The MRC funds £2m study to address global mental health stigma
8 Oct 2018
A landmark global study that looks to understand and reduce the stigma that surrounds mental ill health has received a £2 million grant award from the MRC. The Indigo Partnership is one of the largest studies of its kind and will develop and test new methods to reduce stigma in China, Ethiopia, India and Tunisia.
According to the World Health Organisation 80% of the people likely to experience an episode of a mental disorder in their lifetime come from low- and middle-income countries. Two of the most common forms of mental health illness, anxiety and depression, are widespread and disabling but respond well to a range of treatments. However, due to the stigma that surrounds mental health problems and gaps in funding, these disorders often go virtually untreated. In fact, only around 5% of people with mental health problems receive any treatment in some economically developing countries. The impact of this is significant. In India, for example, suicide is the leading cause of death among women aged 15 to 49, overtaking deaths arising from complications in pregnancy and childbirth. Depression is now the leading cause of disability worldwide and contributes significantly to the global burden of disease.
The stigma associated with mental health problems can result in social isolation, low self-esteem and more limited chances in areas such as employment, education and housing. It can impact personal and social lives, including people’s prospects for marriage. Stigma can hinder people seeking help and impact on the quality of treatment they receive from doctors, contributing to the huge gap in treatment outcomes between those with and those without a mental health condition. What’s more, mental health disorders greatly increase the risk of a person developing another chronic disease and vice versa.
The Indigo Partnership, led by Professor Sir Graham Thornicroft from King’s College London, will address why stigma occurs and how to combat it in economically developing countries. Four low- and middle-income countries will work in close collaboration with four high income countries to develop tailored anti-stigma strategies: China (Peking University Health Science Centre, and Guangzhou Medical University); Ethiopia (Addis Ababa University); Germany (University of Ulm); India (George Institute, New Delhi and NIMHANS, Bengaluru), Switzerland (WHO, Geneva); Tunisia (Hôpital Razi, Tunis); UK (King’s College London); and USA (George Washington University).
The INDIGO partnership research programme will focus on four research activities:
- unconscious bias (for example health care staff who treat people with mental health conditions less well without intending to do so)
- how people can manage to cope with stigma without it having a negative impact
- how to improve the effect of 'inter-personal contact' between people with and without experience of mental illness to reduce stigma
- how to adapt stigma reduction interventions to the local context and culture in low and middle-income countries. These studies are based upon the findings of research in high income countries that such inter-personal contact is the most effective way to reduce stigma.
The project team will culturally adapt nine scales which measure different aspects of stigma and translate them into Amharic, Arabic, English, Hindi, Kannada, and Mandarin and Telugu, and make these openly available as an 'evaluation toolkit'. The research programme will roll out 3 pilot projects to test specific methods intended to reduce mental health related stigma: (i) using inter-personal contact to reduce stigma among primary health care staff; (ii) using inter-personal contact to reduce stigma among mental health care staff; (iii) using a public awareness and social marketing programme to increase referrals for people with mental illness to attend local health care services.
Professor Sir Graham Thornicroft, Professor of Community Psychiatry, King’s College London said:
“Across the globe the stigma that surrounds mental health illness poses a colossal challenge and hits some of the most vulnerable people in our society the hardest. We want the Indigo Partnership to make a real contribution towards people gaining greater access to effective mental health care and better social inclusion. We also want to support research capacity. In the course of this study staff in the whole partnership will support research staff in China, Ethiopia, India and Tunisia to develop their research skills and their careers, so that they can establish centres of excellence in stigma research in each of these countries in future.”
Dr Jo Latimer, Head of Neurosciences and Mental Health, Medical Research Council said:
“The UK’s reputation as a world-class research and innovation base has been built upon international collaboration. Tackling mental health problems on a global level is an important part of MRC research strategy. Research into global mental health gives us a better understanding of the personal, social and economic impact of mental illness as a result of a range of external factors. By looking at how to reduce the stigma and tailoring strategies to make them work in different cultures, this study will make a difference to individuals and our global communities.”
Professor Sir Graham Thornicroft will be speaking at the world’s first global ministerial mental health Summit on 9-10 October 2018.