Reducing stigma and improving access to care for people with mental health conditions in the community: protocol for a multi-site feasibility intervention study (Indigo-Local).

Autor:	Semrau M; Brighton and Sussex Medical School., Gronholm PC; King's College London., Eaton J; London School of Hygiene & Tropical Medicine., Maulik PK; George Institute for Global Health., Ayele B; Addis Ababa University., Bakolis I; King's College London., Mendon GB; National Institute of Mental Health and Neurosciences., Bhattarai K; Transcultural Psychosocial Organization (TPO)., Brohan E; King's College London., Cherian AV; National Institute of Mental Health and Neurosciences., Daniel M; George Institute for Global Health., Girma E; Addis Ababa University., Gurung D; Transcultural Psychosocial Organization (TPO)., Hailemariam A; Addis Ababa University., Hanlon C; King's College London., Healey A; King's College London., Kallakuri S; George Institute for Global Health., Li J; The Affiliated Brain Hospital of Guangzhou Medical University., Loganathan S; National Institute of Mental Health and Neurosciences., Ma N; Peking University Sixth Hospital, Peking University Institute of Mental Health., Ma Y; The Affiliated Brain Hospital of Guangzhou Medical University., Metsahel A; Razi University Hospital., Ouali U; Razi University Hospital., Yaziji N; King's College London., Zgueb Y; Razi University Hospital., Zhang W; Peking University Sixth Hospital, Peking University Institute of Mental Health., Zhang X; Peking University Sixth Hospital, Peking University Institute of Mental Health., Thornicroft G; King's College London., Votruba N; University of Oxford.
Jazyk:	angličtina
Zdroj:	Research square [Res Sq] 2023 Aug 18. Date of Electronic Publication: 2023 Aug 18.
DOI:	10.21203/rs.3.rs-3237562/v1
Abstrakt:	Background: Stigma and discrimination towards people with mental health conditions by their communities are common worldwide. This can result in a range of negative outcomes for affected persons, including poor access to health care. However, evidence is still patchy from low- and middle-income countries (LMICs) on affordable, community-based interventions to reduce mental health-related stigma and to improve access to mental health care. Methods: This study aims to conduct a feasibility (proof-of-principle) pilot study that involves developing, implementing and evaluating a community-based, multi-component, public awareness-raising intervention (titled Indigo-Local), designed to reduce stigma and discrimination and to increase referrals of people with mental health conditions for assessment and treatment. It is being piloted in five LMICs - China, Ethiopia, India, Nepal and Tunisia - and includes several key components: a stakeholder group workshop; a stepped training programme (using a 'Training of Trainers' approach) of community health workers (or similar cadres of workers) and service users that includes repeated supervision and booster sessions; awareness-raising activities in the community; and a media campaign. Social contact and service user involvement are instrumental to all components. The intervention is being evaluated through a mixed-methods pre-post study design that involves quantitative assessment of stigma outcomes measuring knowledge, attitudes and (discriminatory) behaviour; quantitative evaluation of mental health service utilization rates (where feasible in sites); qualitative exploration of the potential effectiveness and impact of the Indigo-Local intervention; a process evaluation; implementation evaluation; and an evaluation of implementation costs. Discussion: The outcome of this study will be contextually adapted, evidence-based interventions to reduce mental health-related stigma in local communities in five LMICs to achieve improved access to healthcare. We will have replicable models of how to involve people with lived experience as an integral part of the intervention and will produce knowledge of how intervention content and implementation strategies vary across settings. The interventions and their delivery will be refined to be acceptable, feasible and ready for larger-scale implementation and evaluation. This study thereby has the potential to make an important contribution to the evidence base on what works to reduce mental health-related stigma and discrimination and improve access to health care. Competing Interests: Declarations Competing interests The authors declare that they have no competing interests.
Databáze:	MEDLINE
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