Experiencias con los Servicios de Salud Mental: perspectivas de las personas diagnosticadas en Cataluña, España
Resum
El campo de la salud mental enfrenta desafíos significativos como la exclusión social, estigmatización, discriminación y violación de derechos humanos, tanto a nivel nacional como internacional en salud pública. En este estudio fenomenológico realizado en Cataluña, España, desde la perspectiva de la representación social, se entrevistó a 12 personas diagnosticadas con trastornos mentales para explorar sus experiencias con los servicios de salud mental. La mayoría describió experiencias marcadas por un modelo jerárquico en las estructuras de poder, donde sus perspectivas fueron deslegitimadas. Las representaciones especializadas y públicas sobre salud mental moldearon sus vidas, dejándolos sentirse mudos e impotentes frente a estas representaciones dominantes. Las experiencias positivas surgieron cuando fueron escuchados, atendidos y comprendidos por los profesionales de la salud. Considerar las voces de quienes tienen diagnósticos de trastornos mentales puede significar mejoras sustanciales en la prestación de atención integral, efectiva y sensible en salud mental.
Paraules clau
Servicios de Salud Mental, Trastornos Mentales, Atención a la Salud, EspañaReferències
Angermeyer, Matthias C. & Dietrich, Sandra (2006). Public beliefs about and attitudes towards people with mental illness: a review of population studies, Acta Psychiatrica Scandinavica, 113(3),163-179.
Aspers, Patrik (2004). Empirical Phenomenology: an approach for qualitative research. Papers in Social Research Methods Qualitative Series, 9, 1-15.
Bernal-Delgado, Enrique; Garcia-Armesto, Sandra; Oliva, Juan; Sanchez Martinez, Fernando I.; Repullo, José R.; Pena-Longobardo, Luz M.; Ridao-Lopez, Manuel; Hernandez-Quevedo, Cristina (2018). Spain: Health System Review. Health Syst Transit., 20(2), 1-179.
Bobes, Julio; Garcia-Portilla Parellada, Maria P.; Bascaran, Maria T.; Saiz, Pilar A. & Arango, Celso (2012). The state of psychiatry in Spain. International Review of Psychiatry, 24(4), 347-355. https://doi.org/10.3109/09540261.2012.691090
Buszewicz, Marta; Pistrang, Nancy; Barker, Chris; Cape, John & Martin, Jonathan (2006). Patients’ experiences of GP consultations for psychological problems: A qualitative study. British Journal of General Practice, 56(528), 496-503.
Chen, Xintong (2021). The Effect of Media Representations and Stigma on Public Perception of Mental Disorders from Late 20th to Early 21st Century. Advances in Social Science, Education and Humanities Research, 615, 622-625. https://doi.org/10.2991/assehr.k.211220.106
Corrigan, Patrick (2004). How stigma interferes with mental health care. The American Psychologist, 59(7), 614-625. https://doi.org/10.1037/0003-066X.59.7.614
Costa-Font, Joan; Hita, Juan C.; Alonso, Jordi; Salvador-Carulla, Luis & McDaid, David (2008). New and old challenges in the reform of mental health systems in Spain. Eurohealth, 14(4), 14-17.
Dixit, Shikha (2005). Meaning and Explanations of Mental Illness: A Social Representations Approach. Psychology & Developing Societies, 17(1), 1-18. https://doi.org/10.1177/097133360501700101
Epstein, Ronald M. (2006). Making communication research matter: What do patients notice, what do patients want, and what do patients need? Patient Education and Counseling, 60(3), 272-278. https://doi.org/10.1016/j.pec.2005.11.003
Flick, Uwe (2009). An Introduction to Qualitative Research. Sage Publications.
Foster, Juliet L.H. (2001). Unification and differentiation: a study of the social representations of mental illness. Papers on Social Representations, 10, 3.1-3.18.
Foster, Juliet L.H. (2003). Beyond otherness: controllability and location in mental health service clients’ representations of mental health problems. Journal of Health Psychology, 8(5), 632-644. https://doi.org/10.1177/13591053030085012
Foster, Juliet L.H. (2013). What can social psychologists learn from architecture? The asylum as example. Journal for the Theory of Social Behaviour, 44(2), 131-147. https://doi.org/10.1111/jtsb.12034
Foucault, Michel (1967). Madness and Civilization: A history of insanity in the age of reason. Tavistock Publications.
Graham, Tanya; Rose, Diana; Murray, Joanna; Ashworth, Mark & Tylee, André (2014). User-generated quality standards for youth mental health in primary care: a participatory research design using mixed methods. BMJ Quality & Safety, 23(10), 857-66. https://doi.org/10.1136/bmjqs-2014-002842
Groenewald, Thomas (2004). A Phenomenological Research Design Illustrated. International Journal, 3(1), 1-26. https://doi.org/10.1177/160940690400300104
Horgan, Aine; Donovan, Moira O.; Manning, Fionnuala; Doody, Rory; Savage, Eileen; Dorrity, Claire; O’Sullivan, Hazel; Goodwin, John; Greaney, Sonya; Biering, Pall; Bjornsson, Einar; Bocking, Julia; Russell, Siobhan, Griffin, Martha; MacGabhann, Liam; Jan van der Vaart, Kornelis; Allon, Jerry; Granerud, Arild; Hals, Elisabeth; Pulli, Jarmo; Vatula, Annaliina; Ellilä, Heikki; Lahti, Mari & Happell, Brenda (2021). ‘Meet Me Where I Am’: Mental health service users’ perspectives on the desirable qualities of a mental health nurse. International Journal of Mental Health Nursing, 30(1), 136-147. https://doi.org/10.1111/inm.12768
Howarth, Caroline; Foster, Juliet & Dorrer, Nike (2004). Exploring the Potential of the Theory of Social Representations in Health Research - and vice versa? Journal of Health Psychology, 9(2), 229-243. https://doi.org/10.1177/1359105304040889
ISGlobal (2023). La Salud Mental en España. Barcelona Institute for Global Health. https://www.isglobal.org/en/-/salud-mental-espana-analisis-estrategia-recomendaciones
Jodelet, Denise (1991). Social representations. EDUERJ.
Jørgensen, Kim; Dahl, Mette B. & Frederiksen, Jesper (2020). Coherence in intersectoral collaboration between psychiatric centres and community mental healthcare: a critical discourse analysis. Nordic Journal of Nursing Research, 40(3), 130-141. https://doi.org/10.1177/2057158520935388
Jørgensen, Kim; Rasmussen, Tonie; Hansen, Morten; Andreasson, Kate & Karlsson, Bengt (2021). User Involvement in the Handover between Mental Health Hospitals and Community Mental Health: a critical discourse analysis. International Journal of Environmental and Research Public Health, 18(3352), 1-13. https://doi.org/10.3390/ijerph18073352
Keusch, Gerald; Wilentz, Joan & Kleinman, Arthur (2006). Stigma and global health: Developing a research agenda. Lancet, 367(9509), 525-527. https://doi.org/10.1016/S0140-6736(06)68183-X
Kleinman, Arthur & Benson, Peter (2006). Anthropology in the Clinic: The Problem of Cultural Competency and How to Fix It. PLoS Medicine, 3(10), 1673-1676. https://doi.org/10.1371/journal.pmed.0030294
Lacerda, Beatriz & Santos, Eduardo (2020). Media Representations on mental illness: a scoping review protocol. Millenium – education and social development, 2(7), 71-76. https://doi.org/10.29352/mill0207e.08.00364
Lee, Sing; Lee, Margaret T.Y; Chiu, Marcus Y.L. & Kleinman, Arthur (2005). Experience of social stigma by people with schizophrenia in Hong Kong. British Journal of Psychiatry, 186(2), 153-157. https://doi.org/10.1192/bjp.186.2.153
Maestre-Miquel, Clara; López-de-Andrés, Ana; Ji, Zichen; Miguel-Diez, Javier; Brocate, Arturo; Sanz-Rojo, Sara; López-Farre, Antonio; Carabantes-Alarcon, David; Jiménez-García, Rodrigo & Zamorano-León, José J. (2021). Gender Differences in the Prevalence of Mental Health, Psychological Distress and Psychotropic Medication Consumption in Spain: A Nationwide Population-Based Study. International Journal of Environmental Research and Public Health, 18(12), 1-15. https://doi.org/10.3390/ijerph18126350
McLaren, Thomas; Peter, Lina‑Jolien; Tomczyk, Samuel; Muehlan, Holger; Schomerus, Georg & Schmidt, Silke (2023). The Seeking Mental Health Care model: prediction of help‑seeking for depressive symptoms by stigma and mental illness representations. BMC Public Health, 23(69), 1-12. https://doi.org/10.1186/s12889-022-14937-5
Morant, Nicola (1995). What is Mental Illness? Social Representations of Mental Illness among British and French Mental Health Professionals. Papers on Social Representations, 4(1), 41-52.
Morant, Nicola (1998). The social representation of mental ill-health in communities of mental health practitioners in the UK and France. Social Science Information, 37(4), 663-685.
Morant, Nicola (2006). Social representations and professional knowledge: the representation of mental illness among mental health practitioners. British Journal of Social Psychology, 45, 817-838. https://doi.org/10.1348/014466605x81036
Moscovici, Serge (1973). Health and illness. A social psychological analysis. In Claudine Herzlich (Ed.), Health and illness. A social psychological analysis (pp. 9-14). Academic P.
Patel, Vikram; Saxena, Shekhar; Lund, Crick; Thornicroft, Graham; Baingana, Florence; Bolton, Paul; Chisholm, Dan; Collins, Pamela Y.; Cooper, Janice; Eaton, Julian; Herrman, Helen; Herzallah, Mohammad M.; Huang, Yueqin; Jordans, Mark; Kleinman, Arthur; Mora, Maria E. M.; Morgan, Ellen; Niaz, Unaiza; Omigbodun, Olayinka; Prince, Martin… Unutzer, Jurgen (2018). The Lancet Commission on global mental health and sustainable development. Lancet, 392(10157), 1553-1598. https://doi.org/10.1016/S0140-6736(18)31612-X.
Pope, Catherine; Ziebland, Sue & Mays, Nicholas (2000). Qualitative research in health care: analysing qualitative data. BMJ - Clinical Research, 320(7227), 114-116. https://doi.org/10.1136/bmj.320.7227.114
Ringer, Agnes & Holen, Mari (2016). “Hell no, they’ll think you’re mad as a hatter”: Illness discourses and their implications for patients in mental health practice. Health, 20(2), 161-175. https://doi.org/10.1177/1363459315574115.
Rodríguez, Francisco (2004). La representación social de la enfermedad y de la institución psiquiátrica en el paciente mental. Cuaderno Venezolano de Sociología, 13(2), 229-247.
Rogers, Anne; May, Carl & Oliver, Dianne (2001). Experiencing depression, experiencing the depressed: the separate worlds of patients and doctors. Journal of Mental Health, 10(3), 317-333. https://doi.org/10.1080/09638230020023840
Rose, Diana (2001). Users’ Voices: the perspectives of mental health service users on community and hospital care. Sainsbury Centre for Mental Health.
Schulze, Beate (2007). Stigma and mental health professionals: a review of the evidence on an intricate relationship. International Review of Psychiatry, 19(2), 137-155. https://doi.org/10.1080/09540260701278929
Trevillion, Kylee; Stuart, Ruth; Ocloo, Josephine; Broeckelmann, Eva; Jeffreys, Stephen; Jeynes, Tamar; Allen, Dawn; Russe, Jessica; Billings, Jo; Crawford, Mike J.; Dale, Oliver; Haigh, Rex; Moran, Paul; McNicholas, Shirley; Nicholls, Vicky; Foyel, Una; Simpson, Alan; Lloyd‑Evans, Brynmor; Johnson, Sonia & Oram, Sian (2022). Service user perspectives of community mental health services for people with complex emotional needs: a co-produced qualitative interview study. BMC Psychiatry, 22(55), 1-18. https://doi.org/10.1186/s12888-021-03605-4
World Health Organization [WHO] (2010). mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings: Mental Health Gap Action Programme (mhGAP). Autor.
World Health Organization [WHO] (2013). Mental Health Action Plan 2013-2020. Autor.
World Health Organization [WHO] (2014). Premature death among people with severe mental disorders. Autor.
World Health Organization [WHO] (2015). Data and Statistics: Prevalence of mental disorders. European Office. Department of Mental Health. http://www.euro.who.int/en/health-topics/noncommunicable-diseases/mental-health/data-and-statistics.
World Health Organization [WHO] (2022). World mental health report: transforming mental health for all. https://www.who.int/publications/i/item/9789240050860
Zamorano, Sara; Sáez-Alonso, María; González-Sanguino, Clara & Muñoz, Manuel (2023). Social stigma towards mental health problems in Spain: A systematic review. Clínica y Salud, 34(1), 23-34. https://doi.org/10.5093/clysa2023a5
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Drets d'autor (c) 2024 Liana Cristina Dalla Vecchia Pereira, Carlos Alberto Severo Garcia-Jr
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