Breaking stigma, discrimination and promoting rights: global evaluation of the World Health Organization QualityRights e-training on mental health, recovery and community inclusion

Background There is an urgent need to address the poor quality of mental healthcare and human rights violations within mental health systems and communities. To achieve this, efforts must focus on changing the attitudes that perpetuate stigma and discrimination against individuals with mental health conditions, as well as psychosocial, intellectual and cognitive disabilities. The World Health Organization (WHO) QualityRights e-training on mental health, recovery and community inclusion is tackling these issues in several countries; however, its global impact has yet to be evaluated. Aims This study aims to assess the changes in attitudes following the completion of the WHO QualityRights e-training in countries worldwide. Method Data from 3026 participants were analysed in this pre-post intervention study. Changes in scores on the WHO QualityRights Attitudes questionnaire were evaluated with the paired t-test and Wilcoxon signed-rank test. Results The mean differences from baseline to post-training on the WHO QualityRights Attitudes questionnaire were 9.91 (95% CI 9.58-10.24, d = 1.07) for the total sample, 8.95 (95% CI 8.59-9.31, d = 0.99) for the high-income countries sample; and 12.75 (95% CI 12.03-13.47, d = 1.33) for the low- and middle-income countries sample. These findings indicate that participants, after completing the e-training, showed a decrease in negative attitudes toward individuals with mental health conditions and psychosocial, intellectual and cognitive disabilities. Conclusions This study suggests that the WHO QualityRights e-training has a positive, large effect in reducing negative attitudes toward individuals with mental health conditions and psychosocial, intellectual and cognitive disabilities, and can contribute to reduced stigma and greater alignment with rights-based approaches. These findings support the scale-up of the WHO QualityRights e-training programme.