Improving the mental health and wellbeing of people affected by leprosy or Buruli ulcer in Nigeria

INTERVENTION: The study proposes a holistic, community‐oriented approach for improving access and utilization of mental health services through interventions using holistic approach work synergistically to reduce mental disorders and improve quality of life among persons affected by leprosy or Buruli ulcer, viz: 1. Engaging selected community members as lay counsellors to provide psychotherapy and counselling services for persons affected by leprosy or Buruli ulcer 2. Formation of self‐help groups (SHG) among persons affected by leprosy or Buruli ulcer for peer support and improving self‐esteem 3. Training of healthcare workers to provide pharmacological treatment or referral services to experts where necessary The intervention phase will take about 1 ‐ 2 years with quarterly community sensitization during supervisory visits by the research team to promote social inclusion, raise awareness on mental health problems and availability of services to create demand and enhance utilization. Re‐training of service providers and self‐help groups will be done twice throughout the project period. The control arm will not receive any form of intervention. CONDITION: Mental health and quality of life of persons affected by leprosy or Buruli ulcer ; Mental and Behavioural Disorders PRIMARY OUTCOME: Mental health status (especially, depression and generalized anxiety disorder) and the quality of life measured using PHQ‐9, GAD‐7 and WHOQOL‐BREF at baseline (before intervention) and repeated after 2 years of intervention SECONDARY OUTCOME: ; 1. Mental well‐being of patients measured using the Warwick Edinburgh Mental Well‐being Scale (WEMWBS) at baseline (before intervention) and repeated after 2 years of intervention; 2. Self‐stigma of leprosy patients measured with SARI Stigma Scale at baseline (before intervention) and repeated after 2 years of intervention; 3. Social inclusion of leprosy patients by community members measured using the Social Distance Scale (SDS) at baseline (before intervention) and repeated after 2 years of intervention; INCLUSION CRITERIA: 1. Any person affected by leprosy or Buruli ulcer 2. All people affected by leprosy or Buruli ulcer registered for treatment from 2014 up to 1 year before the end of the intervention 3. Participants aged between 15 to 65 years registered for treatment