研究背景：随着经济社会的快速发展，精神障碍患病率呈逐年增加趋势。据国家卫生健康委统计数据，我国严重精神障碍患者约1600万人。精神卫生问题已成为我国的重大公共卫生问题，也是较为严重的社会问题。严重精神障碍的致残率较高，对患者自身的身体健康和心理健康都带来了很大的负面影响，也给患者家属带来了很大的经济压力和心理压力。国际研究表明，精神障碍的治疗不仅仅以药物治疗为主，治疗过程中应积极关注患者的心理健康，已成为提升严重精神障碍疾病治疗效果的必要辅助手段，提升患者的心理健康水平有助于患者病情的控制与恢复。因此，本研究从社会工作的视角出发，以稳定期严重精神障碍患者为研究对象，在了解其社会支持、自我病耻感及积极心理健康水平的基础上，运用定性和定量相结合的方式，在中国文化背景下探究在三个变量之间的相关关系，为后续开展提高患者积极心理健康水平相关的干预措施提供数据支持。

研究方法：本研究在广东省江门市某区精神卫生专科医院的支持下，首先通过判断抽样的方法，由经医生对患者病情进行全面评估，以筛选出病情处于稳定期的患者，作为研究对象。其次，利用家属入院探访的时机，由经过培训的调研员对患者及家属开展问卷调查，以获取患者基本人口学特征、社会支持水平、自我病耻感及积极心理健康水平相关信息。最终获取了住院及该医院所辐射管理社区病情处于稳定期的66名严重精神障碍患者信息。受新冠疫情这一不可控因素影响，现场问卷调查无法持续开展，导致本研究样本量较小。本研究采用通过电话访谈的形式对该院主管临床的副院长（主任医师）、精神卫生防治科主任进行了深度访谈，从卫生服务供方了解该区精神卫生防控和管理工作具体开展情况，尤其了解了家庭负担、患者治疗情况、患者及其家属病耻感、区域社会支持体系的构建情况；同时在精神卫生防治科的协助下，联系到了当时参与问卷调查的6名患者家属，通过线上座谈的方式开展了访谈，从卫生服务的需方了解社会支持、自我病耻感、患者康复及患者精神状态等情况，以对定量分析结果作以补充。

Background: With the rapid development of economy and society, the prevalence of mental disorders is increasing year by year. According to the statistics of National Health Commission, there are about 16 million patients with severe mental disorders in China. Mental health problem has become a major public health problem in China, and it is also a serious social problem. The disability rate of severe mental disorders is high, which has a great negative impact on patients' own physical and mental health, and also brings great economic and psychological pressure to patients' families. International research shows that the treatment of mental disorders is not only based on drug therapy, but also the mental health of patients should be actively paid attention to in the treatment process, which has become a necessary auxiliary means to improve the treatment effect of severe mental disorders. Improving the mental health level of patients is helpful to the control and recovery of patients' condition. Therefore, from the perspective of social work, this study takes patients with severe mental disorders in stable stage as the research object, and on the basis of understanding their social support, self-stigma and positive mental health level, it uses a combination of qualitative and quantitative methods to explore the correlation among the three variables under the background of Chinese culture, so as to provide data support for the follow-up intervention measures to improve patients' positive mental health level.Therefore, from the perspective of social work, this study takes patients with severe mental disorders in stable stage as the research object, and on the basis of understanding their social support, self-stigma and positive mental health level, it uses a combination of qualitative and quantitative methods to explore thecorrelation among the three variables under the background of Chinese culture, so as to provide data support for the follow-up intervention measures to improve patients' positive mental health level.

Methods: With the support of a mental health hospital in Jiangmen City, Guangdong Province, this study firstly conducted a comprehensive evaluation of patients' condition by doctors through the method of judgment sampling, so as to select patients with stable condition as the research object. Secondly, taking advantage of the opportunity of family members' hospital visits, the trained researchers conducted a questionnaire survey on patients and their families, so as to obtain information about the basic demographic characteristics, social support level, self-stigma and positive mental health level of patients. Finally, the information of 66 patients with severe mental disorders who were hospitalized and in the radiation management community of this hospital.Affected by the uncontrollable factor of COVID-19 epidemic, the on-site questionnaire survey can't be carried out continuously, resulting in a small sample size in this study. In this study, we conducted in-depth interviews with the vice president (chief physician) in charge of clinic and the director of mental health prevention and control department in our hospital by telephone interview, and learned about the specific development of mental health prevention and control and management in this area from health service providers, especially about family burden, treatment of patients, stigma of patients and their families, and the construction of regional social support system. At the same time, with the help of the Department of Mental Health Prevention and Control, the families of six patients who participated in the questionnaire survey at that time were contacted, and interviews were conducted through online discussion, so as to learn about social support, self-stigma, patients' recovery and patients' mental state from the demanders of health services, so as to supplement the quantitative analysis results.

Results: The average score of patients' social support level was 38.64(SD=5.74), the score of self-ill shame was 64.68(SD=12.96), and the score of positive mental health was 34.51 (SD = 15.39). There is a significant positive correlation between subjective support and positive mental health (β=0.341,p＜0.05).No matter from the interviews of suppliers or demanders, it is found that the construction of social support system in this area has played a positive role in patients' rehabilitation and disease control. To some extent, this explains the reality that the data of this study show a good level of social support and a medium level of positive mental health. From the supplier's point of view, the following work has been mainly carried out: (1) Treating patients' condition by implementing comprehensive treatment; (2) To help patients return to society by developing day hospitals; (3) Strengthen assistance to help patients build a harmonious neighborhood; (4) Carry out rescue services to help patients' families relieve mental stress. From the perspective of demand side, family members have obvious perception of social support: (1) the proportion of medical reimbursement has increased, and the economic burden has been reduced; (2) To help patients' condition control through regular drug delivery to their homes; (3) Neighborhood help each other and help patients and their families integrate into the community; (4) Hospitals take the lead to help some patients find jobs;(5) The mental stress of patients' families was relieved.

Conclusion: Through data analysis, it is found that there is a significant positive correlation between subjective support level, anti-stigma factors and positive mental health level of patients with severe mental disorders. The interview data from both the supplier and the demander also proved this point, because the Institute has improved the social support level of patients and their families as a whole by building and perfecting the social support system in the district, and has played a positive role in helping patients' disease control and rehabilitation.

Recommendations: For a medical social worker, (1) to help patients and their families link social resources, carry out targeted intervention services, and build and improve social support networks, so as to improve the social support level of patients and their families, and help patients control and recover; (2) Starting from the community environment in which patients live, the acceptance of community residents can be improved through health publicity, so that patients can have a friendly treatment and rehabilitation environment and help patients improve their positive mental health level.