Evaluation of an anti-stigma campaign related to common mental disorders in rural India: a mixed methods approach

Abstract

BackgroundStigma related to mental health is a major barrier to help-seeking resulting in a large treatment gap in low- and middle-income countries (LMIC). This study assessed changes in knowledge, attitude and behaviour, and stigma related to help-seeking among participants exposed to an anti-stigma campaign.MethodThe campaign, using multi-media interventions, was part of the SMART Mental Health Project, conducted for 3 months, across 42 villages in rural Andhra Pradesh, in South India. Mixed-methods evaluation was conducted in two villages using a pre-post design.ResultsA total of 1576 and 2100 participants were interviewed, at pre- and post-intervention phases of the campaign. Knowledge was not increased. Attitudes and behaviours improved significantly (p < 0.01). Stigma related to help-seeking reduced significantly (p < 0.05). Social contact and drama were the most beneficial interventions identified during qualitative interviews.ConclusionThe results showed that the campaign was beneficial and led to improvement of attitude and behaviours related to mental health and reduction in stigma related to help-seeking. Social contact was the most effective intervention. The study had implications for future research in LMIC.

Longitudinal assessment of an anti-stigma campaign related to common mental disorders in rural India

“…First, our use of a ‘social contact’ (in the form of a video of a person with mental illness narrating their experience) did not seem to have been used explicitly by the other two projects. Social contact is perceived as the most effective intervention for an anti-stigma campaign, 2 in agreement with our observations 8 . Second, in this article we are reporting the longitudinal outcomes of the intervention, whereas the other two studies only provide cross-sectional data.…”

“…The key components of this complex intervention focused on the delivery of mental health services for common mental disorders (CMDs) (stress, depression and suicide risk) and involved: conducting an anti-stigma campaign prior to the delivery of health services across the villages; training of primary healthcare workers, i.e. lay village health workers known as Accredited Social Health Activists (ASHAs), and doctors on evidence-based tools; developing a mobile technology-based, electronic decision-support system based on those tools to facilitate the work of the health workers and doctors; and developing a system that provided a mechanism to follow-up with people with identifiable CMD using cloud computing and voice messages delivered through an algorithm-based, interactive voice-response system that provided reminders to patients, health workers and doctors 7 , 8 …”

Barriers to Professional Help-seeking for Distress and Potential Utility of a Mental Health App Components: Stakeholder Perspectives

“…The improvement observed in one's health and contact with others who have similar conditions were reported to be facilitators of continued utilization of services. Contact with others who have the same condition, in direct or indirect ways, and group-based intervention can be useful for reducing stigma and decreasing a sense of isolation [26,27]. Availing services in a community-based well-being center rather than a crowded hospital setting was another factor that encouraged continued engagement with mental health services in the present sample.…”

Perceptions of Asha Workers in the Hope Collaborative Care Mental Health Intervention in Rural South India: A Qualitative Analysis

“…This is additional evidence that ASHA workers' beliefs and knowledge are receptive to change [1,7]. Nevertheless, ASHA workers are rarely targeted by community mental health awareness campaigns [12,27]. Considering the importance of ASHA workers in rural healthcare and their increasing participation in mental health interventions [5,13,21,28], they should be included in mental health education efforts.…”