Toward a multi-level strategy to reduce stigma in global mental health: overview protocol of the Indigo Partnership to develop and test interventions in low- and middle-income countries

Petra C. Gronholm, Centre for Global Mental Health and Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. petra.gronholm@kcl.ac.uk.
Ioannis Bakolis, Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Anish V. Cherian, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
Kelly Davies, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Sara Evans-Lacko, Care Policy and Evaluation Centre, London School of Economics and Political Science, Houghton Street, London, UK.
Eshetu Girma, Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Dristy Gurung, Centre for Global Mental Health and Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Charlotte Hanlon, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Fahmy Hanna, Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland.
Claire Henderson, Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Brandon A. Kohrt, Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA.
Heidi Lempp, Centre for Rheumatic Diseases, Department of Inflammation Biology, School of Immunology and Microbial Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.
Jie Li, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
Santosh Loganathan, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India.
Pallab K. Maulik, George Institute for Global Health, New Delhi, India.
Ning Ma, Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China.
Uta Ouali, Department Psychiatry A, Razi University Hospital, La Manouba, Tunisia.
Renee Romeo, King's Health Economics, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Nicolas Rüsch, Section of Public Mental Health, Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm, Germany.
Maya Semrau, Centre for Global Health Research, Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton, UK.
Tatiana Taylor Salisbury, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Nicole Votruba, Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK.
Syed Shabab Wahid, Division of Global Mental Health, Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA.
Wufang Zhang, Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China.
Graham Thornicroft, Centre for Global Mental Health and Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Document Type

Letter to the Editor

Publication Date

2-3-2023

Journal

International journal of mental health systems

Volume

17

Issue

1

DOI

10.1186/s13033-022-00564-5

Keywords

Community mental health; Discrimination; Global health; Health service research; Intervention; Low- and middle-income countries; Mental health; Stigma

Abstract

There is increasing attention to the impacts of stigma and discrimination related to mental health on quality of life and access to and quality of healthcare. Effective strategies for stigma reduction exist, but most evidence comes from high-income settings. Recent reviews of stigma research have identified gaps in the field, including limited cultural and contextual adaptation of interventions, a lack of contextual psychometric information on evaluation tools, and, most notably, a lack of multi-level strategies for stigma reduction. The Indigo Partnership research programme will address these knowledge gaps through a multi-country, multi-site collaboration for anti-stigma interventions in low- and middle-income countries (LMICs) (China, Ethiopia, India, Nepal, and Tunisia). The Indigo Partnership aims to: (1) carry out research to strengthen the understanding of mechanisms of stigma processes and reduce stigma and discrimination against people with mental health conditions in LMICs; and (2) establish a strong collaborative research consortium through the conduct of this programme. Specifically, the Indigo Partnership involves developing and pilot testing anti-stigma interventions at the community, primary care, and mental health specialist care levels, with a systematic approach to cultural and contextual adaptation across the sites. This work also involves transcultural translation and adaptation of stigma and discrimination measurement tools. The Indigo Partnership operates with the key principle of partnering with people with lived experience of mental health conditions for the development and implementation of the pilot interventions, as well as capacity building and cross-site learning to actively develop a more globally representative and equitable mental health research community. This work is envisioned to have a long-lasting impact, both in terms of the capacity building provided to participating institutions and researchers, and the foundation it provides for future research to extend the evidence base of what works to reduce and ultimately end stigma and discrimination in mental health.

Department

Psychiatry and Behavioral Sciences

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