Timothy D Becker, Drew Blasco, María Soledad Burrone, Gabriella Dishy, Paola Velasco, Gabriel Reginatto, Franco Mascayano, Maximillian S Wu, Cindy Hu, Simran Bharadwaj, Shivangi Khattar, Liz Calderon, Cynthia Filgueira, Rubén Alvarado, Ezra S Susser, Lawrence H Yang
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引用次数: 1
Abstract
Objective: Stigma jeopardizes recovery and successful implementation of mental health services (MHS) globally. Despite cultural variation in how stigma manifests, few studies have examined how culture fundamentally impacts the concept of "personhood" in Latin America. Chile has expanded MHS, providing universal coverage for evaluation and treatment of first episode psychosis (FEP). We applied the "what matters most" (WMM) framework of stigma to identify culturally salient factors that shape or protect against stigma in urban Chile, identifying potential implications for MHS and recovery.
Methods: In-depth interviews (n = 48) were conducted with MHS users with psychotic disorders (n = 18), their family members (n = 15), and community members (n = 15), from two urban regions in Chile. Interviews were coded and analyzed to identify WMM, how WMM shapes stigma, and how MHS can influence achieving WMM.
Results: Traditional values emphasizing physical/social appearance, gender roles, family, and social connectedness are highly valued. Socioeconomic transitions have engendered capitalistic variations on traditional values, with increasing emphasis on professional careers for men and women, individualism, and independence. Psychotic disorders interfere with fulfillment of both traditional and capitalist values, thereby reinforcing stigma. However, MHS are seen as partially effective in enabling fulfillment of some goals, including employment, appearance, and independence, while often remaining insufficient in enabling capacity to achieve marriage and having a family.
Conclusions and implications for practice: MHS that facilitate recovery by engaging users in services, such as pharmacotherapy, education/vocational rehabilitation, and family-centered care aligned with cultural values can mitigate stigma and facilitate recovery by enabling users to fulfill WMM. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
期刊介绍：
The Psychiatric Rehabilitation Journal is sponsored by the Center for Psychiatric Rehabilitation, at Boston University"s Sargent College of Health and Rehabilitation Sciences and by the US Psychiatric Rehabilitation Association (USPRA) . The mission of the Psychiatric Rehabilitation Journal is to promote the development of new knowledge related to psychiatric rehabilitation and recovery of persons with serious mental illnesses.
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