title: Community conversation: addressing mental health stigma with ethnic minority communities.
abstract: BACKGROUND
  Stigma associated with mental health problems is a significant public health issue. Patterns of stigma and discrimination vary between and within communities and are related to conceptualisations of, and beliefs about, mental health. Population approaches to addressing stigma rarely consider diverse cultural understandings of mental health.
  
  
  METHODS
  257 members of the major black and minority ethnic communities in Scotland participated in 26 mental health awareness workshops that were designed and delivered by community organisations. Questionnaires measuring knowledge, attitudes and behavioural intent were completed before and after the intervention.
  
  
  RESULTS
  Community led approaches that acknowledge cultural constructs of mental health were received positively by community groups. The study found significant reported stigma in relation to public protection, marriage, shame and contribution, but also high levels of recovery optimism. The workshops resulted in significant positive change in relation to knowledge, attitudes and behavioural intent amongst participants, with most aspects of stigma showing significant improvement, with the exception of dangerousness.
  
  
  CONCLUSIONS
  The paper argues community approaches to tackling stigma are more valuable than top-down public education and could form the basis of national initiatives. Refinements to the evaluation framework are considered.
authors.affiliation: Glasgow School of Social Work, A Joint School of Universities of Glasgow and Strathclyde, Glasgow, Scotland, UK. Leeknifton@gmail.com
authors.forename: Lee
authors.initials: L
authors.lastname: Knifton
authors.forename: Mhairi
authors.initials: M
authors.lastname: Gervais
authors.forename: Karen
authors.initials: K
authors.lastname: Newbigging
authors.forename: Nuzhat
authors.initials: N
authors.lastname: Mirza
authors.forename: Neil
authors.initials: N
authors.lastname: Quinn
authors.forename: Neil
authors.initials: N
authors.lastname: Wilson
authors.forename: Evette
authors.initials: E
authors.lastname: Hunkins-Hutchison
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D017677:Age Distribution; D001294:Attitude to Health / Q000208:ethnology; D003469:Culture; D003625:Data Collection / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D033182:Intention; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology* / Q000706:statistics & numerical data; D011639:Public Opinion; D012606:Scotland / Q000208:ethnology; D013240:Stereotyping; D011795:Surveys and Questionnaires