Addressing “what matters most” to reduce mental health stigma in primary healthcare settings: a qualitative study in Lebanon

Abstract Background “What matters most” (WMM) is a theoretical framework based on medical anthropology and draws on cultural concepts of values and morals. It has been employed to identify cross-cultural aspects of mental health stigma. This approach assists practitioners, advocates, and researchers...

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Main Authors: Racha Abi Hana, Eva Heim, Pim Cuijpers, Marit Sijbrandij, Rabih El Chammay, Brandon A. Kohrt
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Primary Care
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Online Access:https://doi.org/10.1186/s12875-024-02680-2
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author Racha Abi Hana
Eva Heim
Pim Cuijpers
Marit Sijbrandij
Rabih El Chammay
Brandon A. Kohrt
author_facet Racha Abi Hana
Eva Heim
Pim Cuijpers
Marit Sijbrandij
Rabih El Chammay
Brandon A. Kohrt
author_sort Racha Abi Hana
collection DOAJ
description Abstract Background “What matters most” (WMM) is a theoretical framework based on medical anthropology and draws on cultural concepts of values and morals. It has been employed to identify cross-cultural aspects of mental health stigma. This approach assists practitioners, advocates, and researchers in assessing stigma-related factors that are relevant to the experiences of individuals in diverse cultural contexts. To implement effective anti-stigma programmes it is vital to identify and prioritize WMM for primary healthcare providers and people with lived experience of mental health conditions (PWLE). Our current objective was to explore WMM to primary healthcare providers, PWLE, primary care managers, and policymakers in Lebanon to inform mental health stigma reduction initiatives. Methods We conducted a total of 45 qualitative interviews with primary healthcare providers, PWLE, primary care managers, and policymakers. The WMM framework was applied to analyse data from primary healthcare centres in Lebanon to identify themes related to stigma against PWLE. The analysis identified common themes related to WMM. The analysis aimed to identify (a) WMM values for participants, (b) factors that threaten these WMM values and their relationship to stigma, and (c) potential interventions that could leverage WMM principles to reduce stigma. Results WMM for primary healthcare providers encompassed competency, time management, willingness, and self-care. WMM for PWLE focused on equality, support, compassion, and confidentiality. Policymakers emphasised resource sustainability as a top priority. Myths about mental health illnesses perpetuated threats to WMM, and organisational barriers also threatened WMM for primary healthcare providers and PWLE, thus creating major roadblocks to achieving stigma reduction. Conclusion This study identified key domains to understand the factors for WMM in reducing mental health stigma in Lebanon and explored factors that shape the values and priorities of both PWLE and primary healthcare providers. The study suggests assessing the effectiveness of anti-stigma interventions that actively engage PWLE in their design and implementation, while exploring the broader applicability of the WMM framework across different cultural and healthcare settings.
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spelling doaj-art-3ea31a40c3fb4b348d85e2df09cdcb192025-08-20T02:39:52ZengBMCBMC Primary Care2731-45532024-12-0125111210.1186/s12875-024-02680-2Addressing “what matters most” to reduce mental health stigma in primary healthcare settings: a qualitative study in LebanonRacha Abi Hana0Eva Heim1Pim Cuijpers2Marit Sijbrandij3Rabih El Chammay4Brandon A. Kohrt5National Mental Health Programme, Ministry of Public HealthInstitute of Psychology, University of LausanneDepartment of Clinical, Neuro- and Developmental Psychology, Vrije UniversiteitDepartment of Clinical, Neuro- and Developmental Psychology, Vrije UniversiteitNational Mental Health Programme, Ministry of Public HealthCenter for Global Mental Health Equity, Department of Psychiatry and Behavioral Health, George Washington UniversityAbstract Background “What matters most” (WMM) is a theoretical framework based on medical anthropology and draws on cultural concepts of values and morals. It has been employed to identify cross-cultural aspects of mental health stigma. This approach assists practitioners, advocates, and researchers in assessing stigma-related factors that are relevant to the experiences of individuals in diverse cultural contexts. To implement effective anti-stigma programmes it is vital to identify and prioritize WMM for primary healthcare providers and people with lived experience of mental health conditions (PWLE). Our current objective was to explore WMM to primary healthcare providers, PWLE, primary care managers, and policymakers in Lebanon to inform mental health stigma reduction initiatives. Methods We conducted a total of 45 qualitative interviews with primary healthcare providers, PWLE, primary care managers, and policymakers. The WMM framework was applied to analyse data from primary healthcare centres in Lebanon to identify themes related to stigma against PWLE. The analysis identified common themes related to WMM. The analysis aimed to identify (a) WMM values for participants, (b) factors that threaten these WMM values and their relationship to stigma, and (c) potential interventions that could leverage WMM principles to reduce stigma. Results WMM for primary healthcare providers encompassed competency, time management, willingness, and self-care. WMM for PWLE focused on equality, support, compassion, and confidentiality. Policymakers emphasised resource sustainability as a top priority. Myths about mental health illnesses perpetuated threats to WMM, and organisational barriers also threatened WMM for primary healthcare providers and PWLE, thus creating major roadblocks to achieving stigma reduction. Conclusion This study identified key domains to understand the factors for WMM in reducing mental health stigma in Lebanon and explored factors that shape the values and priorities of both PWLE and primary healthcare providers. The study suggests assessing the effectiveness of anti-stigma interventions that actively engage PWLE in their design and implementation, while exploring the broader applicability of the WMM framework across different cultural and healthcare settings.https://doi.org/10.1186/s12875-024-02680-2StigmaPrimary careDeveloping countriesMental healthEducationTraining
spellingShingle Racha Abi Hana
Eva Heim
Pim Cuijpers
Marit Sijbrandij
Rabih El Chammay
Brandon A. Kohrt
Addressing “what matters most” to reduce mental health stigma in primary healthcare settings: a qualitative study in Lebanon
BMC Primary Care
Stigma
Primary care
Developing countries
Mental health
Education
Training
title Addressing “what matters most” to reduce mental health stigma in primary healthcare settings: a qualitative study in Lebanon
title_full Addressing “what matters most” to reduce mental health stigma in primary healthcare settings: a qualitative study in Lebanon
title_fullStr Addressing “what matters most” to reduce mental health stigma in primary healthcare settings: a qualitative study in Lebanon
title_full_unstemmed Addressing “what matters most” to reduce mental health stigma in primary healthcare settings: a qualitative study in Lebanon
title_short Addressing “what matters most” to reduce mental health stigma in primary healthcare settings: a qualitative study in Lebanon
title_sort addressing what matters most to reduce mental health stigma in primary healthcare settings a qualitative study in lebanon
topic Stigma
Primary care
Developing countries
Mental health
Education
Training
url https://doi.org/10.1186/s12875-024-02680-2
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