Tom Osborn: A new way to help young people with their mental health | TED

65,611 views ・ 2022-02-21

TED


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譯者: Lilian Chiu 審譯者: Helen Chang
00:04
Around the world and especially in low-resource countries
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在全世界,特別是像我的祖國 肯亞這種資源不多的國家,
00:07
like my home country of Kenya,
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00:09
mental health problems prevent young people
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心理健康問題讓年輕人無法過著
00:11
from living independent and successful lives.
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獨立、成功的生活。
00:16
I was born and raised in a small sugarcane farm.
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我在一個小型的 甘蔗農場出生、長大。
00:18
Some of my early memories are those of my younger brother and I
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我的兒時記憶包括我和我弟弟
00:22
walking around and pretending that we owned the sugarcane.
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跑來跑去,假裝我們擁有那些甘蔗。
00:26
But most of these memories were actually from school.
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不過大部分的兒時記憶 還是和學校有關。
00:30
My parents and especially my mother,
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我的父母,特別是我母親,
00:32
made sure that I knew how much they'd sacrificed
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確保我清楚知道他們做了 多少犧牲才讓我能接受教育,
00:35
for me to have the education
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00:36
and the path to success that they did not.
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有機會成功,這是他們沒有的。
00:39
They were very clear that the stakes were too high.
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他們表明得很清楚, 投入的賭注太高了。
00:43
There was no room for disappointment.
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沒有容許失望的空間,
00:45
There was no room for failure.
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沒有容許失敗的空間。
00:48
When I was 12,
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我十二歲時,
00:49
I moved to the boarding section of a local primary school.
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我搬到一間當地小學的寄宿區。
00:52
Here we will wake up at 4am to a set of math problems
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在那裡我們早上四點 要起床,面對一組
數學問題,且要在早餐前解決。
00:56
that we had to solve before breakfast.
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00:58
We'd only go to bed, sometimes after 11,
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我們還得解決晚上的 科學問題才能睡覺,
01:01
if we solved that night's science problems.
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有時會超過十一點。
01:04
In high school, the pressure was even higher.
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高中的壓力還更大。
01:08
The early-morning to late-night routines
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除了一天早到深夜的日常,
01:10
were now supplemented by Saturday and Sunday classes.
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現在還加上了星期六、日的課。
01:14
It was here in high school
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是在高中的時候,
01:16
where I began to notice the personal,
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我開始注到這個壓力鍋體制所造成的
01:18
emotional and behavioral toll that this pressure-cooker system
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個人、情緒,及行為上的打擊,
01:22
had exerted of myself and those around me.
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打擊的不僅是我,還有我身邊的人。
01:26
I noticed it, for example,
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我會注意到,是在,比如當我厭倦了
01:28
when tired of cramming the production of sulfuric acid,
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死背硫酸產物的時候,
01:31
I stopped taking notes or engaging with chemistry in 10th grade.
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我在十年級時就不再 做筆記或好好讀化學了。
01:36
I noticed it when my friend Onsongo
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我會注意到,是在我的朋友安松戈
01:39
tired that his life had been reduced to a letter grade,
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厭倦了他的人生只剩下成績的時候,
01:42
had enough and quit school.
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他受夠了,選擇退學。
01:44
I noticed it when a schoolmate, whom I will call Otieno,
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我會注意到,是在一位同學, 就稱他為歐提安諾,
01:48
took his own life.
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自殺的時候。
01:51
But all this time,
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但在這段時間,
01:54
all this time, what came to mind was that this was life.
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在這段時間,腦中想的 就只有「這就是人生」。
01:59
Life was trouble sleeping or sleeping too much.
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人生就是難以入眠或睡太多。
02:02
Life was little interest or pleasure in doing the things that gave you joy.
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人生就是去做你喜愛的事 也沒多少趣味或樂趣。
02:07
Life was constantly feeling down,
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人生就是經常覺得很低落,
02:10
crushing under the weight of the feelings of hopelessness.
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被毫無希望的感受給壓垮。
02:15
That was life.
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那就是人生。
02:17
It was only recently, some five years after high school,
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要到最近,大約是高中後五年,
02:21
that I began to realize that what we thought was life
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我才開始了解,我們以為的人生
02:24
could have, in fact, been mental health problems.
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有可能其實是心理健康問題。
02:27
Was it possible that we were struggling with depression and anxiety
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有沒有可能,我們當時 為憂鬱和焦慮所苦,
02:31
and just didn't know about it?
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只是自己不知道?
02:33
That, in fact, was the case.
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事實上的確是如此。
02:36
Studies now show that almost 50 percent of Kenyan adolescents
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研究指出現在有近五成的肯亞青少年
02:40
struggle with mental health problems.
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都為心理健康問題所苦。
02:43
And in such a youthful country,
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這個國家的人口十分年輕,
02:45
where half the population is 19 years or younger,
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有一半的人口是十九歲以下,
02:48
youth mental health has now become an urgent public health priority.
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青少年心理健康現在已經成為 迫切的公共衛生重點。
02:55
Over the past few years,
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在過去幾年間,我一直在努力
02:57
I've been working to turn this public health problem
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把這個公共衛生問題 轉變成年輕人的機會,
02:59
into an opportunity for young people
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03:01
to reimagine and redefine what mental health care could look like.
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來重新思考和重新定義 心理健康照護是什麼樣子。
03:05
We're doing this by tackling the three big issues
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我們的做法是去處理阻擋 年輕人求助的三大問題,
03:07
that prevent young people from getting help.
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03:10
One, the lack of mental health experts.
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第一,缺乏心理健康專家。
03:13
Two, the stigma around mental health.
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第二,心理健康的汙名。
03:15
And three, the sad reality that most mental health treatments
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第三,一個讓人感傷的事實: 大部分心理健康治療
03:19
were not built and designed for young people
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都不是針對外表、背景像我 這樣的年輕人所打造、設計。
03:21
who look like me and have my background.
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03:25
Because we have only two clinicians for every one million Kenyans,
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因為每一百萬肯亞人 只有兩位臨床醫生,
03:30
and two -- yes, only two --
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此外,兩位——對,只有兩位—— 兒童及青少年精神病醫生
03:32
child and adolescent psychiatrist in the whole country,
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要負責全國。
03:36
we are expanding mental health care access by training [18- to 22-year-old] Kenyans
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我們在努力讓心理健康照護更普及,
做法是訓練十八到二十二歲的肯亞人
03:42
as lay providers.
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成為非專業的照護提供者。
03:44
These young Kenyans are delivering evidence-based care to their peers
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這些肯亞年輕人能透過 有結構有層次的模型來提供
以證據為基礎的照護給他們的同儕,
03:49
through a structured and tiered model
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03:51
that ensures that all young people who want can get help.
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以確保想要取得 協助的年輕人都能如願。
03:55
Because of a stigma of mental health
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因為肯亞過去給心理健康 冠上的汙名至今仍然存在,
03:57
that still exists from Kenya's colonial past,
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04:00
we are delivering interventions
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我們所提供的介入治療 並不需要正式的心理健康診斷,
04:02
without a formal diagnosis of mental health,
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04:04
and our interventions focus on building character strengths,
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且我們的介入治療重點 在於建立性格優勢,
04:08
on strengthening individual autonomy
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在於強化個人的自主能力,
04:10
and on improving overall human functioning and well-being.
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在於改善整體 人類功能的發揮及幸福。
04:15
Because our lay providers work within the communities
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因為我們的非專業照護提供者, 是在自己所屬的社區中服務,
04:18
where they come from,
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04:19
in the school systems that they themselves went to
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在自己就讀過的學校體系中服務,
04:22
and deliver what is truly a for-youth and by-youth mental health care treatment,
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且提供的是真正 由年輕人為年輕人而做的
心理健康照護治療,
04:27
we are fixing the divide between mental health treatment
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我們在努力讓心理健康治療更接近
04:32
and the social and cultural needs of the communities that they serve.
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他們所服務的社區中的 社會和文化需求。
04:38
Since 2018, we have used this youth-based model
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從 2018 年起,我們開始用 這個以年輕人為基礎的模型
04:42
to bring mental health care across Kenya.
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將心理健康照護帶到肯亞各地。
04:46
And what we have found is that this model works.
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我們發現這個模型是行得通的。
04:50
Young people are reporting reductions in depression and anxiety symptoms.
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年輕人回報的憂鬱 和焦慮症狀在減少。
04:54
They’re reporting improvements in their social relationships
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他們回報社交關係有所改善,
04:57
and in their views about their abilities to change the world.
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也更能相信自己有能力改變世界。
05:01
And in what will make my mom happy,
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還有一點是我媽媽會 很樂見的,他們也回報
05:03
they are also reporting improvements in their academic grades.
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學校成績有所改善。
05:09
Mental health is not a Kenyan problem.
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心理健康不是肯亞的問題。
05:13
It is not an African problem.
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它不是非洲的問題。
05:16
This is a global problem.
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它是全球的問題。
05:18
We need big ideas to tackle this problem.
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我們需要大想法大計畫 來處理這個問題。
05:21
And our case for optimism is that our youth-oriented,
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樂觀的是,我們這個年輕人 導向且著重社區的模型
05:24
community-focused model can be a template for the rest of the world.
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可以當作樣板給全世界參考。
05:30
One other early memory from childhood
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還有一段兒時記憶,
05:32
is a story that my grandmother, Yunita, told me.
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是我祖母尤妮塔告訴我的故事。
05:36
A long time ago, before the sugarcane farms,
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很久以前,
在甘蔗農場之前,
05:39
before the grass-thatched huts and the round compounds,
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在茅草小屋之前,在圓形大院之前,
05:43
the animals lived happily because there was plenty in the land
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動物快樂地生活著,因為土地充足,
05:46
and a future to look forward to.
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也有可期待的未來。
05:49
But farming threatened the land,
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但農業威脅到了土地, 突然間,未來變得毫無希望。
05:51
and the future was all of a sudden bleak.
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05:54
And so the lion roared.
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於是,獅子怒吼了。
05:56
But there was no water.
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但沒有水。
05:58
And the elephant grunted.
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大象也叫起來。
06:00
But there was no water.
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但沒有水。
06:03
And the cheetah yelped,
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獵豹也叫起來,
06:05
but there was no water.
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但沒有水。
06:06
But when the young antelope asked them to come together
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但當年輕的羚羊要牠們 集結起來建立水井,
06:09
and build a well, there was water.
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就有水了,
06:13
There was a future.
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就有未來了,
06:14
There was hope.
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就有希望了。
06:16
This is our young antelope moment.
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此刻就是我們的年輕羚羊時刻,
06:20
Let us come together and let us build a world
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讓我們集結起來建造一個世界
06:22
where all young people, all over the world can flourish and thrive.
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讓世界各地所有年輕人 都能夠活躍、成功。
06:27
Thank you.
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謝謝。
06:28
(Applause)
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(掌聲)
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