Citation

Maulik PK, Devarapalli S, Kallakuri S, Tripathi AP, Koschorke M, Thornicroft G. Br. J. Psychiatry 2019; 214(2): 90-95.

Affiliation

Professor of Community Psychiatry,Centre for Global Mental Health and Centre for Implementation Science Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London,UK.

Copyright

(Copyright © 2019, Royal College of Psychiatry)

DOI

10.1192/bjp.2018.190

PMID

30681052

Abstract

BACKGROUND: Stigma related to mental health and lack of trained mental health professionals is a major cause for an increased treatment gap, particularly in rural India. The Systematic Medical Appraisal, Referral and Treatment (SMART) Mental Health project delivered a complex intervention involving task sharing, an anti-stigma campaign and use of technology-based, decision-support tools to empower primary care workers to identify and manage depression, anxiety, stress and suicide risk.AimsThe aim of this article is to report changes in stigma perceptions over three time points in the rural communities where the anti-stigma campaign was conducted.

METHOD: A multimedia-based anti-stigma campaign was conducted over a 3-month period in the West Godavari district of Andhra Pradesh, India. Following that, the primary care-based mental health service was delivered for 1 year. The anti-stigma campaign was evaluated in two villages and data were captured at three time points over a 24-month period (N = 1417): before and after delivery of the campaign and after completion of the health services delivery intervention. Standardised tools captured data on knowledge, attitude and behaviour towards mental health as well as perceptions related to help seeking for mental illnesses.

RESULTS: Most knowledge, attitude and behaviour scores improved over the three time points. Overall mean scores on stigma perceptions related to help seeking improved by -0.375 (minimum/maximum of -2.7/2.4, s.d. 0.519, P < 0.001) during this time. Loss to follow-up was 10%.

CONCLUSIONS: The data highlight the positive effects of an anti-stigma campaign over a 2-year period.Declaration of interestNone.

Language: en

Keywords

India; Stigma; community based; longitudinal analysis; mental health services