Efficacy of an Intervention to Reduce Stigma Beliefs and Attitudes among Primary Care and Mental Health Professionals: Two Cluster Randomised-Controlled Trials.

Although it may seem paradoxical, primary care and mental health professionals develop prejudices and discriminatory attitudes towards people with mental health problems in a very similar way to the rest of the population. The main objective of this project was to design, implement and evaluate two awareness-raising interventions respectively tailored to reduce stigmatising beliefs and attitudes towards persons with a mental health diagnosis among primary care (PC) and mental health (MH) professionals. These interventions were developed by Obertament, the Catalan alliance against stigma and discrimination in mental health. Activists from this organisation with lived experience of mental health diagnosis carried out awareness-raising interventions in PC and MH health centres. The Targeted, Local, Credible, Continuous Contact (TLC3) methodology was adapted to the Catalan healthcare context. The efficacy of these interventions was evaluated using two prospective double-blind cluster-randomised-controlled trials. Stigmatizing beliefs and behaviours were measured with the Opening Minds Stigma Scale for Health Care Providers in PC centres and with the Beliefs and Attitudes towards Mental Health Service users' rights in MH centres. Reductions in both PC and MH professionals' stigmatising beliefs and attitudes were found in the 1-month follow-up, although a 'rebound effect' at the 3-month follow up was detected. This emphasizes the importance of the continuity of the presence of anti-stigma activities and messages. Attrition rates were high, which can hamper the reliability of the results. Further follow-up studies should enquiry effects of long-term interventions aimed at reducing stigmatising beliefs and attitudes among primary care and mental health professionals using assessment systems that include the measurement of knowledge acquired and actual behavioural change.

Training mental health activists increases the well-being of participants with high baseline levels of self-stigma: Results of the Obertament training evaluation.

There is a strong interest in improving the quality of anti-stigma contact-based interventions. Hence, some mental health anti-stigma campaigns offer prior training to their activists with lived experience of mental disorders. Additionally, collective mobilization seems to impact the identity and well-being of its participants. The main objective of this work was to understand the impact that activism training activities have on the internalized/self-stigma and well-being of activists being trained by the Obertament alliance against stigma in mental health. The Internalized Stigma of Mental Illness Inventory and the Pemberton Happiness Index were used to measure internalized stigma and well-being, respectively, at the beginning and the end of anti-stigma training courses. Sixty-eight activists receiving training were enrolled within a pretest, posttest, 1-group design. A total of 39 participants were included in repeated measures calculations. Twenty-seven participants did not complete the total training schedule and two more did not complete baseline assessment. Our results show generalized increases in well-being and decreases in the internalized stigma of participants. Additionally, a covariation between these changes was found. To further illustrate this covariation, separate groups were created using the baseline median. Hence, greater increases in well-being were for those participants with higher levels of baseline self-stigma and vice versa. This article shows the importance of addressing internalized stigma among mental health activists, thus boosting their recovery process. (PsycINFO Database Record (c) 2018 APA, all rights reserved).