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Strengths, Struggles, and Strategies: How Adults with Serious Mental Illness Navigate Long-Term Romantic Relationships. 优势、挣扎和策略:患有严重精神疾病的成年人如何处理长期恋爱关系》(How Adults with Serious Mental Illness Navigate Long-Term Romantic Relationships)。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-05-07 DOI: 10.1007/s10597-024-01288-1
Catherine H Stein, Rachel A Redondo, Sharon Simon, Zachary J Silverman

Married individuals and those in committed romantic relationships generally report having better mental health outcomes than their single or divorced counterparts. However, studies of romantic relationships for adults with mental illness have often ignored rewarding aspects of romantic relationships and have focused primarily on relationship difficulties. In this study, 23 adults with serious mental illness in long-term romantic relationships described their relationship strengths and struggles in small focus group discussions. Content analysis was used to characterize themes from participant accounts. Overall, participants described deep emotional bonds with their partners, a mutual willingness to work on their relationship, and good communication skills as relationship strengths. Mental health symptoms and internalized stigma were identified as major contributors to relationship struggles. Participants spontaneously identified intentional strategies that they used to navigate mental health challenges in their relationship that included self-directed, partner-directed, and couple-directed actions. Implications of findings for research and practice are discussed.

与单身或离异的同龄人相比,已婚人士和有稳定恋爱关系的人一般都会有更好的心理 健康状况。然而,针对成年精神疾病患者的恋爱关系研究往往忽视了恋爱关系中的有益方面,而主要关注恋爱关系中的困难。在这项研究中,23 名长期恋爱关系中的重性精神病患者在小型焦点小组讨论中描述了他们在恋爱关系中的优势和挣扎。研究采用了内容分析法来描述参与者叙述的主题。总的来说,参与者将与伴侣之间深厚的情感纽带、双方都愿意为他们的关系付出努力以及良好的沟通技巧描述为他们关系中的优势。心理健康症状和内在化的耻辱感被认为是导致关系挣扎的主要因素。参与者们自发地找出了他们用来应对关系中的心理健康挑战的有意策略,其中包括自我导向、伴侣导向和情侣导向的行动。本文讨论了研究结果对研究和实践的影响。
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引用次数: 0
Occupational Therapy in Psychiatric Short-Term Hospitalization Units: Scoping Review. 精神病短期住院病房的职业疗法:范围审查。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-05-09 DOI: 10.1007/s10597-024-01286-3
Uxia García-Gestal, Miguel-Ángel Talavera-Valverde, Ana-Isabel Souto-Gómez

Given the context, the overarching aim is to identify scientific publications on occupational therapy in Psychiatric-Short-Term-Hospitalization-Units. Specific objectives include: (a) Analyzing the historical development of this research area; (b) Synthesizing existing evidence on the nature of documentary sources on occupational therapy in in Psychiatric-Short-Term-Hospitalization-Units; (c) Detailing the volume of scientific literature on occupational therapy in these units; (e) Evaluating available evidence on occupational therapy interventions to improve functionality, quality of life, and recovery in individuals admitted to in Psychiatric-Short-Term-Hospitalization-Units. A scoping review method was employed to conduct a historical mapping of research on in Psychiatric-Short-Term-Hospitalization-Units. The review proceeded in five stages following PRISMA guidelines. After applying selection criteria, the search identified 446 references. Findings are presented under three headings: (a) Historical trends in the scientific literature on occupational therapy and in Psychiatric-Short-Term-Hospitalization-Units; (b) Nature and volume of articles included in the occupational therapy synthesis in Psychiatric Short-Term Hospitalization Units; (c) Data extraction on methodological variables in the research of occupational therapy articles in in Psychiatric-Short-Term-Hospitalization-Units; and (d) Data extraction on research outcome variables of occupational therapy articles in Psychiatric Short-Term Hospitalization Units. The growth of occupational therapy in in Psychiatric-Short-Term-Hospitalization-Units is emphasized, with an increase in qualitative studies. Occupational therapy is underscored as an integral part of care, supporting the diversity and effectiveness of interventions. Common diagnoses include schizophrenia and depressive disorders. Group interventions and the spiritual dimension positively influence the quality of care and meaningful routines for recovery in in Psychiatric-Short-Term-Hospitalization-Units.

鉴于这一背景,总体目标是确定有关精神病短期住院病房职业疗法的科学出版物。具体目标包括(a) 分析这一研究领域的历史发展;(b) 综合有关精神病短期住院病房职业疗法文献来源性质的现有证据;(c) 详细说明有关这些病房职业疗法的科学文献数量;(e) 评估有关职业疗法干预措施的现有证据,以改善精神病短期住院病房收治人员的功能、生活质量和康复情况。我们采用了范围审查法,对精神病短期住院病房的研究进行了历史梳理。综述按照 PRISMA 指南分五个阶段进行。在应用了选择标准后,搜索确定了 446 篇参考文献。研究结果分为三个标题:(a)有关职业疗法和精神病短期住院病房的科学文献的历史趋势;(b)纳入精神病短期住院病房职业疗法综述的文章的性质和数量;(c)精神病短期住院病房职业疗法文章研究方法变量的数据提取;以及(d)精神病短期住院病房职业疗法文章研究成果变量的数据提取。强调了职业疗法在精神病短期住院病房中的发展,以及定性研究的增加。强调职业疗法是护理工作不可或缺的一部分,支持干预措施的多样性和有效性。常见的诊断包括精神分裂症和抑郁症。小组干预和精神层面对精神病短期住院病房的护理质量和有意义的康复常规产生了积极影响。
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引用次数: 0
Understanding Barriers and Facilitators of Primary Care Use Among Assertive Community Treatment Teams Via Qualitative Analysis of Clients and Clinicians. 通过对客户和临床医生的定性分析,了解支持性社区治疗小组使用初级保健的障碍和促进因素。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-05-03 DOI: 10.1007/s10597-024-01284-5
Sophia Zhao, Walter Mathis

Individuals with severe mental illness and substance use disorders face complex barriers to achieving physical health. This study aims to explore the barriers and facilitators of primary care access among an Assertive Community Treatment (ACT) team. Semi-structured qualitative interviews were conducted with 14 clients and 7 clinicians from an ACT team at a community mental health center in Connecticut. Data analysis followed a grounded theory approach, with codes and themes emerging iteratively during the interview process. The study identified multifaceted barriers to accessing primary care, including economic challenges, homelessness, and the prioritization of mental health and substance use symptoms over healthcare. The conceptual framework consists of nine dominant themes: clients' attitudes, knowledge, mental health, and motivations ("Client-Level Barriers and Facilitators"); ACT team-directed care coordination and relationship-building as well as primary care provider communication ("Provider-Level Barriers and Facilitators"); and clients' experiences with medical care and socioeconomic status ("Systemic-Level Barriers and Facilitators"). This research provides valuable insights into the various barriers faced by ACT clients in accessing primary care. Improving primary care access for individuals with severe mental illness and substance use disorders is crucial for reducing health disparities in this vulnerable population.

患有严重精神疾病和药物使用障碍的人在获得身体健康方面面临着复杂的障碍。本研究旨在探讨协助性社区治疗(ACT)团队在获得初级保健服务方面遇到的障碍和促进因素。研究人员对康涅狄格州一家社区心理健康中心 ACT 小组的 14 名客户和 7 名临床医生进行了半结构化定性访谈。数据分析采用了基础理论方法,在访谈过程中反复出现代码和主题。研究发现了获得初级医疗服务的多方面障碍,包括经济困难、无家可归、心理健康和药物使用症状优先于医疗保健。概念框架由九个主导主题组成:客户的态度、知识、心理健康和动机("客户层面的障碍和促进因素");ACT 团队指导的护理协调和关系建立以及初级保健提供者的沟通("提供者层面的障碍和促进因素");客户的医疗保健经验和社会经济地位("系统层面的障碍和促进因素")。这项研究为了解 ACT 患者在获得初级医疗服务时所面临的各种障碍提供了宝贵的见解。改善患有严重精神疾病和药物使用障碍的个人获得初级医疗服务的机会,对于减少这一弱势群体的健康差距至关重要。
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引用次数: 0
Exploring LGBT2Q+ Intracategorical Factors in Mental Health Service Utilization: Differences in Gender Modalities, Sexual Orientations, and Ethnoracial Groups in Canada. 探索 LGBT2Q+ 心理健康服务使用中的分类内因素:加拿大性别模式、性取向和种族群体的差异。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-06-08 DOI: 10.1007/s10597-024-01299-y
Samson Tse, Kenny Chee, Todd A Coleman, Simon Coulombe, Robb Travers

LGBT2Q+ (lesbian, gay, bisexual, transgender, Two-Spirit, queer, plus) Canadians face minority stressors that lead to higher mental health inequalities such as worse self-reported mental health and increased risk of mental health issues when compared to their heterosexual/straight and cisgender counterparts. However, there are within-group (intracategorical) differences within a community as large as LGBT2Q+ peoples. Guided by the Andersen Model of Healthcare Utilization, we sought to explore intracategorical differences in LGBT2Q+ Canadian predisposing, enabling, and need factors in mental health service utilization within the past year. Using data from the 2020 LGBT2Q+ Health Survey (N = 1542), modified Poisson logistic regression found that more polysexual respondents and trans/gender-diverse respondents were more likely to have utilized mental health services within the past year than their gay, lesbian, and cis male counterparts. As well, compared to White respondents, Indigenous respondents were more likely to have utilized mental health services, while other racialized respondents were associated with less utilization. Backwards elimination of Andersen model of healthcare utilization factors predicting mental health service utilization retained two predisposing factors (ethnoracial groups and gender modality) and two need factors (self-reporting living with a mood disorder and self-reporting living with an anxiety disorder). Results suggest that polysexual, trans and gender-diverse, and racialized LGBT2Q+ peoples have an increased need for mental health services due to increased specific minority stressors that cisgender, White, monosexual peoples do not face. Implications for healthcare providers are discussed on how to improve service provision to LGBT2Q+ peoples.

加拿大的 LGBT2Q+(女同性恋、男同性恋、双性恋、变性人、双灵人、同性恋者、加人)面临着少数群体的压力,这些压力导致了更大的心理健康不平等,例如与异性恋/直男和同性别的人相比,自我报告的心理健康状况更差,出现心理健康问题的风险更高。然而,在像 LGBT2Q+ 这样一个庞大的群体中,也存在着群体内部(类别内)的差异。在安徒生医疗保健利用模型的指导下,我们试图探索 LGBT2Q+ 加拿大人在过去一年中利用心理健康服务的倾向因素、有利因素和需求因素的类别内差异。通过使用来自 2020 年 LGBT2Q+ 健康调查(N = 1542)的数据,修正泊松逻辑回归发现,与男同性恋、女同性恋和同性男性受访者相比,更多的多性受访者和变性/跨性别受访者更有可能在过去一年内利用过心理健康服务。此外,与白人受访者相比,土著受访者更有可能利用心理健康服务,而其他种族受访者的利用率较低。对预测心理健康服务利用率的安徒生医疗保健利用率因素模型进行反向消除,保留了两个诱发因素(种族群体和性别模式)和两个需求因素(自述患有情绪障碍和自述患有焦虑症)。研究结果表明,多性人、变性人、性别多样性人和种族化的 LGBT2Q+ 人对心理健康服务的需求增加了,这是因为他们面临着更多特殊的少数群体压力,而顺性人、白人和单性恋人则不会面临这些压力。本研究还讨论了如何改善为 LGBT2Q+ 群体提供的服务对医疗保健提供者的影响。
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引用次数: 0
A Universal Program to Improve Mental Health among Youth from Low-Income Predominantly Minority Communities: Implementation of Advocates 4 ALL Youth (ALLY). 改善低收入少数民族社区青少年心理健康的普及计划:实施 "倡导所有青少年 "计划(ALLY)。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-05-27 DOI: 10.1007/s10597-024-01292-5
Adefunke Dadematthews, Melissa M Pangelinan, Anne E Bowen, Stacey L Simon, Jessica L Chandrasekhar, Rashelle Musci, Jill L Kaar

Disparities in mental health care and access to care disproportionately affect youth from minoritized and low-income communities. School-based prevention programs have the potential to offer a non-stigmatized approach to mental health care as well as the ability to reach many students simultaneously. Advocates 4 All Youth (ALLY) is a program developed for 5-6th grade students aimed at improving self-efficacy and resilience via individualized sessions with a trusted adult (ALLYs). The feasibility of delivering ALLY in a racially and minoritized low-income community is discussed and modifications required to implement the program documented. Students completed questionnaires and sessions with an ALLY. Aspects of program delivery deemed feasible included training ALLYs to delivery program, stakeholder buy-in regarding missing class time, and students attending the sessions. Further modifications included adjustments to materials due to lower reading level and health literacy related-educational needs. Programs designed in one demographic setting may not work in a different setting.

心理健康护理和获得护理方面的差异对来自少数民族和低收入社区的青少年造成了极大的影响。以学校为基础的预防项目有可能提供一种非污名化的心理健康护理方法,并能同时覆盖许多学生。倡导所有青少年(ALLY)是一个针对 5-6 年级学生开发的项目,旨在通过与可信赖的成年人(ALLYs)进行个性化的交流,提高学生的自我效能感和适应能力。本文讨论了在种族和少数族裔低收入社区实施该计划的可行性,并记录了实施该计划所需的修改。学生们填写了调查问卷,并与 ALLY 进行了交流。被认为可行的计划实施方面包括对 ALLY 进行培训以实施计划、利益相关者对缺课时间的认可以及学生参加课程。进一步的修改包括根据较低的阅读水平和与健康素养相关的教育需求对材料进行调整。在一个人口环境中设计的计划在不同的环境中可能行不通。
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引用次数: 0
Mobile Crisis Teams' Implementation in the Context of new Medicaid Funding Opportunities: Results from a National Survey. 移动危机小组在新的医疗补助资助机会背景下的实施情况:全国调查的结果。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-10-01 Epub Date: 2024-06-03 DOI: 10.1007/s10597-024-01296-1
Rachel Odes, Preston Looper, Deepa Manjanatha, Megan McDaniel, Matthew L Goldman

This cross-sectional survey study describes characteristics of mobile crisis teams (MCTs) in the United States. Mobile crisis teams (MCTs) are increasingly recognized as essential responders to help those experiencing mental health crises get urgent and appropriate care. Recent enhanced federal funding is designed to promote adoption of MCTs, but little is known about their current structure and function and whether teams meet new Medicaid rules governing their utilization. Survey participants (N = 554) are a convenience sample of MCT representatives recruited through professional organizations, listservs, and individual email contacts from October 2021 - May 2022. Respondents most frequently identified themselves as MCT program director/manager (N = 237, 43%). 63% (N = 246) of respondents reported billing insurance for services provided (including Medicaid), while 25% (N = 98) rely on state or county general funds only. Nearly all respondents (N = 390, 98%) reported including behavioral health clinicians on their teams, and 71% (N = 281) reported operating on a 24/7 basis, both of which are required by Medicaid's enhanced reimbursement. Just over half of respondents (N = 191, 52%) reported being staffed with 11 or more FTE staff members, our estimated number required for adequate 2-person coverage on a 24/7 basis. MCTs are a popular policy initiative to reduce reliance on law enforcement to handle mental health emergencies, and enhanced federal funding is likely to expand their utilization. Federal rule makers have a role in establishing guidelines for best practices in staffing, billing, and outcomes tracking, and can help ensure that stable financing is available to improve stability in service delivery.

这项横断面调查研究描述了美国流动危机处理小组(MCTs)的特点。人们越来越认识到,流动危机处理小组(MCTs)是帮助那些遭遇心理健康危机的人们获得紧急和适当护理的重要响应者。最近,联邦加大了对移动危机处理小组的资助力度,旨在促进移动危机处理小组的采用,但人们对其目前的结构和功能以及小组是否符合医疗补助计划关于其使用的新规定却知之甚少。调查参与者(N = 554)是在 2021 年 10 月至 2022 年 5 月期间通过专业组织、列表服务器和个人电子邮件联系招募的 MCT 代表的便利抽样。受访者最常自称为 MCT 项目主任/经理(N = 237,43%)。63%的受访者(N = 246)称所提供的服务要向保险机构付费(包括医疗补助),25%的受访者(N = 98)仅依靠州或县级普通基金。几乎所有的受访者(N = 390,98%)都表示他们的团队中有行为健康临床医生,71%(N = 281)的受访者表示他们的团队每周 7 天每天 24 小时都在工作,而这两项都是医疗补助加强报销所要求的。略多于一半的受访者(N = 191,52%)称其团队配备了 11 名或更多的全职员工,这是我们估计的全天候充足的 2 人覆盖所需的人数。MCT 是一项广受欢迎的政策措施,旨在减少对执法部门处理心理健康突发事件的依赖,而联邦资 助的增加很可能会扩大 MCT 的使用范围。联邦规则的制定者可以在制定人员配备、账单和结果跟踪方面的最佳实践指南方面发挥作 用,并可以帮助确保提供稳定的资金,以提高服务提供的稳定性。
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引用次数: 0
Key Considerations in Integrating a Peer Support Model Within Psychiatric Emergency Services at a Canadian Pediatric Emergency Department: A Qualitative Study. 加拿大儿科急诊室在精神科急诊服务中整合同伴支持模式的主要考虑因素:定性研究。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-09-30 DOI: 10.1007/s10597-024-01365-5
Julia C Hews-Girard, Emma Cullen, Jessica Sauerwein, Carol Coventry, Gina Dimitropoulos

Difficulties accessing primary care and community-based mental health supports has contributed to youth (aged < 18 years) with mental health concerns presenting to Emergency Departments (EDs). Peer support services in community-based mental health settings are associated with improved outcomes; research exploring this in pediatric EDs is lacking. Determine feasibility and acceptability of integrating peer support services into a pediatric ED. 13 peer support workers (PSWs) and 30 mental health providers and stakeholders participated in interviews or focus groups. Using codebook thematic analysis, recommendations for integration were identified. Key recommendations were: clear conceptualization of youth and family peer support, effective communication pathways between the multidisciplinary team and PSWs, provision of training for ED staff to ensure workplace readiness for peer support, and consistent support for PSWs. Integration of peer support into pediatric EDs offers a feasible and acceptable way to support youth experiencing mental health crises.

由于难以获得初级保健和社区心理健康支持,导致青少年(岁)的心理健康水平下降。
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引用次数: 0
Development and Implementation of Mental Healthcare Plans in Three Districts in Ghana: A Mixed-Method Process Evaluation Using Theory of Change. 加纳三个地区心理保健计划的制定与实施:采用变革理论的混合方法过程评估》。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-09-27 DOI: 10.1007/s10597-024-01357-5
Kenneth A Ae-Ngibise, L Sakyi, L Adwan-Kamara, T D Cooper, B Weobong, C Lund

In Ghana, a severe mental healthcare gap of 95-98% exists due to limited services. Ghana Somubi Dwumadie set out to address this by developing district mental healthcare plans (DMHPs) in three demonstration districts. Following the Programme for Improving Mental Healthcare model, district mental health operations teams were formed and used Theory of Change (ToC) to develop DMHPs. Key elements included training non-specialist health workers and enrolling individuals in relevant healthcare programmes. Evaluation methods included routine data, health facility surveys, and qualitative analysis within the ToC framework. Results showed improved integration of mental health services, enhanced case management through training, and increased service utilisation, shown through 691 service user enrollments. However, there was limited commitment of new resources and no significant improvement in primary care workers' capacity to detect priority mental health conditions. The study concludes that DMHPs, implemented with an integrated approach, can improve mental health service utilisation, contingent on committed leadership, resource availability, and stakeholder engagement.

在加纳,由于服务有限,精神保健缺口高达 95-98%。加纳 Somubi Dwumadie 通过在三个示范区制定地区心理保健计划 (DMHP) 来解决这一问题。按照 "改善心理保健计划 "的模式,成立了地区心理保健行动小组,并采用 "变革理论"(ToC)来制定地区心理保健计划。主要内容包括培训非专业卫生工作者,并将个人纳入相关的医疗保健计划。评估方法包括常规数据、医疗机构调查以及 ToC 框架内的定性分析。评估结果表明,心理健康服务的整合得到了改善,通过培训加强了病例管理,并通过 691 名服务用户的加入提高了服务利用率。然而,新资源的投入有限,初级保健工作者检测重点精神健康状况的能力也没有显著提高。该研究得出结论,以综合方法实施的 DMHPs 可以提高心理健康服务的利用率,但前提是领导层的承诺、资源的可用性和利益相关者的参与。
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引用次数: 0
A Pilot Study in Adapting the Chronic Care Model to Address Shortage of Child and Adolescent Psychiatry. 采用慢性病护理模式解决儿童和青少年精神病学人才短缺问题的试点研究。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-09-24 DOI: 10.1007/s10597-024-01355-7
Neha Sharma, Rachel Olfson, Rachel Gomes Casseres

There is a nationwide shortage of child and adolescent psychiatrists. This, combined with the mental health crisis caused by the coronavirus 2019 pandemic has lead to low access to care for many individuals. Child Psychiatry Access Programs have been developed to address this need, but we believe they are not sufficient to care for complex cases. We propose that the Chronic Care Model can address these issues by providing, more longitudinal and and faster access to mental health care for patients. Our pilot study had 50 children and adolescent participants in our clinic model, which included the use of trainees supervised by an attending. We found that the mean wait time to appointment with a child and adolescent psychiatrist was 13.54 ± 14.8 days, which is significantly shorter by that reported by other studies. We believe our model clinic may be helpful in a variety of settings and want to share it with other psychiatrists.

全国范围内都存在儿童和青少年精神科医生短缺的问题。再加上 2019 年冠状病毒大流行引发的心理健康危机,导致许多人很难获得治疗。为了满足这一需求,我们制定了儿童精神科就医计划,但我们认为这些计划不足以满足复杂病例的治疗需求。我们建议,慢性病护理模式可以解决这些问题,为患者提供更纵向、更快捷的心理保健服务。在我们的试点研究中,有 50 名儿童和青少年参与了我们的诊所模式,其中包括使用由一名主治医师监督的受训人员。我们发现,预约儿童和青少年精神科医生的平均等待时间为 13.54 ± 14.8 天,比其他研究报告的时间要短得多。我们相信,我们的示范诊所可能会对各种环境有所帮助,并希望与其他精神科医生分享。
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引用次数: 0
Racialized Immigrants' Encounters of Barriers and Facilitators in Seeking Mental Healthcare Services in Ontario, Canada. 加拿大安大略省种族移民在寻求心理保健服务时遇到的障碍和便利因素。
IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES Pub Date : 2024-09-24 DOI: 10.1007/s10597-024-01362-8
Zoha Salam, Mirna Carranza, Bruce Newbold, Olive Wahoush, Ameil Joseph

Racialized immigrants have low rates of accessing mental healthcare services. However, there are notable differences among immigrant groups (e.g., refugees, international students, dependants). The aim of this study is to understand racialized immigrants' experiences of accessing mental healthcare services at both systemic and individual levels. Through a qualitative descriptive methodology, interviews were conducted in English with 16 racialized immigrants to understand barriers and facilitators encountered. Additionally, focusing on how cultural and social conceptualizations ideas shape mental healthcare services. Interviews were analyzed through Braun & Clarke's six-step method to reflexive thematic analysis in identifying factors. Three major themes were identified: structural constraints, individual influences, and appraisal of services. With the first, racialized immigrants signaled to issues related to the systemic level that included affordability, wait times, and trust in the system. Individual influences highlighted factors of mental health literacy, social supports, stigma, severity of the issues, and awareness of services themselves. Lastly, extending on the previous theme, appraisal of services was reflective of how social and cultural ideals shaped attitudes towards the appropriateness of the provider or services themselves. The findings from this paper emphasize that racialized immigrants are not homogenous in their experiences and attitudes towards mental healthcare services. While there were similarities across different groups in the individual and systemic factors identified, there were key distinctions driven by appraisal of services themselves and if they were congruent based on their needs, more specifically, what was contributing to their negative mental health status.

种族移民获得心理保健服务的比例较低。然而,不同移民群体(如难民、留学生、家属)之间存在明显差异。本研究旨在从系统和个人两个层面了解种族移民获得心理保健服务的经历。通过定性描述方法,用英语对 16 名种族移民进行了访谈,以了解他们遇到的障碍和促进因素。此外,还重点关注文化和社会概念化思想如何影响心理保健服务。通过布劳恩和克拉克的六步反思式主题分析法对访谈进行分析,以确定各种因素。确定了三大主题:结构限制、个人影响和服务评价。在第一个主题中,种族移民指出了与系统层面有关的问题,包括负担能力、等待时间和对系统的信任。个人影响因素强调了心理健康知识、社会支持、耻辱感、问题的严重性以及对服务本身的认识。最后,在前一个主题的基础上,对服务的评价反映了社会和文化理想是如何影响人们对服务提供者或服务本身是否合适的态度的。本文的研究结果强调,种族化移民对心理保健服务的经历和态度并不一致。虽然不同群体在个人因素和系统因素方面有相似之处,但对服务本身的评价,以及服务是否符合他们的需要,更具体地说,是什么导致了他们消极的心理健康状况,这些都是关键的区别所在。
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Community Mental Health Journal
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