From Stigma to Understanding: Effect of an Educational Intervention on Caregivers' Attitudes Toward Mental Illness — A Randomised Controlled Trial in Enugu, Nigeria

Background: Attitudes toward individuals with mental illness have existed across different cultures and time periods and are often characterised by stigma, stereotypes, and prejudice. These negative perceptions affect not only individuals living with mental illness but also their caregivers and families. Such attitudes can discourage help-seeking behaviour and limit access to appropriate mental health services. Objective: This study assessed the effectiveness of a structured educational intervention on caregivers' attitudes toward patients with mental illness at Federal Neuropsychiatric Hospital in Enugu, Nigeria.  Methods: A randomised controlled trial using a pretest–posttest design was conducted among 92 caregivers, with 46 participants assigned to the intervention group and 46 to the control group. Participants were randomly allocated using a balloting technique. The intervention consisted of a structured educational programme delivered over six weeks, with each session lasting approximately 50 minutes. Attitudes were measured using a 4-point Likert scale, and the instrument of data collection was the Community Attitudes toward Mental Illness (CAMI) framework. Data were analysed using descriptive statistics and inferential tests, including paired and independent samples t-tests, at the 5% significance level. Results: At baseline, both groups demonstrated predominantly negative attitudes toward mental illness (intervention: 80.4%; control: 84.8%). Following the intervention, the intervention group showed a marked improvement, with 82.6% demonstrating positive attitudes, while the control group showed no significant change. The difference between groups was statistically significant (p < .001). Conclusion: Structured educational interventions significantly improved caregivers' attitudes toward individuals with mental illness. Implementing such interventions in psychiatric settings may help reduce stigma and improve patient care outcomes.