Reducing stigma among healthcare providers to improve mental health services
Reducing Stigma Among Healthcare Providers to Improve Mental Health Services: Cluster Randomized Controlled Trial (RESHAPE-cRCT)
This study is testing if training primary care providers in Nepal to interact with people who have mental health issues can help reduce stigma and improve their ability to recognize mental illness.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 1300 (estimated) |
| Ages | 16 Years and up |
| Sex | All |
| Sponsor | George Washington University Academic / other |
| Locations | 1 site (Pokhara, Gandaki) |
| Trial ID | NCT04282915 on ClinicalTrials.gov |
What this trial studies
This intervention aims to reduce stigma among primary care providers in low-resource settings, specifically targeting mental health issues. By incorporating social contact with individuals experiencing mental illness into training programs, the study seeks to enhance the quality of mental health services provided by non-specialists. A cluster randomized control trial will measure changes in stigma and the accuracy of mental illness detection among primary care workers. The study is conducted in Nepal, where mental health care access is critically low.
Who should consider this trial
Good fit: Ideal candidates for this study are primary care providers aged 18 to 65 who are actively engaged in care provision within the government health system in Nepal.
Not a fit: Patients with emergency medical needs or those not presenting with a mental illness diagnosis may not benefit from this study.
Why it matters
Potential benefit: If successful, this intervention could lead to improved mental health service delivery and better outcomes for patients with mental disorders.
How similar studies have performed: Other studies have shown that stigma reduction interventions can improve mental health service delivery, suggesting potential success for this approach.
Eligibility criteria
Show full inclusion / exclusion criteria
\*\*Primary Care Providers\*\* Inclusion Criteria: * All health workers from the facilities included in the study will be invited to participate * Health workers will be between 18 and 65 years of age based on employment criteria * within the government health system. * All participants will need to have Nepali language competency, * be actively engaged in care provision in their health cluster, * have a valid certificate of practice from the Ministry of Health * Health workers will need to have permission from their health supervisor to attend the entire duration of the training, Exclusion Criteria: * any prior citations on their clinical practice licensure or any other government credentialing violations. \*\*Patients\*\* Inclusion Criteria: * All patients (with non-emergency medical needs) presenting to the primary care * any of the following groups: * (a) any mental illness diagnosis including depression, psychosis (bipolar disorder with a manic episode, schizophrenia, major depressive disorder with psychotic features, and alcohol use disorder with psychosis) and alcohol use disorder; plus the other conditions included in Nepal's mental health Gap Action Programme: anxiety, conversion, epilepsy, dementia, child and adolescent, other substance abuse (these patients are included because misdiagnosis is common with regard to missing or overdiagnosing one condition in place of another mental illness); comorbid conditions are also acceptable; * (b) any patients screening above cut-off scores on the tools; and * (c) 10% of patients who are negative on all of the above criteria. * any patients previously treated for mental illness would be included * age range will be 16 years or older, with no upper age limit (mental health Gap Action Programme training covers child and adolescent through mental illnesses affecting elderly population). * all participants will be able to speak Nepali * able to complete the research interview with the research assistants who will read all of the assessment tools. Exclusion Criteria: * Patients with immediate medical needs requiring referral and emergency services (e.g., serious injury; pre-eclampsia; dehydration; status epilepticus) * patients needing acute psychiatric services (e.g., suicide attempts, alcohol withdrawal, psychosis/mania that cannot be managed in a community setting) who are referred for immediate hospitalization * Patients under the age of 16 years old will be excluded
Where this trial is running
Pokhara, Gandaki
- Transcultural Psychosocial Organization Nepal — Pokhara, Gandaki, Nepal (Recruiting)
Study contacts
- Principal investigator: Brandon A Kohrt, MD, PhD — George Washington University
- Study coordinator: Brandon Kohrt, MD, PhD
- Email: bkohrt@gwu.edu
- Phone: 2027412896
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.