-Saharan Africa. The region's limited representation and scarcity of facilitators highlights an urgent need for targeted interventions to improve mental health accessibility.

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