少数民族儿童和青年获得精神保健和支助的经验:快速范围审查

H. Coelho, A. Price, Fraizer Kiff, Laura Trigg, S. Robinson, J. Thompson Coon, R. Anderson
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引用次数: 1

摘要

心理健康问题在英国的儿童和年轻人中很常见。一些少数民族背景的年轻人经历的心理健康问题与非少数民族背景不同。此外,那些来自少数民族背景的人在获得心理健康支持和不同程度的服务方面往往会遇到更大的困难,他们可能更喜欢与英国白人同龄人不同的支持。描述关于少数民族背景的儿童和年轻人在寻求或获得心理健康问题护理或支持方面的经历的定性研究的性质和范围。2021年6月23日,我们使用相关术语搜索了七个书目数据库(应用社会科学索引和摘要、护理和相关健康文献累积索引、MEDLINE、PsycInfo®、健康管理信息联盟、社会政策与实践以及科学网)。范围界定审查包括对年轻人寻求或参与心理健康问题服务或支持的经历进行定性研究。纳入的研究从2012年开始发表,来自英国,涉及10-24岁的人群,重点关注少数民族背景的人群(即非英国白人)。研究选择、数据提取和质量评估(采用“Wallace”标准)由两名评审员进行。我们对纳入研究的目的、范围、样本、方法和质量进行了描述性总结,并对作者的研究结果进行了选择性陈述(即没有正式的综合)。从5335个独特的搜索记录中,我们纳入了26篇论文或报告,描述了22项不同的定性研究。大多数研究都进行得很好,描述得很清楚。对难民/寻求庇护者进行了研究(n = 5) ,大学生(n = 4) 以及对经历特殊心理健康问题的年轻人的研究(n = 14) (一些研究分为多个类别):精神分裂症或精神病(n = 3) ,饮食失调(n = 3) ,创伤后应激障碍(n = 3,在寻求庇护者中),药物滥用(n = 2) ,自残(n = 2) 和强迫症(n = 1) 。还有三项针对正在接受特定治疗的少数民族年轻人的研究(认知-行为疗法、针对家庭的多系统疗法和基于文化适应的家庭谈话疗法)。大多数研究都是针对来自不同种族背景的年轻人或他们的父母进行的。然而,对特定族裔群体进行了九项研究:来自阿富汗的寻求庇护者(n = 2) ,以及黑人和南亚人(n = 2) ,非洲黑人和加勒比黑人(n = 2) ,南亚(n = 1) 、巴基斯坦人或孟加拉人(n = 1) 和正统犹太教徒(n = 1) 人民。研究表明,从年轻人及其父母的信仰和知识、服务的设计和推广以及护理专业人员的特点等方面来看,有一系列因素会影响寻求护理和获得心理健康护理。接触不良的原因是对心理健康问题缺乏了解,缺乏有关服务的信息,对护理专业人员缺乏信任,社会污名化,以及对心理恢复能力的文化期望。由于这是一次快速的范围界定审查,因此只有对研究结果的基本综合。未来关于少数民族年轻人的研究可以涵盖更广泛的少数民族,分别抽样和分析特定少数民族的经历,涵盖那些为不同需求获得不同服务的人,并采用多种视角(如服务用户、护理人员、临床医生、服务管理)。本研究注册为https://osf.io/wa7bf/.该项目由国家卫生与护理研究所(NIHR)卫生与社会护理提供方案资助,并将在《卫生与社会保健提供》上全文发表;第10卷,第22期。有关更多项目信息,请访问NIHR期刊图书馆网站。
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Experiences of children and young people from ethnic minorities in accessing mental health care and support: rapid scoping review
Mental health problems are common among children and young people in the UK. Some young people from ethnic minority backgrounds experience mental health problems in different ways from those from non-ethnic minority backgrounds. Furthermore, those from ethnic minority backgrounds often experience greater difficulties in accessing mental health support and variable levels of engagement with services, and may prefer different support to their white British peers. To describe the nature and scope of qualitative research about the experiences of children and young people from ethnic minority backgrounds in seeking or obtaining care or support for mental health problems. We searched seven bibliographic databases (Applied Social Sciences Index and Abstracts, Cumulative Index to Nursing and Allied Health Literature, MEDLINE, PsycInfo®, Health Management Information Consortium, Social Policy and Practice, and Web of Science) using relevant terms on 23 June 2021. The scoping review included qualitative research about young people’s experiences of seeking or engaging with services or support for mental health problems. Included studies were published from 2012 onwards, were from the UK, were about those aged 10–24 years and were focused on those from ethnic minority backgrounds (i.e. not white British). Study selection, data extraction and quality assessment (with ‘Wallace’ criteria) were conducted by two reviewers. We provide a descriptive summary of the aims, scope, sample, methods and quality of the included studies, and a selected presentation of authors’ findings (i.e. no formal synthesis). From 5335 unique search records, we included 26 papers or reports describing 22 diverse qualitative studies. Most of the studies were well conducted and clearly described. There were studies of refugees/asylum seekers (n = 5), university students (n = 4) and studies among young people experiencing particular mental health problems (n = 14) (some studies appear in multiple categories): schizophrenia or psychosis (n = 3), eating disorders (n = 3), post-traumatic stress disorder (n = 3, in asylum seekers), substance misuse (n = 2), self-harm (n = 2) and obsessive–compulsive disorder (n = 1). There were also three studies of ethnic minority young people who were receiving particular treatments (cognitive–behavioural therapy, multisystemic therapy for families and a culturally adapted family-based talking therapy). Most studies had been conducted with young people or their parents from a range of different ethnic backgrounds. However, nine studies were conducted with particular ethnic groups: asylum seekers from Afghanistan (n = 2), and black and South Asian (n = 2), black African and black Caribbean (n = 2), South Asian (n = 1), Pakistani or Bangladeshi (n = 1) and Orthodox Jewish (n = 1) people. The studies suggested a range of factors that influence care-seeking and access to mental health care, in terms of the beliefs and knowledge of young people and their parents, the design and promotion of services, and the characteristics of care professionals. Poor access was attributed to a lack of understanding of mental health problems, lack of information about services, lack of trust in care professionals, social stigma and cultural expectations about mental resilience. As this was a rapid scoping review, there was only a basic synthesis of the research findings. Future research about young people from ethnic minorities could cover a wider range of ethnic minorities, sample and analyse experiences from particular ethnic minorities separately, cover those accessing different services for different needs, and adopt multiple perspectives (e.g. service user, carer, clinician, service management). This study is registered as https://osf.io/wa7bf/. This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery programme and will be published in full in Health and Social Care Delivery; Vol. 10, No. 22. See the NIHR Journals Library website for further project information.
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