The innovation is a comprehensive anti-stigma and discrimination intervention for primary health care workers who deliver care to persons with mental illness and substance use problems. There is an emphasis on a recovery oriented approach in service provision. The five components of the intervention are as follows:
Developing local teams of leaders
The local team of leaders or champions at each primary health care centre includes primary health care workers and in most of the cases the head of the centre. This component was critical for adapting the components of the intervention (contact-based training, analysis of organizational policies and procedures for stigmatizing content, raising awareness of mental illness-related stigma in the community, and recovery-based arts) to the Peruvian cultural context as well as generating buy-in for the intervention by staff at participating primary health care centres.
Innovative contact-based training
Training includes key anti-stigma and recovery principles along with specific mental health and substance use topics relevant to primary health care providers. Using an adult education model, modules have been tailored according to results from situational assessments of each centre, and recognized best practices. A special emphasis on cultural perspectives and values has been integrated into the training. A total of twelve-hour workshops were held at each primary health care centre. A client with a mental illness participated in the trainings.
Analysis of policies and procedures
The analysis of policies and procedures aimed to evaluate strengths and areas for improvement in service delivery for individuals with mental illness and substance use problems. Recommendations were provided to each centre in order to promote changes for improving access and quality of care of healthcare service users who present these conditions.
Team of local leaders of two centres selected painting for their primary health care centre. Individuals with mental illness, who access primary healthcare services, worked with staff members, to create art based on the experience of stigma, discrimination, acceptance and recovery. In one centre volunteer health promoters (community members who link people with services) and staff members participated in the group of art. At the end of a ten session workshop series, participants presented their work to staff and clients at each centre.
A video was used to increase awareness about stigma and recovery for people with mental illness and substance use problems in the community. The video portrayed the daily life of a person who lives with a mental illness and how she is coping with the illness and promoting her recovery. It also showed the components of the intervention.