Nervenheilkunde 2019; 38(01): 30-34
DOI: 10.1055/a-0813-9493
Schwerpunkt
Georg Thieme Verlag KG

In Würde zu sich stehen – Ein peer-geleitetes Gruppenprogramm für Jugendliche mit psychischen Erkrankungen

Honest, Open, Proud – a peer-led group program for adolescents with mental illness
Nicolas Rüsch
1   Klinik für Psychiatrie und Psychotherapie II der Universität Ulm am BKH Günzburg
,
Luise Nehf
1   Klinik für Psychiatrie und Psychotherapie II der Universität Ulm am BKH Günzburg
,
Julia Djamali
1   Klinik für Psychiatrie und Psychotherapie II der Universität Ulm am BKH Günzburg
,
Nadine Mulfinger
2   Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm
,
Sabine Müller
3   Klinik für Kinder- und Jugendpsychiatrie und –psychotherapie, Universitätsklinikum Ulm
› Author Affiliations
Further Information

Publication History

Publication Date:
22 February 2019 (online)

ZUSAMMENFASSUNG

Angesichts in der Gesellschaft verbreiteter stigmatisierender Einstellungen kämpfen Jugendliche mit psychischen Erkrankungen häufig mit der Entscheidung, ob sie Anderen von ihrer Erkrankung berichten sollen. Die Entscheidung für oder gegen Offenlegung stellt dabei oft eine Schlüsselreaktion im Umgang mit Stigmatisierung dar. Offenlegung und Geheimhaltung können Vor- und Nachteile haben, je nach Kontext und Person. ,In Würde zu sich stehen‘ (IWS) ist ein peer-geleitetes Gruppenprogramm, um Jugendliche bei solchen Offenlegungsentscheidungen zu unterstützen. Hier werden Grundlagen, Ansatz, Aufbau, Inhalt und Daten zu Wirksamkeit sowie Erfahrungen mit IWS für Jugendliche vorgestellt. Eine randomisiert-kontrollierte Studie mit überwiegend in stationärer kinder- und jugendpsychiatrischer Behandlung befindlichen Jugendlichen zeigte signifikante positive Effekte von IWS auf Stigma-Variablen (Selbststigma, Stigma-Stress) sowie auf Lebensqualität, depressive Symptomatik, Recovery und Einstellungen zu Behandlungsteilnahme. Schließlich werden Implikationen für die Implementierung und Stigma-Interventionen diskutiert.

ABSTRACT

Due to public stigma, many adolescents with mental illness struggle with the decision whether to disclose their condition to others. This decision is often a key reaction in coping with public stigma and self-stigma. Disclosure and secrecy have risks as well as benefits, depending on the person and the context. „Honest, Open, Proud“ is a peer-led group program to support adolescents with mental illness in their disclosure decisions. Here we explain the concept, approach, structure and content of HOP. We also present data on its efficacy and experiences with HOP for adolescents with mental illness. A recent randomized controlled trial with adolescents, who mainly received inpatient psychiatric treatment at the time of the study, showed significant positive effects of HOP on stigma variables (self-stigma, stigma stress) as well as on quality of life, depressive symptoms, recovery and attitudes to help-seeking. Implications for program implementation and anti-stigma interventions are discussed.

 
  • Literatur

  • 1 Kaushik A, Kostaki E, Kyriakopoulos M. The stigma of mental illness in children and adolescents: A systematic review. Psychiatry Research 2016; 243: 469-94.
  • 2 Patel V, Flisher AJ, Hetrick S, McGorry P. Mental health of young people: a global public-health challenge. Lancet 2007; 369 9569 1302-13.
  • 3 Rüsch N, Angermeyer MC, Corrigan PW. Das Stigma psychischer Erkrankung: Konzepte, Formen und Folgen. Psychiatrische Praxis 2005; 32: 221-32.
  • 4 Corrigan PW, Larson JE, Rüsch N. Self-stigma and the “why try” effect: Impact on life goals and evidence-based practices. World Psychiatry 2009; 8: 75-81.
  • 5 Rüsch N, Müller M, Heekeren K, Theodoridou A, Metzler S, Dvorsky D. et al. Longitudinal course of self-labeling, stigma stress and well-being among young people at risk of psychosis. Schizophrenia Research 2014; 158 1–3 82-4.
  • 6 Rüsch N, Heekeren K, Theodoridou A, Müller M, Corrigan PW, Mayer B. et al. Stigma as a stressor and transition to schizophrenia after one year among young people at risk of psychosis. Schizophrenia Research 2015; 166: 43-8.
  • 7 Rüsch N, Oexle N, Reichhardt L, Ventling S. In Würde zu sich stehen – Konzept und Wirksamkeit eines peer-geleiteten Programms zu Offenlegung und Stigma-Bewältigung. Psychiatrische Praxis 2019. doi: 10.1055/a-0800-3695.
  • 8 Moses T. Self-labeling and its effects among adolescents diagnosed with mental disorders. Social Science & Medicine 2009; 68 (Suppl. 03) 570-8.
  • 9 Moses T. Stigma and self-concept among adolescents receiving mental health treatment. American Journal of Orthopsychiatry 2009; 79 (Suppl. 02) 261-74.
  • 10 Rose D, Thornicroft G. Service user perspectives on the impact of a mental illness diagnosis. Epidemiologia e Psichiatria Sociale 2010; 19 (Suppl. 02) 140-7.
  • 11 Perkins A, Ridler J, Browes D, Peryer G, Notley C, Hackmann C. Experiencing mental health diagnosis: a systematic review of service user, clinician, and carer perspectives across clinical settings. Lancet Psychiatry 2018; 5 (Suppl. 09) 747-764.
  • 12 Thoits PA. “I’m not mentally ill”: Identity deflection as a form of stigma resistance. Journal of Health and Social Behavior 2016; 57 (Suppl. 02) 135-51.
  • 13 Moses T. Determinants of mental illness stigma for adolescents discharged from psychiatric hospitalization. Social Science & Medicine 2014; 109: 26-34.
  • 14 Lysaker PH, Roe D, Yanos PT. Toward understanding the insight paradox: internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders. Schizophrenia Bulletin 2007; 33 (Suppl. 01) 192-9.
  • 15 Quinn DM. When stigma is concealable: The costs and benefits for health. In: Major B, Dovidio JF, Link BG. editors. The Oxford Handbook of Stigma, Discrimination, and Health. Oxford: Oxford University Press; 2018: 287-300.
  • 16 Rüsch N, Corrigan PW, Waldmann T, Staiger T, Bahemann A, Oexle N. et al. Attitudes toward disclosing a mental health problem and reemployment: A longitudinal study. Journal of Nervous and Mental Disease 2018; 206 (Suppl. 05) 383-5.
  • 17 Rüsch N, Malzer A, Oexle N, Waldmann T, Staiger T, Bahemann A. et al. Disclosure and quality of life among unemployed individuals with mental health problems: a longitudinal study. Journal of Nervous and Mental Disease 2019 doi: 10.1097/NMD.0000000000000914.
  • 18 Corrigan PW, Kosyluk KA, Rüsch N. Reducing self-stigma by coming out proud. American Journal of Public Health 2013; 103 (Suppl. 05) 794-800.
  • 19 Mulfinger N, Müller S, Böge I, Sakar V, Corrigan PW, Evans-Lacko S. et al. Honest, Open, Proud for adolescents with mental illness: Pilot randomized controlled trial. Journal of Child Psychology & Psychiatry 2018; 59 (Suppl. 06) 684-91.
  • 20 Mulfinger N, Rüsch N, Bayha P, Müller S, Böge I, Sakar V. et al. Secrecy versus disclosure of mental illness among adolescents: I. The perspective of adolescents with mental illness. Journal of Mental Health 2019; doi: 10.1080/09638237.2018.1487535.
  • 21 Mulfinger N, Rüsch N, Bayha P, Müller S, Böge I, Sakar V. et al. Secrecy versus disclosure of mental illness among adolescents: II. The perspective of relevant stakeholders. Journal of Mental Health 2019; doi: 10.1080/09638237.2018.1487537.
  • 22 Rüsch N, Abbruzzese E, Hagedorn E, Hartenhauer D, Kaufmann I, Curschellas J. et al. Efficacy of Coming Out Proud to reduce stigma’s impact among people with mental illness: pilot randomised controlled trial. British Journal of Psychiatry 2014; 204: 391-7.
  • 23 Corrigan PW, Larson JE, Michaels PJ, Buchholz BA, Del Rossi R, Javier M. et al. Diminishing the self-stigma of mental illness by Coming Out Proud. Psychiatry Research 2015; 229 1–2 148-54.