Implementing Educational Intervention to Address Mental Illness Stigma (Thesis Proposal Sample)

The Implementation of an Educational Intervention to Address Mental Illness Stigma and Increase Mental Health-Seeking Behavior among Nigerian Immigrants Residing in an Urban Texan Community in the United States of America Name Institutional Affiliations Course Date Abstract Cultural beliefs, misconceptions, and myths contributing to mental illness stigma prevent some Nigerian immigrants from acknowledging mental health awareness and understanding its role in overall wellbeing. This proposed quality improvement project seeks to utilize an educational intervention with a pre and post assessment of knowledge amongst participants. Published literature supports the use of culturally sensitive educational intervention to bridge this knowledge gap, thereby changing the myths/misconceptions that surround mental illness. This project is in response to community identified concerns following recent suicides, suicide attempts and hospitalization of individuals with severe mental conditions in this cultural community with the intention to focus on cultural beliefs and stigma as it pertains to mental illness and stigma. The community may benefit from culturally sensitive education that creates awareness and improved mental health literacy with the hope that members will openly discuss challenges and seek mental health care as needed. One goal for this project is to dismantle misconceptions and embolden this population to ‘normalize’ mental illness similar to other medical conditions, such as hypertension. Education may lead to early intervention and decreased stigma amongst community members. The project’s findings have positive implications for nursing in that they will guide psychiatric mental health practitioners to design culturally-sensitive educational programs to address mental health stigma in the community. Keywords: mental illness, stigma, cultural beliefs, community, Nigerian immigrants. Table of Contents TOC \o "1-3" \h \z \u Abstract PAGEREF _Toc150462609 \h 2Background and Significance PAGEREF _Toc150462610 \h 5Problem Statement PAGEREF _Toc150462611 \h 10Purpose Statement PAGEREF _Toc150462612 \h 10Project Outcomes and PICOT PAGEREF _Toc150462613 \h 10Theoretical Frameworks PAGEREF _Toc150462614 \h 10Evidence-Based Practice Framework PAGEREF _Toc150462615 \h 10Practice Theory PAGEREF _Toc150462616 \h 11Literature Review PAGEREF _Toc150462617 \h 14Themes and Concepts PAGEREF _Toc150462618 \h 17Methods PAGEREF _Toc150462619 \h 22Project Intervention Plan (Procedures) PAGEREF _Toc150462620 \h 22Participants/population PAGEREF _Toc150462621 \h 23Recruitment PAGEREF _Toc150462622 \h 23Data Collection Instruments PAGEREF _Toc150462623 \h 24Procedures for Project Implementation PAGEREF _Toc150462624 \h 25Key Personnel and Stakeholders PAGEREF _Toc150462625 \h 26Potential Barriers to Implementation and Sustainability PAGEREF _Toc150462626 \h 27Ethical Considerations PAGEREF _Toc150462627 \h 27Risk-Benefits PAGEREF _Toc150462628 \h 28Proposed Timeline PAGEREF _Toc150462629 \h 28Anticipated Resources and Budget PAGEREF _Toc150462630 \h 28Evaluation Plan PAGEREF _Toc150462631 \h 29Specific Plan for Evaluation of Each Objective PAGEREF _Toc150462632 \h 29Evidence-Based Measures to Be Applied to Evaluation Plan PAGEREF _Toc150462633 \h 29Analysis Method for Each Objective PAGEREF _Toc150462634 \h 30References PAGEREF _Toc150462635 \h 31Appendices PAGEREF _Toc150462636 \h 37 Appendix A Prisma flow Diagram……………………………………………………………37 Appendix B Evidence Matrix……………………………………………………………...38-51 Appendix C Level of Evidence………………………………………………………………..52 Appendix D Quality of Evidence……………………………………………………………...52 Appendix E Pre-test Questionnaire……………………………………………………………53 Appendix F Post-test Questionnaire………………………………………………………54-55 Appendix G Project Timeline ………………………………………………………………..56 Appendix H JHNEBP Permission……………………………………………………………57 Appendix I JHNEBP Model’s PET Process ………………………………………………...58 Appendix J Dr. Joseph H. Hammer Reply……………………………………………….59-60 Appendix K How to obtain a copy of ISMI-9……………………………………………….60 Appendix L Educational intervention……………………………………………………61-63 Appendix M Recruitment Flyer………………………………………………………………64 Appendix N Bandura’s Social Cognitive Model…………………………………………….65 Appendix O Cover Letter/Waiver of Consent……………………………………………….66 Appendix P IRB Site Letter……………………………………………………………..........67 Background and Significance Unmanaged mental health problems among Nigerian immigrants residing in the United States (U.S.) are a concern across the country. Mental illness has always posed a great public health concern globally and the immigrant populations may be the most affected. According to Jing et al. (2023), immigrants are at a higher risk of experiencing mental health conditions, not only due to discrimination but also as a result of their cultural beliefs and attitudes. Nigerian immigrants constitute a significant and diverse population within the U.S., with unique cultural backgrounds and experiences. A study by Omenka et al. (2020) shows African immigrants make about 5% of the United States population and Nigerians constituting over 14% of this population. Nigerian immigrants, like any other immigrant communities, are confronted with series of challenges that are attributed to acculturation, accessing and understanding healthcare services, as well as limited awareness of mental health as a medical health condition. In the Nigerian cultural context, mental illness is mostly attributed to spiritual or supernatural causes leading to preference for religious or traditional healing methods rather than professional mental healthcare. Derr (2016) reports the most frequently used treatment strategy for African immigrants is spiritual healing and 23% of Nigerian immigrants endorse this treatment strategy. According to Pederson et al. (2022) Black immigrants endorse the beliefs that mental illness is a punishment from God or could be due to possession by evil spirits. Many immigrants who may experience symptoms associated with mental illness due to immigration issues access mental health care at rates far below the general population. This low access rate leaves many immigrants feeling vulnerable and at elevated risk of untreated mental health conditions (Derr, 2016; Jing et al., 2023). Many Nigerian immigrants in the US encounter challenges in accepting, understanding, and accessing mental healthcare. Immigrant communities face barriers accessing mental healthcare due to culture beliefs, social context and language barriers. Nigerian cultural beliefs often present mental illness as attributable to spiritual or supernatural causes. These cultural beliefs may lead to delayed care, misconceptions, stigma, and limited acceptance of mental health as a medical condition (Anjorin & Wada, 2022; Okafor et al., 2022). Black immigrants seek mental health services from traditional healers rather than healthcare professionals due to mental illness stigma and knowledge deficit (Pederson et al., 2022). Stigmatization of people with mental illness is very prevalent in African countries such as Nigeria and stigma has remained a strong barrier to accessing mental health care in Nigeria (Ubaka et al., 2018). Therefore, it is imperative to address these issues to improve the mental health outcomes of Nigerian immigrants residing in the US. In order to achieve this, targeted educational interventions portraying mental illness like any other medical health condition may be helpful at improving understanding, reducing stigma and improving likelihood to seek care while promoting acceptance of mental health illness within a Nigerian community. Likewise, it is important to discredit myths and challenge cultural beliefs. Education may improve understanding, lessen stigmatization and facilitate sooner access to mental health services for Nigerian immigrants. Therefore, normalizing mental health as a medical treatment in need of care is extremely important to ensure access to care and improve outcomes. Poor mental health literacy as exemplified by knowledge deficit of the cause of mental illness has significantly influenced the behaviors of Nigerian immigrant in the US towards people diagnosed with mental health illness and the ability to seek help. Associating mental health illness with supernatural causes and curses from God signifies the misunderstanding of the cause of mental illness among Nigerian immigrants. Limited mental health literacy may negatively influence the response of members of the Nigerian community toward others who may be quietly facing a mental health crisis. This ethnic community view traditional healers as experts who can help people to address problems related to mental health. They consult the traditional healers before seeking help from hospitals and trained mental health professionals. Family caregivers within this ethnic community also have poor knowledge and attitude in relation to the causes of mental health problems, a problem that further affects the help seeking behaviors of families. A reliance on family caregivers who lack knowledge may exacerbates mental health stigma and poor mental health outcomes among Nigerian immigrants in the United States (Okafor et al.,...