Supernatural Causes Research Articles

Building an explanatory model for snakebite envenoming care in the Brazilian Amazon from the indigenous caregivers' perspective.

In the Brazilian Amazon, snakebite envenomings (SBE) disproportionately affect indigenous peoples. Communication between indigenous and biomedical health sectors in regards to SBEs has never been explored in this region. This study aims to build an explanatory model (EM) of the indigenous healthcare domain for SBE patients from the perspective of the indigenous caregivers. This is a qualitative study involving in-depth interviews of eight indigenous caregivers who are representatives of the Tikuna, Kokama and Kambeba ethnic groups, in the Alto Solimões River, western Brazilian Amazon. Data analysis was carried out via deductive thematic analysis. A framework was built containing the explanations based on three explanatory model (EM) components: etiology, course of sickness, and treatment. To indigenous caregivers, snakes are enemies and present conscience and intention. Snakebites have a natural or a supernatural cause, the last being more difficult to prevent and treat. Use of ayahuasca tea is a strategy used by some caregivers to identify the underlying cause of the SBE. Severe or lethal SBEs are understood as having been triggered by sorcery. Treatment is characterized by four components: i) immediate self-care; ii) first care in the village, mostly including tobacco smoking, chants and prayers, combined with the intake of animal bile and emetic plants; iii) a stay in a hospital, to receive antivenom and other treatments; iv) care in the village after hospital discharge, which is a phase of re-establishment of well-being and reintroduction into social life, using tobacco smoking, massages and compresses to the affected limb, and teas of bitter plants. Dietary taboos and behavioral interdictions (avoiding contact with menstruating and pregnant women) prevent complications, relapses, and death, and must be performed up to three months after the snakebite. Caregivers are in favor of antivenom treatment in indigenous areas. There is a potential for articulation between different healthcare sectors to improve the management of SBEs in the Amazon region, and the aim is to decentralize antivenom treatment so that it occurs in indigenous health centers with the active participation of the indigenous caregivers.

Isolated sleep paralysis: Clinical features, perception of aetiology, prevention and disruption strategies in a large international sample

Study objectivesIsolated sleep paralysis is a benign but frightening condition characterised by a temporary inability to move at sleep onset or upon awakening. Despite the prevalence of this condition, little is known concerning its clinical features, associated demographic characteristics, and prevention as well as disruption strategies. MethodsAn online cross-sectional study was conducted. The sample comprised 3523 participants who had reported at least one lifetime episode of ISP and 3288 participants without a lifetime episode. Participants answered a survey including questions about sleep quality, sleep paralysis, and sleep paralysis prevention/disruption techniques. ResultsA total of 6811 participants were investigated (mean age = 46.9, SD = 15.4, age range = 18–89, 66.1% female). Those who reported experiencing ISP at least once during their lives reported longer sleep onset latencies, shorter sleep duration, and greater insomnia symptoms. Females (vs. male) and younger (vs. older) participants were more likely to experience ISP. Significant fear during episodes was reported by 76.0% of the participants. Most people (63.3%) who experienced ISP believed it to be caused by ‘something in the brain’. A minority endorsed supernatural causes (7.1%). Five prevention strategies (e.g., changing sleep position, adjusting sleep patterns) with at least 60.0% effectiveness, and five disruption strategies (e.g., physical/bodily action, making noise) with varying degrees of effectiveness (ranging from 29.5 to 61.8) were identified through open-ended responses. ConclusionsISP is associated with shorter sleep duration, longer sleep onset latency, and greater insomnia symptoms. The multiple prevention and disruption techniques identified in this study support existing treatment approaches and may inform subsequent treatment development. Implications for current diagnostic criteria are discussed.

The Kalām Cosmological Argument Meets the Mentaculus

According to the orthodox interpretation of bounce cosmologies, the universe was born from an entropy reducing phase in a previous universe. To defend the thesis that the whole of physical reality was caused to exist a finite time ago, William Lane Craig and co-author James Sinclair have argued the low entropy interface between universes should instead be understood as the beginning of two universes. Here, I present Craig and Sinclair with a dilemma. On the one hand, if the direction of time is reducible, as friends of the Mentaculus -- e.g., David Albert, Barry Loewer, and David Papineau -- maintain, then there is reason to think that the direction of time and the entropic arrow of time align. But on that account, efficient causation is likely reducible to non-causal phenomena. In consequence, contrary to Craig and Sinclair's theological aims, things can begin to exist without causes. On the other hand, if the direction of time is not reducible, Craig and Sinclair's interpretation of bounce cosmologies is unjustified. Lastly, a reply to a potential objection motivates a discussion of how to interpret bounce cosmologies on the tensed theory of absolute time favored by Craig and Sinclair. I offer two interpretations of bounce cosmologies that, given a tensed theory of absolute time, are preferable to those Craig and Sinclair offer, yet inconsistent with their project in natural theology; on one interpretation, the universe does not require a supernatural cause and, on the other, bounce cosmologies represent the universe as never having begun to exist.

Preferences for Health Care and Its Determinants Among Mentally Ill Patients of the West Shoa Zone Community, Oromia, Ethiopia.

Over 9 million people die from mental diseases each year, making them the second highest cause of mortality and the primary cause of disability worldwide. To explore the preferences for health care and its determinants among mentally ill patients in the West Shoa Zone Community in Oromia, Ethiopia, from July 11-September 20, 2022. The preference for health care and its determinants among mentally ill patients in the West Shoa Zone community were explored using an ethnographical study. Purposefully, a total of 16 FGD participants and 10 unstructured interview subjects, who had pertinent experiences and perspectives, were carefully selected from the urban and district levels. Data was collected utilizing two approaches in a triangulated manner and then coded, findings were contextualized, and a thematic plot was developed for thematic analysis. In this study, in response to the questions, three main findings were thematized according to the causes, and six sub-themes were framed under the themes according to the preferences for treatment among mentally ill patients. The themes that emerged from the data were; 1. Supernatural causes, 2. Traditional non-spiritual beliefs and practices; and 3. Medico-surgical problems. The majority of the participants responded that residents preferred religious spiritualists the most (46%), followed by traditional counselors (Wabeka) (19%), traditional spiritualists (15%), institutional care (12%), herbalists (4%), and psychologists (4%). In this study, the most commonly perceived causes of mental illnesses were bad spirits, devilish activity, and engaging in actions that violated social norms and regulations. Religious spiritualists were the study's first choice for mental health care. This study advises collaboration and a shared strategy between health care professionals and traditional and religious stakeholders.

Of Popes & Unicorns: Science, Christianity, and How the Conflict Thesis Fooled the World

Of Popes & Unicorns: Science, Christianity, and How the Conflict Thesis Fooled the World

Mental illness stigmatization factors: Survey among caregivers in Mahajanga Madagascar

Introduction: Psychiatric patients' stigmatization is a major public health problem. The objective of this survey is to determine the factors reinforcing the stigmatizing behaviors of nursing staff towards psychiatric patients. Methods: This study is descriptive, cross-sectional and prospective analytic conducted in the Emergency Departments of the both Mahajanga University Hospitals and the CSB of the District of Mahajanga I from November to December 2021. Results: Toxic causes of mental illness were the most mentioned by caregivers (91.4%) followed by environmental causes (74.29%), neurobiological and genetic causes (74.29%) and supernatural causes (17.1%). Thirty-four point three percent of staff believed that mental disorders are not curable. In 73.08% of cases, the staff referred the patient directly. In our study, both groups of staff had high social distance scores with averages of 22.58 for physicians and 23.15 for nurses. High scores were found in 87.5% of cases for physicians and in 89.1% of cases for nurses. There was an association between social distancing and the following stereotypes as perceived by staff: craziness (p=0.002), dangerousness (p=0.031). The decision to treat or refer patients depends mostly on the acquisition of additional Training in Psychiatry (p=0.000). The Training improved skills to take care of the patients. Conclusion: Anti-stigma actions must be carried out in Mahajanga, particularly among healthcare staff, to improve the quality of life of patients.

“After the rains” – A qualitative study exploring flood-related experiences, community response, coping mechanisms, and strategies from Kerala

Background: Natural disasters can result in various physical and psychological effects on victims. Kerala witnessed one of the worst floods in 2018. Objective: To explore the flood-related experiences, the role of the community in dealing with the disaster and strategies used for the management of floods in the selected districts of Kerala. Methodology: This qualitative study was done among flood-affected victims residing in three selected districts of Kerala from December 2018 to June 2019. The qualitative data were collected through 16 in-depth interviews and six focus group discussions using a topic guide till data saturation. A sociogram was plotted, and the thematic analysis of data with data triangulation was done to validate the findings. Results: The study identified natural, man-made and supernatural causes of floods. Most respondents described the event as the “Most unexpected disaster of the century.” Floods caused severe psychological trauma to the victims. The elderly and children were the most affected age groups, with behavioral changes noted among children. Fishermen came as “life saviors.” The majority of the victims were shifted to relief camps and were extremely happy with the facilities provided in the camp. The most difficult challenges faced were moving people at night during the flood event and post-flood cleaning. The support provided by government, nongovernmental organizations, and the local community was very much appreciated. Many were grateful for the initial response by the local youth community in their areas. Participants shared that they understood the true meaning of unity and realized the temporary nature of worldly possessions. Self-help group formation and prayer were identified as the most commonly used coping strategy. Conclusion: Addressing man-made causes of floods, empowering local communities, ensuring disaster preparedness, providing psychological support, and preserving the environment are the major strategies that emerged for the effective management of floods in future.

How the Light of Christ Illuminates the Deeper Reality behind the Social Issues that Plague Our Age

As scholars and academics, members of the Society of Catholic Social Scientists are not immune to the problem of sometimes overlooking our Catholic focus in our analyses of the social events and problems of the day. This article, whose author has a background in psychology and mental health care services, seeks to challenge us on that point. Without denigrating the incredible contributions natural science has made to human life, particular the field of health care, the article reminds us that many human problems stem from supernatural causes, such as sin, and require divine, rather than human solutions. The article gore on to present some speculations about how things will be during two periods of future history—the time of the antichrist and the era of peace—and concludes by reminding us of some of the subtle but significant things that have happened in the field of faith-based healing of late.

Adaptive narratives and fantastical falsehoods?

Johnson et al. make a strong case for Conviction Narrative Theory, but it remains unclear why so many adaptive narratives include supernatural causes and other falsehoods. Focusing on religions, I argue that an adaptive decision-making system might include supernatural falsehoods because they simplify complex problems, they are sensitive to long-term incentives, and they evoke strong emotions in a communicative context.

Pathways to the first contact with mental health services among patients with schizophrenia: A cross-sectional observational study.

Schizophrenia is a mental illness with a profound impact on patient and their caregivers. There is increasing evidence that delay in the commencement of treatment following the onset of illness may be related to the pathways; patients navigate before accessing mental health services. The aim of this study is to assess the pathways of care to the first contact with mental health services among patients with schizophrenia. A total of 150 diagnosed schizophrenia patients aged 12-60 years were recruited as per inclusion and exclusion criteria. The sociodemographic details were gathered using semistructured sociodemographic data sheets; semistructured pathways to care questionnaire and positive and negative syndrome scale for schizophrenia were administered. The most common first pathway to care was faith healers. The education of the head of family, socioeconomic status, rural background, and occupational status of patients have a significant impact on the first pathway of psychiatric care. The findings suggest that while planning mental health services, emphasis should be made on collaboration between psychiatric and nonpsychiatric services. The pathways patient choose depend on a number of factors like their socio-cultural background, belief about the supernatural causation of psychiatric illness, stigma associated with psychiatric illness, lack of knowledge about the mental illness, and influence of close family relatives on the choice of treatment.

PATHWAY TO CARE: HEALTH BELIEF MODEL AND BARRIERS IN MENTAL HEALTH SETTINGS

Objective: This study was planned to assess the pathway to mental health care including the health belief model and barriers faced by patients at a private tertiary care psychiatric facility in Rawalpindi, Pakistan Study Design: Cross sectional research Place and duration of study: This study was conducted from June to Dec 2016 at Fauji Foundation Hospital, Rawalpindi. Subjects and Methods: Through consecutive sampling, 246 patients presenting to the study venue were made part of the sample. A semi structured questionnaire was used to identify the symptom origin according to their health belief model as well as the barriers to care. Study variables were summarized using Descriptive statistics, and Chi square test was applied for association between common barriers to care and relevant socio-demographic variables using SPSS 20.0. Results: Out of 246 patients (61.4% females and 38.6% males), the majority of patients (39%) believed in a physical origin of their mental health symptoms followed by supernatural (32.9%) and psychological causes (28%). The most commonly reported type of barrier to care was Structural (68%) including Financial constraints and Lack of easy access to specialist resources whereas Attitudinal barriers such as Low perceived need and Perceived side effects of psychiatric medications were found in 22% of the cases. Stigma associated with psychiatric illnesses was reported by 10% cases. The educational status, locality of residence and monthly family income were significantly associated with structural and attitudinal barriers to mental health care. Conclusion: Patients with low literacy rates, rural based living and socioeconomic disadvantage are more likely to report structural and attitudinal barriers to accessing mental health services.

Ophthalmology in Ancient Egypt

The civilization of Ancient Egypt is the one that has the most references regarding the work of ophthalmologists, compared to the rest of the ancient civilizations. There are complete anatomical and treatment descriptions. Pepi Ankh Or Iri, who lived between 2270 and 2210 BC, is recognized as the first documented ophthalmologist in history. Ophthalmological cures were carried out with prayers, incantations, astrology for prognosis, amulets and pharmacotherapy with eye drops and ointments. Details of ophthalmologic surgery are unknown. The Edwin Smith (1600 BC), Ebers (1550 BC), Hearst (1550 BC) and London (1300 BC) medical papyri include ophthalmological pathologies. Ophthalmological medical assistance was in charge of lay doctors or swnw, priests and magicians, who worked together, since they believed that the origin of diseases was the result of external agents, as well as supernatural causes. The importance of this historical review article lies in pointing out some of the avant-garde aspects of the ancient Egyptian civilization with respect to ophthalmology and its practice, and the coexistence in their society of a rational medical practice together with a magical-religious approach.

Role of Mosque Communities in Supporting Muslims with Mental Illness: Results of CBPR-oriented Focus Groups in the Bay Area, California.

Objective The purpose of this study was to explore perspectives of Muslims residing in the Bay Area, California on the role of the mosque community in supporting community members' mental health needs and barriers to mental health care for members who experience mental health challenges. Methods This study employed a CBPR-focused qualitative approach in the form of content analysis of three focus group discussions organized and conducted with the help of a Community Advisory Board made up of members of the Muslim Community Association. Results Two major themes were identified upon examination of the data: services needed in the mosque community and barriers to addressing mental health issues in the mosque community. Specifically, participants reported wanting support groups within the mosque space, mosque-based activities, virtual support, community social workers, and family-oriented services. Barriers reported included community stigma, lack of cultural awareness of race-ethnic minorities within the community, attribution of mental illness to lack of faith or supernatural causes, and specific barriers unique to vulnerable/special subgroups within the community. Conclusion These findings highlight the need for developing mental health-related services and social support initiatives within the mosque space, specifically for those Muslim Americans living in the Bay Area in California. Furthermore, special attention needs to be placed on the barriers to accessing these services as identified by the community members.

Cross-cultural differences in depression between White British and South Asians: Causal attributions, stigma by association, discriminatory potential.

Numerous facets of public and internalized mental illness stigma have been established. This study focuses on the stigma of being associated with someone with depression and cultural differences between a Western and an Eastern culture. The aim was to compare White British and South Asians living in the United Kingdom regarding their causal explanations for depression, stigma towards people with depression and stigma by association. A cross-sectional design. White British and South Asians (N=137) in the United Kingdom completed a survey measuring attributions about the aetiology of depression, discriminatory potential towards people with depression and stigma by association. Results revealed that South Asians attributed greater supernatural, moral and psychosocial causes to depression, while White British endorsed greater biological beliefs. South Asians reported a greater discriminatory potential towards people with depression (lower willingness for closeness, greater desire for social distance) than White British. They also indicated greater affective, cognitive and behavioural stigma by association. Stigma by association mediated the relationship between cultural group and willingness for closeness as well as desire for social distance. Perceived dangerousness was a mediator for willingness for closeness. These findings suggest that a greater consideration of the role of culture in the understanding of mental health is important to combat stigma towards individuals with depression and those close to them across Western and Eastern cultures.

Categorisation of Lubukusu conceptual metaphors of pain in doctor-patient consultation

This study examines the metaphors of pain embedded in the conceptual systems of Lubukusu speakers and seeks to establish how categories of these metaphors becomes significant for adequate understanding of emotional reality. The study adopted analytical research design. Nurses were engaged in a role-play of doctor-patient consultations in Lubukusu to bring out a reflection of their experiences with terminally ill Bukusu patients in their medical care. The source domain for the categories of the metaphors analysed to map the source domain are; PLANT, ANIMAL, BAD SMELL, BAD TASTE, SUPERNATURAL, NON-LIVING and MIXED CAUSE onto the target domains of pain. Although there is a lot of research on emotion metaphors, much still remain unknown especially as pertains to the knowledge of corporeal experiences in the conceptualisation of pain. In this view, the paper explores the role of these experiences in the structuring of Lubukusu speaking patients’ concepts of pain when seeking medical services from non-native Lubukusu Doctors. The study sheds light on the need for stakeholders in the health sector to engage linguists in addressing the glaring mismatches, miscommunication and misunderstandings in health communication.

The experience of families caring for relatives with mental disorder under physical restraint: A qualitative community-based study in Indonesia

In Indonesia, physically restraining a person with a mental disorder is a common practice. It is considered a practical solution and is accepted as part of the treatment. This study aims to explore the family experience caring for relatives with mental disorders under physical restraint, locally called pasung . Qualitative research with a phenomenological approach and in-depth interviews was conducted in Gunungsitoli Sub-district of North Sumatra, Indonesia. The family caregivers of a person with a mental disorder were the participants of the study. The families perceived that pasung is a “normal” or acceptable act to restrain the mobility of the person with a mental disorder. They usually obtain information about mental disorders and possible treatment from other family members or fellow villagers. The person with a mental problem tends to be consulted by traditional or religious healers at first, as they believe that mental disorders are caused by supernatural causes. The treatment at traditional healers delays the treatment at health professionals. The coping mechanism within the family is more likely to be ineffective to handle the problem caused by the person with a mental disorder, thus opting for restraint as the solution. The way families treat the person with mental disorders, by restraining or chaining them, is against the act of human rights. Therefore, it is important to conduct awareness-raising campaigns on mental health and mental disorders to the family and community, as well as provide counseling to the patients and their families, stressing the more acceptable methods in treating the person with a mental disorder.

Beliefs About Causes and Cures of Prolonged Grief Disorder Among Arab and Sub-Saharan African Refugees.

BackgroundMany refugees have experienced the death of a loved one under traumatic circumstances. Accordingly, the prevalence of Prolonged Grief Disorder (PGD) among refugees is high. Culture-specific symptoms of PGD have been described previously, but beliefs about causes and cures of PGD among refugees remain unknown. We therefore aimed at identifying illness beliefs and treatment expectations regarding PGD among refugees.MethodWe focused on refugees from Arab countries (n = 14) and from Sub-Sahara Africa (n = 9) and applied qualitative and quantitative methods. In a semi-structured interview, participants first answered questions about assumed causes and potential cures for prototypical PGD symptoms according to ICD-11 that were presented in a vignette as representatives of their own culture. In the quantitative part, they completed the Cause Subscale of the Illness Perception Questionnaire (IPQ-R) that included additional culture-specific items. Interviews were analyzed with Qualitative Content Analysis.ResultsIn both groups of refugees, PGD symptoms were predominantly attributed to a close relationship to the deceased, lack of social support, personal vulnerabilities, and circumstances of the death. Participants also named a number of flight-related causes (e.g., inability to perform or participate in rituals, feeling isolated in the host country). None of the participants attributed PGD symptoms to supernatural causes. Descriptive analyses of responses on the IPQ-R indicated that participants predominantly attributed PGD symptoms to psychological causes. Participants believed that PGD can be cured and predominantly mentioned social and religious support. Psychological help was only mentioned by a minority of participants. In both groups, participants emphasized that a therapist must be familiar with the patient's culture and rituals. Participants also mentioned stigma associated with seeking psychological help.ConclusionResults suggest specific beliefs of refugees regarding causes and cures of PGD as well as similarities with Western conceptualizations. A culture-sensitive approach to the treatment of PGD in refugees that can include knowledge of culture-specific rituals and incorporating religious beliefs as well as decreasing stigma and increasing mental health literacy seem important. The study is limited by its focus on only two groups of refugees and its small sample size.

Creationism is not special

Most debates surrounding the teaching of creationism in the science classroom have been addressed under a standard frame: whether creationism is science or religion. As creationism suggests supernatural causation, it has been understood as beyond the purview of science, and therefore as religion. This argument for methodological naturalism has been increasingly challenged by philosophers of science as a demarcation criterion. The disaggregation approach introduced by Cecile Laborde provides an alternative framework to address this debate. It suggests that the problem with creationism lies in its epistemic inaccessibility, as it is a theory with weak explanatory capacity that has been superseded by Darwinian evolution. Thus, the exclusion of creationism from the science classroom is not grounded in its religious character, but rather in a set of epistemic shortcomings, which are shared by other fully secular pseudoscientific theories. In the same way that religion is not special as a legal-political category under Laborde’s analysis, creationism in the curriculum should not be treated as special either.

Community mental health literacy in Tshwane region 1: A quantitative study.

BackgroundAlthough mental health literacy is a major determining factor of mental health outcomes and functional capacity of individuals, there is dearth of research on the issue in South Africa.AimTo assess the literacy of three mental disorders, namely major depressive disorder (MDD), schizophrenia and generalised anxiety disorder (GAD) and to compare the resultant assumed literacy level between urban and townships participants.SettingFive clinics of region 1 in Tshwane, South Africa.MethodA cross-sectional descriptive study was performed between November 2019 and January 2020. A total of 385 questionnaires were distributed equally in all five clinics. By means of questions about three fictive cases with clinical pictures indicative of MDD, schizophrenia and GAD the following were assessed: recognising a mental disorder, identifying the cause and knowledge about what would help best.ResultsThe majority of participants (67.3%) recognised the clinical picture indicative of schizophrenia as a mental disorder, almost half of the participants (49.9%) recognised the clinical picture indicative of MDD as a mental disorder, whilst just more than one third (36.3%) of participants recognised the clinical picture GAD as a mental disorder. Concerning the causes for the clinical pictures, most participants indicated that stress was the cause for MDD and GAD (77.4% and 68.1%, respectively), whilst indicating that biological or psychological (59.5%) causes are relevant to the clinical picture indicative of schizophrenia symptoms. Fewer participants indicated supernatural causes for any of the clinical case (MDD: 2.6%; schizophrenia 15.3%; GAD 4.2%). Most participants chose professional help as the best option for all three cases (MDD 81.3%, schizophrenia 82.2%, GAD 66.1%). The indicators for health literacy in this study show that urban participants had better knowledge than township participants across all questions about the cases.ConclusionOverall, the study indicated a variable knowledge regarding the three mental disorders in region 1 of Tshwane and variable literacy levels in townships compared with urban settings. The results indicate that awareness campaigns should focus on the deficient areas.

Integrating mental health into primary care: evaluation of the Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) pilot project

BackgroundThe Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) project trains non-specialist and primary health care workers in Imo State, Nigeria. This project adapted the World Health Organization’s Mental Health Gap Action Programme-Intervention Guide (mhGAP-IG), emphasizing stigma reduction among trainees. This convergent mixed-methods proof-of-concept study evaluates the HAPPINESS pilot project mhGAP-IG training’s impact on mental illness stigma among trainees and barriers, facilitators, and opportunities to consider for project improvement.MethodsTrainees (n = 13) completed a 43-item questionnaire before and after their 5-day training to assess perceptions of mental disorders and attitudes towards people with mental illness. These responses were analyzed using paired-sample t-tests for four subscales of the questionnaire: acceptance of socializing with people with mental illness, normalizing activities and relationships with people with mental illness, supernatural causation of mental illness, and endorsement of a biopsychosocial approach to mental illness. Semi-structured key informant interviews (n = 11) with trainees, trainers, and local health officials who participated in or supported the HAPPINESS project were thematically analyzed to understand their experiences and perspectives of the project’s barriers, facilitators, and opportunities.ResultsTrainees showed significant improvements on socializing, normalizing, and supernatural causation subscales of the stigma questionnaire (p < 0.05). No significant effect was seen on the biopsychosocial subscale; however, evidence of biopsychosocial beliefs was found in interview responses. Key informant interviews revealed that the HAPPINESS project enhanced trainees’ diagnostic and treatment abilities, mental health awareness, and empathy towards patients. Misinformation, stigma, inadequate funding, and lack of road access to clinics were identified as barriers to mental health care integration into general care in Imo State. Respondents also suggested ways that the HAPPINESS project could be improved and expanded in the future.ConclusionsThis study adds to the limited evidence on the implementation of mhGAP-IG in Nigeria. Using mixed methods, it evaluates how mhGAP-IG can impact perceptions and knowledge of stigma among primary care trainees. It also highlights barriers, facilitators, and opportunities to consider for project growth. Future efforts should focus on clinical support, supervision, health outcomes, as well as scaling up and assessing the cost-effectiveness of the HAPPINESS project intervention.