Engagement with services in Black African and Caribbean people with psychosis: The role of social networks, illness perceptions, internalized stigma, and perceived discrimination

IF 3.8 3区 心理学 Q1 PSYCHOLOGY, CLINICAL British Journal of Clinical Psychology Pub Date : 2022-07-30 DOI:10.1111/bjc.12385
Amy Degnan, Katherine Berry, Matthew Vaughan, Nick Crossley, Dawn Edge
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Abstract

Objectives

Research and policies in the United Kingdom have repeatedly highlighted the need to reduce ethnic disparities and improve engagement with mental health services among Black African and Caribbean people with psychosis. The aim of this study was to examine the role of social network characteristics and psychological factors in engagement with services in Black people with psychosis.

Methods

A cross-sectional study was conducted with 51 Black African and Caribbean adults with non-affective psychosis and currently receiving care from mental health services in England. Measures were completed to examine relationships between social networks, illness perceptions, perceived racial or ethnic discrimination in services, internalized stigma, and current engagement with services from service user and staff perspectives.

Results

Social network composition (ethnic homogeneity) moderately correlated with better service user and staff reported engagement. Greater perceived personal control over problems was associated with better staff reported engagement. Lower perceived ethnic or racial discrimination in services, and specific illness perceptions (higher perceived treatment control, greater self-identification with psychosis symptoms, more concern and greater emotional response related to problems) were associated with better service user reported engagement. Internalized stigma was not associated with service engagement. Multivariate regression analyses suggested that a more ethnically homogenous social network was the strongest predictor of better service user and staff reported engagement.

Conclusions

Psychosocial interventions that target social networks, perceived ethnic and racial discrimination in services, and illness perceptions may facilitate better engagement and improve outcomes. Further longitudinal studies are required to examine causal mechanisms.

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非洲和加勒比黑人精神病患者的服务参与:社会网络、疾病认知、内化污名和感知歧视的作用
联合王国的研究和政策一再强调有必要减少种族差异,改善非洲和加勒比黑人精神病患者接受心理健康服务的情况。本研究的目的是研究社会网络特征和心理因素在黑人精神病患者参与服务中的作用。方法对51名非情感性精神病的非洲和加勒比黑人成年人进行横断面研究,这些成年人目前正在英国的精神卫生服务机构接受治疗。完成了从服务用户和工作人员的角度检查社会网络、疾病认知、服务中感知的种族或民族歧视、内化的耻辱以及目前与服务的接触之间关系的措施。结果社会网络构成(种族同质性)与服务用户和员工的参与度有中等相关性。对问题的个人控制程度越高,员工的敬业度就越高。服务中较低的族裔或种族歧视感知和特定疾病感知(较高的治疗控制感知、对精神病症状的更大自我认同、对问题的更多关注和更大的情绪反应)与较好的服务用户参与度报告相关。内化污名与服务参与无关。多变量回归分析表明,种族同质的社交网络是更好的服务用户和员工参与度的最强预测因子。针对社会网络、服务中存在的民族和种族歧视以及疾病认知的社会心理干预可能促进更好的参与并改善结果。需要进一步的纵向研究来检验因果机制。
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来源期刊
CiteScore
5.80
自引率
3.20%
发文量
57
期刊介绍: The British Journal of Clinical Psychology publishes original research, both empirical and theoretical, on all aspects of clinical psychology: - clinical and abnormal psychology featuring descriptive or experimental studies - aetiology, assessment and treatment of the whole range of psychological disorders irrespective of age group and setting - biological influences on individual behaviour - studies of psychological interventions and treatment on individuals, dyads, families and groups
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