Exploring Stigma, Discrimination & Recovery-Based Perspectives Towards Mental Health & Substance Use

Background

The proposed research is unique in several respects:

This is the first Brazilian study to evaluate a comprehensive anti-stigma intervention targeting FHU providers from an organizational perspective.
Sao Paulo Research Foundation (FAPESP).
This is the first Brazilian cluster randomized controlled trial to test the effectiveness of a standardized intervention aimed at reducing stigmatizing attitudes and practices of FHU providers toward people with MISUP.
This will lead to the first evidence-based, standardized, validated recovery-oriented anti-stigma intervention targeting FHU providers, which may be scaled up to other FHUs and primary health care centres across Brazil, including but not limited to, Basic Health Units, Health Centres, Social Community Health Centres and Emergency Medical Care Centres.

Aims

The main objective of this five year study was to determine the effectiveness of a comprehensive antistigma/recovery-oriented intervention in reducing stigmatizing attitudes and behaviours among PHC providers toward individuals with MISUP in the Brazilian context, using FHUs as the point of intervention.

Project plan

This study involved two conditions:

Control: Three FHUs in the municipality of Ribeirão Preto will be randomly selected as controls.
Experimental: Three FHUs in the municipality of Ribeirão Preto will be randomly selected to receive the intervention.

Specific Hypotheses

Participation in the experimental group will result in a significant decrease in stigmatizing attitudes among PHC providers toward individuals with MISUP compared with the control group.
Participation in the experimental group will result in a significant decrease of service user’s experiences of MISUP stigma conveyed by PHC providers compared with the control group.

Secondary Hypothesis

Changes in attitudes and behaviours within the experimental group will be sustained over time.

Impact

This study adapted the Opening Minds Scale for Health Care Providers (OMS-HC) for use with health-care practitioners in Brazil. Evidence from the study suggests that the OMS-HC could be used to monitor stigmatizing attitudes of health professionals, and this could strengthen the implementation of mental health policies, however, this requires further study with a more diverse population.