Manifestaciones de la violencia de género

Participants recommended that complementing the programme with the introduction of community-wide mental health education would be beneficial because they recognised that most people in their communities had little or no knowledge about people with mental disorders. They pointed out that most communities had a radio network, often called the ‘information centre’, where community information was broadcast. Participants suggested that this resource could be used to disseminate mental health information throughout their communities. They envisioned that the benefit of this resource was that many people had easy access to it and it would help improve their understanding of, and attitudes towards, people with mental disorders.

You have given us, we the assembly members, the training, but to me, I think if the training can extend [sic] even to the various localities, it will be better. (IC2.F7)

70 _{Local community members elected to assist the assembly member fulfil his or her responsibilities.}

I think we should not have been the only people to be given training on things of this nature… If possible, it should have been a programme on a radio network or information centre. (IC3.M23)

In addition, they emphasised that a community-wide mental health education programme would create awareness about mental disorders and encourage members to provide appropriate support to people with mental disorders.

There should be public education to create awareness that mental health problems exist and, therefore, we should treat it [mental disorders] as such [provide appropriate support]. (IC3.M25)

Some participants also believed that a community-wide education programme would be beneficial because people were more receptive to acquiring new knowledge when it was provided by an expert who was external to their community. This approach would also help foster cooperation between assembly members and their respective communities when dealing with people with mental disorders.

I suggest that you organise periodic meetings in the communities to share the programme with the people, because there is not much interest in the programme when a familiar individual always does it in their communities. It is much more effective when an unfamiliar person handles the programme in the communities. I’m appealing that, if there is enough time, you will organise outreach meetings in the community for the people to know that what we have been teaching them is authentic as a result of the training we have had with you. (IC1.M4)

Similarly, participants expressed frustration at the lack of receptiveness of some community members in comprehending the importance of what they, as assembly members, were teaching them about people with mental disorders. They believed that a community-wide mental health education programme would augment their own efforts by reinforcing the knowledge and attitude necessary for dealing with mental disorders.

… in future when the assembly members encounter any problem within the community or in their town, you will organise the programme, including film shows, like what you showed to us, for the people in the community or neighbourhood. I think it will help members of these communities to

understand that if any sibling or family member encounters this situation this is how we should handle it. We taught them all these things and it has made our task difficult. They do not understand what we teach them, so if you are able to organise a “video van” [Outdoor cinema] and show films to the members of the community, I feel, it will be very beneficial. (IC1.F10)

Another benefit of a community-wide programme is that it could help address discrimination. Participants indicated that if their communities were provided with knowledge about mental disorders, they would be less likely to be discriminatory towards people with these disorders.

I suggest that, from time to time, you go to the communities and deliver this message or programme to them so that they will not discriminate against those people [with mental disorders](IC3.M24)

I wish that this training will be organised from time to time for community leaders and assembly members, so that they will be able to deal with this canker [neglect and abuse of people with mental disorders] and they will be able to help the community with this canker. (IC3.M25)

People with mental problems were left to rot [disowned and abandoned], but with your training you have helped a lot. I suggest that you should come to the communities; people will benefit more from the training you gave to us. (IC2.M18)

6.7

Summary

In this chapter, the mixed methods process evaluation of the intervention cluster participants about the usefulness of the mental health literacy programme, was presented. The findings indicated that the programme was valuable and useful to participants. The programme was viewed as very helpful because it re-oriented participants and allowed them to overcome their fear of perceived dangerousness of people with mental disorders and encouraged them to interact with these individuals and to provide them with appropriate assistance.

people with mental disorders, which, consequently, bolstered their confidence to proactively engage with people with these conditions and to support their families. They commented that their engagement efforts were beneficial as it encouraged help-seeking behaviours in affected families to ensure better outcomes, including creating opportunities to pursue life-goals after recovery. The programme was also regarded as helpful in positively changing participants’ attitudes and behaviours towards people with mental disorders and their families. Developing empathy and being non-judgmental resulted in them being more supportive of people with these disorders. Finally, recommendations were made about strengthening the programme and extending it to others as well as the community in general.

Chapter Seven

Discussion and Conclusion

7.1

Introduction

This study was the first cluster randomised controlled trial of a mental health literacy programme using a problem-solving Story-bridge72 approach, underpinned by andragogy, with a group of assembly members in Ghana. The broad aim of the study was to evaluate the effectiveness of the programme on assembly members’ knowledge about and attitudes toward people with mental disorders. In addition, the study sought to evaluate the perspectives of the community leaders who took part in the programme about its usefulness in dealing with people with mental disorders and their families. These objectives were achieved by engaging the assembly members in a three-hour mental health literacy programme and a process evaluation to assess its usefulness, impact and methodological appropriateness. It was anticipated that the programme would be valuable and have a positive effect on participants. Overall, the findings of the study indicated that the programme was somewhat effective in improving participants’ knowledge about and attitudes toward people with mental disorders. Overall, both clusters demonstrated an increase in their mean scores at follow-up; however, the intervention cluster demonstrated a greater improvement than the control cluster.Apart from the community mental health ideology outcome measure, which had a medium and statistically significant difference between the two groups in changes over the two time-points, all other outcome measures had small differences which were not statistically significant. The process evaluation found that participants commented favourably about the value of the programme and the positive contribution it made to their role as assembly members and adults. In addition, they commended its delivery and recommended that community education activities should be introduced to improve mental health literacy in the community.

In this chapter, a discussion of the findings of the study is presented. The chapter begins with a discussion of the findings related to the socio-demographic characteristics of the participants. The discussion then focuses on the outcomes of the programme under three broad headings: knowledge of helpful interventions, attitudes and social distance. Next,

the link between the andragogical and Story-bridge approaches is analysed. Then, a discussion of the process evaluation takes place. After this, an overall discussion of the findings is presented, followed by a review of the strengths and limitations of the study. Finally, the recommendations and conclusions of the study are presented.