Abstract
BackgroundLaunched in 2018, Time to Change Global is a new anti-stigma programme to tackle stigma and discrimination towards people with mental health problems in low- and middle-income countries. Our aim was to evaluate pre-post changes in stigma within the target populations for the social marketing campaigns ran in Ghana and Kenya carried out as components of the wider Time to Change Global programme.MethodsUsing data collected before and after each campaign in Accra and Nairobi, we investigated pre-post differences in stigma-related outcome measures: mental health-related knowledge (MAKS), mental health-related attitudes (CAMI), and desire for social distance (RIBS), with regression analyses. Other covariates were included in the models to control for differences in participant demographics.ResultsA significant positive change in a stigma related outcome was found at each site. Reported in standard deviation units, desire for social distance from people with mental health problems in Accra was lower after the launch of the campaign, measured as an increase in intended contact (β = 0.29, 95% CI = 0.14 to 0.43, p < 0.001). In Nairobi, the stigma related knowledge score was higher in the post campaign sample (β = 0.21, 95% CI = 0.07 to 0.34, p = 0.003).ConclusionThe increase in intended contact in the absence of other changes seen in Ghana, is consistent with the early results for Time to Change England. The estimate for the magnitude of this change is the same as Time to Change England for the general population between 2009 and 19, a very promising result for a short term public mental health campaign. The different results observed between sites may be due to campaign as well as population differences.
Highlights
Launched in 2018, Time to Change Global is a new anti-stigma programme to tackle stigma and discrimination towards people with mental health problems in low- and middle-income countries
Most research on stigma reduction interventions has been conducted in high income countries (HICs) [4], and there is a growing literature on stigma reduction interventions in low- and middle- income countries (LMICs) [5]
We investigate whether stigma outcomes vary by demographic groups, as this information can inform the design of subsequent campaigning
Summary
Launched in 2018, Time to Change Global is a new anti-stigma programme to tackle stigma and discrimination towards people with mental health problems in low- and middle-income countries. Structural level stigma and discrimination is apparent from the lack of priority often given to mental health on the part of policymakers, and from the abuses of human rights in psychiatric institutions across countries of all income levels [2]. Lack of knowledge and stigmatising beliefs have been identified as a barrier to mental health care [3]. In HICs there is evidence that when combined with other strategies its use is associated with population level changes in stigma related outcomes [6,7,8]
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