The period as a Marie Skłodowska-Curie researcher began on June 2016. The first 24 months have been very intense. The project has achieved most of its objectives and technical goals for the mid-term period with practically no deviations. We have worked hard to be able to fulfil the research schedule. Research and transference objectives within this project are focused on the analysis of strategies for the awareness of mental health service users and professionals, to improve communication between them, enhancing participation of the former and critical reflection and self-care of the latter. Relatedly, the activities that have given us more satisfaction has been our involvement with local and international mental health stakeholders.
Starting from the theoretical elaboration of the sociocultural dynamics of well-being and distress, our project aims to promote Citizenship practices through continuous training of professionals and users of mental health services and their relatives.
Regarding the first milestone, we carried a randomised enquiry of the interaction between Wellbeing and Citizenship to identify the strength of the relationship between both. In addition, the study aimed to investigate the capability of changing wellbeing and citizenship levels over time after exposure to a short intervention which involved the following variables; ‘Social Justice Beliefs’, ‘Assertiveness’ and ‘Values’. A longitudinal randomised design was implemented with a self-selected sample, in which participants were randomly assigned to an experimental (n=84) or control condition (n=91). Results indicated a strong positive relationship between wellbeing and citizenship. Results also demonstrated an effect of time for the citizenship subscale related to ‘Personal Responsibilities’ and for the moderator ‘Social Justice Beliefs’. The study helped to increase the awareness of the injustices that disadvantaged groups experience whilst simultaneously promoting ways for individuals to empower themselves. Professionals could use the findings to provide a platform for vulnerable groups, as by merely offering them with the resources to be more assertive and be involved in community projects this can help to increase their responsibilities, roles and meaningful relationships which subsequently could improve their overall wellbeing and sense of citizenship.
As for the second milestone, focus groups were held with local stakeholders. Twenty focus groups including 90 mental health professionals, 50 service users and 10 relatives were conducted. Our choice of strategic actions was supported by the preliminary results of these focus groups obtained through thematic analysis. These results show how speaking about Citizenship and its most intuitive components, rights and responsibilities, implies a change that can be facilitated by user participation in the design and implementation of interventions.
Once this exploratory phase was completed, needs assessments were carried out and valid measurement instruments were designed to evaluate activities of mutual support and training of mental health activists and professionals. To date we have carried the evaluation of mental health activists training and we are in the process of performing mental health professionals training and awareness activities. Regarding the former, we carried a study whose main objective was to understand the impact that activism training activities have on the internalized stigma and wellbeing of activists being trained. We measured internalized stigma and wellbeing at the beginning and the end of anti-stigma training courses. Sixty-eight activists receiving training were enrolled in the study. Our results show generalized increases in wellbeing and decreases in the internalized stigma of participants. Additionally, a covariation between these changes was found. Hence, greater increases in wellbeing were for those participants with higher levels of baseline self-stigma and vice-versa. This study shows the importance of addressing internalized stigma among mental health activists, thus boosting their recovery process.
The final project phase includes an intense activity to interact with a diverse range of health managers and policy makers with the intention of proposing profound organizational changes. This phase, however, only makes sense if at the same time, we are offering stakeholders’ feedback, in the form of scientific evaluation of their activities, and carrying out training and awareness activities.
