# Reducing stigma among healthcare providers to improve mental health services (RESHAPE)

> **NIH NIH R01** · GEORGE WASHINGTON UNIVERSITY · 2020 · $625,942

## Abstract

PROJECT SUMMARY/ABSTRACT
There continues to be a major gap between the global burden of mental illness and the number of patients
receiving adequate treatment. To address this gap in low- and middle-income countries, a key strategy has
been the use of primary care health workers to detect and deliver of care for mental illness. The World Health
Organization has developed the mental health Gap Action Programme (mhGAP) to train primary care workers
to detect mental illness and deliver evidence-supported treatment. However, research to date suggests that
implementation strategies for mhGAP are inadequate as evidenced by low detection rates, with multiple
studies demonstrating post-training detection at fewer than 10% of persons with mental illness detected. A
potential barrier to effective implementation of detection in primary care is stigma among primary care workers
against persons with mental illness. Our preliminary work suggests that reducing primary care workers' stigma
against persons with mental illness may improve accurate detection of mental illness. We developed a version
of mhGAP training that includes a stigma reduction component: “REducing Stigma among HealthcAre
ProvidErs” (RESHAPE). In RESHAPE, persons with mental illness (i.e., mental health service users) are
trained to share recovery stories, conduct myth-busting sessions, and promote mental health advocacy. Our
preliminary studies of RESHAPE suggest that involvement of mental health service users in training primary
care workers reduces stigma, and that stigma reduction may mediate improved detection of mental illness. We
are proposing a hybrid implementation-effectiveness (Type-3) cluster randomized controlled trial in Nepal
comparing mhGAP standard implementation with the RESHAPE implementation strategy. Target conditions
will be depression, generalized anxiety, psychotic disorders, and alcohol use disorder. In Aim 1, we will
evaluate the impact of the RESHAPE service user engagement on stigma among primary care workers. In Aim
2, we will evaluate the impact of the RESHAPE training on accurate reach of services (i.e., detection) and
evaluate stigma as a mediator of differences in accuracy. Building on the same theoretical approaches to
stigma in our primary research study, for Aim 3 we will conduct capacity building activities with to promote
greater involvement of service users in research. We will also address conduct activities to counter gender-
related stigma in mental health research careers. Successful completion of these aims will contribute to the
NIMH Strategic Plan employing implementation science to maximize the public health impact of research and
involve service users. This research advances the Fogarty International Center's mission for implementation
science and commitment to evidence-based stigma reduction. We will build capacity by reducing institutional
barriers to gender equity in research. These findings will shed light on the potential role of service use...

## Key facts

- **NIH application ID:** 10000211
- **Project number:** 5R01MH120649-02
- **Recipient organization:** GEORGE WASHINGTON UNIVERSITY
- **Principal Investigator:** Brandon Alan Kohrt
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $625,942
- **Award type:** 5
- **Project period:** 2019-09-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10000211

## Citation

> US National Institutes of Health, RePORTER application 10000211, Reducing stigma among healthcare providers to improve mental health services (RESHAPE) (5R01MH120649-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10000211. Licensed CC0.

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