INTRODUCTION:

Mental health stigma is an ongoing problem in many parts of the world. Especially in South Asian countries like India, teenagers are a particularly vulnerable group. This is because mental health concerns often go undiagnosed or untreated due to the stigma surrounding mental illness. Influence of cultural beliefs family expectations and traditional attitudes about mental health may exacerbate these barriers to care.

In rural areas, for example, erosion in Tamil Nadu Mental health problems are often misunderstood. And there is a stigma about seeking help for mental problems. The reluctance to seek help in such communities stems from fear of social exclusion and lack of knowledge about mental health. Psychoeducation aims to educate individuals about mental health issues and reduce stigma. One effective strategy for addressing these challenges is culturally tailored psychoeducational programs. which combines local customs, beliefs and values to increase the relevance and acceptability of these interventions. The objective of this study was to evaluate the effectiveness of a culturally tailored psychoeducational program. It is designed to reduce stigma and increase help-seeking behavior among youth in Erode.

Stigma regarding mental illness is well documented in Indian society. Mental health is often associated with shame and rejection from society (Sathiyaseelan & Ahmed, 2017). Adolescents face unique challenges in addressing mental health issues. This is often exacerbated by academic pressure and family expectations (Sharma et al., 2015). Psychoeducational programs that aim to reduce stigma and improve mental health knowledge have been shown to be effective in various global contexts (Chandran et al., 2021). However, in rural India where cultural norms play an important role the effectiveness of the project is still being researched.

Culturally tailored interventions have shown promise in aligning mental health education with community cultural values and addressing barriers stemming from stigma. These programs are not only informative but it also addresses local perspectives on mental illness and promotes community solutions (Patel et al., 2020).

METHODS:

This study used a quasi-experimental design with pre-assessment, post-test, and follow-up. Participants were divided into two groups: an intervention group (n=200) and a control group (n=200). Both groups completed baseline assessments. This was followed by a final intervention evaluation and a post-intervention follow-up period for the experimental group. A total of 400 adolescents (aged 14-19) were recruited from schools and community centers in Erode. Participants were selected through stratified random sampling from urban and rural areas of Erode to ensure a representative sample. Inclusion criteria included adolescents who were willing to participate and had no previous experience in psychoeducation about mental health. The culturally adapted psychoeducational program consists of four 90-minute sessions over a two-week period. Program content was developed with input from local mental health professionals.

The program included:

· Introduction to Mental Health: Understanding mental health and common mental illnesses.

· Debunking Myths: Addressing misconceptions and stigma about mental illness.

· Cultural Context: Exploring mental health within the cultural framework of Erode, incorporating local traditions, values, and family roles.

· Help-Seeking Behaviors: Encouraging participants to seek help when needed, highlighting local mental health resources.

The Mental Health Stigma Scale (MHSS) was used as a validated scale for measuring mental health stigma. Higher scores indicate greater stigma. The Help Seeking Behavior Intentions Instrument (HSBIS) was used to assess adolescents' intentions to seek help for mental health problems. Higher scores indicate a greater willingness to seek help. A demographic questionnaire was used to collect basic demographic information including age, gender, and educational level. and previous exposure to mental health knowledge. Descriptive statistics were used to summarize demographic characteristics. Paired t tests were used to assess changes within groups from pre- to post-intervention. Meanwhile, independent t-tests were used to compare changes in the intervention and control groups, and a p value < 0.05 was considered to be statistically significant.

RESULTS:

Participant Demographics

Demographic Factor	Intervention Group (n=200)	Control Group (n=200)
Gender
Male	104 (52%)	101 (50.5%)
Female	96 (48%)	99 (49.5%)
Age (Mean±SD)	16.5 ± 1.2	16.4 ± 1.1
Previous Mental Health Knowledge	85 (42.5%)	89 (44.5%)

Pre- and Post-Intervention Comparison

Within the intervention group, significant changes were observed in both stigma and help-seeking behavior. The reduction in stigma and the increase in help-seeking intentions were statistically significant.

Measure	Pre-Intervention (M±SD)	Post-Intervention (M ± SD)	p-value
Mental Health Stigma Scale (MHSS)	43.2±6.4	28.1±5.2	< 0.001
Help-Seeking Behavior Intentions (HSBIS)	34.9 ±5.3	45.4±5.1	< 0.001

Intervention vs. Control Group

At post-intervention, the intervention group showed significantly lower stigma and higher help-seeking behavior intentions compared to the control group.

Measure	Intervention Group (Post)	Control Group (Post)	p-value
Mental Health Stigma Scale (MHSS)	28.1 ± 5.2	39.5 ± 6.8	< 0.001
Help-Seeking Behavior Intentions (HSBIS)	45.4 ± 5.1	37.8 ± 6.4	< 0.001

Follow-up Results:

At the 3-month follow-up, the intervention group maintained significant reductions in stigma and increased help-seeking behavior compared to baseline.

Measure

Baseline

(M ± SD)

Follow-up

(M ± SD)

p-value

Mental Health Stigma Scale (MHSS)

43.2 ± 6.4

30.4 ± 5.6

< 0.001

Help-Seeking Behavior Intentions (HSBIS)

34.9 ± 5.3

46.0 ± 5.3

< 0.001

DISCUSSION:

The findings of this study indicate that a culturally tailored psychoeducational program is effective in reducing stigma and promoting help-seeking behavior among Erode youth. These results are consistent with previous studies showing evidenced the positive effects of a psychoeducational program on mental health attitudes (Chandran et al., 2021), with significantly reduced stigma and significantly reduced help-seeking behavior in the intervention group. It reinforces the importance of cultural relevance in health education.

The program's effectiveness can be attributed to its culturally sensitive content. It addresses local myths and misconceptions about mental illness and promote help-seeking behavior that is consistent with community values. This approach ensures a high level of participation and buy-in from teenagers who are often reluctant to discuss. Mental health due to socio-cultural barriers. Despite these positive outcomes, the study has some limitations. The reliance on self-report measures may introduce biases, and the study was conducted in a specific region, which may limit the generalizability of the findings to other areas of India. Future research should focus on longitudinal studies to assess the long-term impact of such interventions and their scalability to other regions.

CONCLUSION:

This study highlights the effectiveness of a culturally tailored psychoeducation program in reducing stigma and increasing help-seeking behavior among adolescents in rural India. These findings have important implications for mental health interventions in similar settings, suggesting that culturally adapted psychoeducation programs can significantly improve mental health literacy and help-seeking intentions in adolescents. Expanding such programs across rural India could play a key role in reducing mental health stigma and promoting early intervention.

REFERENCES:

1. Chandran, V., et al. Cultural Sensitivity in Mental Health Interventions: A Review. Indian Journal of Psychiatry. 2021; 63(5): 75-83.

2. Patel, V., et al. Mental Health in South Asia: A Review of the Evidence. The Lancet Psychiatry. 2020; 7(8): 673-684.

3. Sathiyaseelan, V., and Ahmed, M. Mental Health Stigma in South Asia: A Review of the Literature. Asian Journal of Psychiatry. 2017; 31: 10-15.

4. Sharma, S., et al. Mental Health and Adolescents: A Review of the Literature from India. Journal of Child and Adolescent Mental Health. 2015; 27(2): 111-117.

Received on 26.11.2024 Revised on 14.02.2025

Accepted on 22.04.2025 Published on 23.05.2025

Available online from May 26, 2025

A and V Pub Int. J. of Nursing and Med. Res. 2025; 4(2):100-102.

DOI: 10.52711/ijnmr.2025.20

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