Arthur, Yaw Amankwa (2018) Evaluation of a mental health literacy programme on community leaders’ knowledge about and attitude towards people with mental disorders in Ghana: cluster randomised controlled trial. PhD thesis, Victoria University.

Abstract

In Ghana, poor knowledge about mental disorders, compounded by negative attitudes developed from deep-rooted stigma, may be responsible for inappropriate behaviour towards people with mental disorders. The effects of negative societal reactions toward individuals with mental disorders and their families may be minimised considerably if people are exposed to credible and adequate information about mental disorders. The broad aim of this study was to evaluate the effectiveness of a mental health literacy programme on Ghanaian assembly members’ knowledge about and attitudes toward people with mental disorders. In addition, the study sought to evaluate the perspectives of the assembly members who participated in the programme about its usefulness and in what ways, if any, they used this acquired information in their routine dealings with people with mental disorders and their families. This was a mixed method, sequential explanatory design, comprising a cluster randomised controlled trial and a process evaluation. A mental health literacy programme, based on a problem-solving Story-bridge approach, underpinned by andragogy, was developed for the study. Ten district assemblies were randomised into intervention and control clusters. Overall, an equal sample of 70 assembly members in the intervention group received the programme while the control group received a plain language basic brochure about mental health issues. Data were collected from both groups at baseline and 12-week follow-up. In addition, a mixed method process evaluation was undertaken with the intervention group. Principal 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 highlighted the usefulness of the programme. Participants expressed value in the programme; improved knowledge, increased confidence and willingness to engage, and increased empathetic and non-judgemental attitudes toward people with mental disorders and their families. In addition, participants commended the delivery of the programme, and recommended ways to boost realisation of the programme objectives and education activities that could be introduced to improve community mental health literacy. Overall, the findings indicate that it is possible to improve people’s knowledge about and attitudes toward people with mental disorders and their families. The outcomes suggest that mental health education should be intensified to improve mental health literacy and reduce deep-rooted stigma. These improvements, in turn, may contribute to positive attitudes towards people with mental disorders and their families, enhance the quality of mental health service delivery, and decrease the treatment gap and burden of mental disorders in Ghana.

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