Background In rural areas of low- and middle- income countries, mental health care is often unavailable and inaccessible, and stigma is a major barrier to treatment. Destigmatization can increase treatment-seeking attitudes, community support, and acceptance of individuals suffering from mental illness. This study’s primary objective was to evaluate the impact of a community-led, theater-based destigmatization campaign for mental illness conducted in the Busoga region of Eastern Uganda. Methods One hundred residents of the Busoga region were randomly selected via cluster sampling to complete a structured questionnaire assessing mental health stigma. Four focus groups were conducted for qualitative data on mental health stigma. Common misconceptions and specific points of stigma were identified from these responses, and local village health team personnel developed and performed a culturally-adapted theatrical performance addressing these points. Changes in perceptions of mental illness were measured among 57 attendees using two measures, the Broad Acceptance Scale (designed to reflect factors that contribute to structural stigma) and Personal Acceptance Scale (designed to reflect factors that contribute to interpersonal, or public stigma), before and after the performance. Results There was a significant increase in acceptance according to the Broad Acceptance Scale (p < .001) and Personal Acceptance Scale (p < .001). Qualitative responses from play attendees also indicated a decrease in stigma and an increased sense of the importance of seeking treatment for mentally ill patients. Conclusion This study shows community-led, theater intervention may be an effective tool for the destigmatization of mental illness in rural areas of Uganda. Larger studies are needed to further test the efficacy of this approach and potential for longer-term scalabilityand sustainability.

Purpose Evaluate the long-term effectiveness of a community-led theatrical intervention in reducing mental health stigma in a low-income setting in Uganda. Methods A follow-up survey of study participants was conducted 12 months after the initial community-led theatrical intervention measuring the primary outcomes of mental illness stigma using the Broad Acceptance Scale (BAS) and the Personal Acceptance Scale (PAS). Results Of the initial 57 participants, 46 (80%) completed the follow-up survey. The average improvement in Broad Acceptance Scale and Personal Acceptance Score observed from baseline to twelve months after the intervention was 1.435 (95% CI: 0.826–2.044, p < 0.0001, SD: 1.64) and 2.152 (95% CI: 1.444–2.860, p < 0.0001, SD: 1.93), respectively. Both effect sizes were within the confidence intervals of the average improvement observed one week after the intervention. Conclusion Exposure to the community-led theatrical intervention continued to confer a significant and substantial reduction in mental illness stigma.