En cuanto al segundo objetivo específico: Analizar e interpretar las características

The programme was conducted by the student researcher in English because English is the country's official language, used in government, businesses, schools and universities (www.ghanario.com/ghana-faq/16603). The training programme was an interactive three-hour session, conducted in an environment that suited adults learners (Knowles, 1980). It was about people with depression and schizophrenia, delivered using a combination of PowerPoint presentations, video recordings and large and small group discussions. Participants were also given printed material about people with depression and schizophrenia: Guidelines for Carers of Someone with a Mental Disorder (www.mhfa.com). The reading material contained information about mental disorders with strategies and attitudes needed to support an individual experiencing a disorder. The programme drew on participants’ life experiences in dealing with people with mental disorders in their communities and families. It focused on the application of knowledge of the symptoms and signs of the disorders and appropriate attitudes towards people with

mental health problems.

In the introduction to the programme, participants shared their understanding and stereotypes of people with mental disorders. With the aid of a short video clip, five harmful myths about mental disorders were shown to participants and these myths were explained in the clip to reveal the truth about mental disorders. Probing questions were asked to assess participants’ familiarity with these myths and how they may have affected their perceptions and particularly their attitudes toward people with mental disorders. Participants were then shown video clips of two individuals talking about their real-life experiences with depression and schizophrenia. Next, the researcher initiated a discussion enabling participants to share their thoughts and experiences, to compare whether they were similar to the real-life experiences of the people in the video clips. Subsequently, PowerPoint presentations were used to introduce the signs, symptoms and treatment options for people with depression and schizophrenia. Another round of discussion was held to allow participants to share their perceptions on the concepts. Following this, participants were introduced to the next phase of the programme, which was the problem- solving ‘Story-bridge’ concept (Lubman et al., 2014), summarised below.

4.3.8.2 Background and summary of the problem-solving Story-bridge

The mental health literacy programme developed for this study was adapted from Lubman et al. (2014), who designed and piloted a mental health promotion resource from a strengths-based problem-solving framework for sub-Saharan African immigrant communities living in Melbourne, Australia. The resource was designed to improve young people’s and parents’ knowledge about mental health problems and to reduce stigmatising attitudes toward young people with these problems. The characters, context and key messages were written by the project team and translated into pictorial vignettes. Each vignette comprised six scenes presenting a specific mental health problem. Each scene presented a key theme (e.g., conflict, negotiation, communication) and when linked together, the scenes depicted the story of a family dealing with a mental health problem of a teenage son or daughter. The scenes in the vignette were presented in a visual manner called a Story-bridge, which is problem-solving based, in an arc form, to show the different situations the family experienced. Lubman et al. (2014) designed the resource

to encourage discussion about key communication and conflict resolution parenting strategies.

In the Story-bridge, a scene or sequence of scenes is presented at each end of a bridge, separated by blank spaces. In these blank spaces, participants were asked to identify strategies parents in the vignette could use to ‘bridge the gap’ between the mental health problem presented initially and successful outcomes. These strategies were written into the blank spaces provided on the Story-bridge until all the spaces were filled. The exercise was completed when the blank spaces were full of suggestions; thus, bridging the gap between the problem and the successful solution. Evaluation of the mental health resource in an educational and a community setting found that participants reported improved knowledge about mental health problems and help-seeking attitudes (Lubman et al., 2014).

The problem-solving Story-bridge approach was adopted in the present study because it was a valuable concept that could be used in a group format. The approach encouraged discussion, thus drawing on participants’ knowledge and experience of dealing with people with mental health problems, consistent with an andragogy approach. The final consideration for adopting the resource was that it was developed to promote engagement among family members to deal with mental health problems, and this is consistent with the Ghanaian cultural approach of engaging family members to deal with a wide range of issues (Tsai & Dzorgbo, 2012), including mental health problems.

In this training programme, every scene in the vignette (Appendix 3) was shown to participants in the order in which it appeared in the vignette. Participants were asked to discuss what was happening in the scene. Participants further discussed the story behind each scene. Then, all the scenes were presented together (vignette). Participants were again asked to comment on how the scenes linked up and worked as a story. Using group discussion method, participants were divided into small groups (minimum of six members) with one of them as group leader. They were asked to draw on the knowledge acquired in the programme to suggest strategies or ideas that could be used to address the mental health issue portrayed in each scene. Group leaders presented their suggestions to the larger group, which were then discussed to draw out common themes in their

strategies or ideas.