Project coordination
The Leprosy Mission Trust India
The Leprosy Mission Nepal

Partners
The Leprosy Mission Great Britain
University of Sussex (Brighton & Sussex Medical School)

Aim: The main aim of this Participatory Action Research study is to develop a replicable process through which persons affected by leprosy with anxiety and depression co-produce local community-based mental health interventions in India and Nepal.

Full project title: Working towards mental health Recovery Among Persons affected by leprosy (WRAP): A feasibility study in India
and Nepal

Project summary

Physical symptoms and complications of leprosy, such as visible changes to the skin, chronic pain, and ulcers and wounds which can lead to physical impairments, have a negative effect on the mental health of those who are affected by the disease. This negative effect on mental health is often exacerbated by the exclusion and stigma people affected by leprosy experience in their daily lives. Not being allowed to leave one’s house, losing a job or being denied the opportunity for education or marriage may result in feeling lonely, anxious or depressed, even suicidal. It is not surprising, then, to see that most studies find a significantly higher prevalence of depression and anxiety among persons affected by leprosy, in addition to low self-esteem and low quality of life.

While there is plethora of interventions that target anxiety and depression originating from the Global North, some of which are available globally, there is a gap in understanding and identifying local mental health idioms using local cultural perspectives and vocabularies, and in developing and evaluating locally-rooted interventions, for and with people affected by leprosy. This study aims to improve the lives of individuals affected by leprosy and experiencing mental health issues, by empowering them through the co-production of locally-rooted, meaningful and effective interventions.

To that end, the research team will work with persons affected by leprosy in India and Nepal to explore whether it is feasible to develop together a mental health intervention that is replicable in other similar contexts. First, persons affected by leprosy will decide on what ‘good’ mental health means for them, identify the factors that contribute to good mental health, and design interventions that may lead to good mental health. These interventions will be assessed to see whether they make a positive difference for the mental health of people affected by leprosy.

The immediate purpose of the study is to make those interventions that work available for the use of other people affected by leprosy in other similar communities. However, every community and culture is different; therefore it is more important to give the tools to person affected by leprosy in other communities to produce interventions that are appropriate and efficient in their own contexts. With that in mind, the broader purpose of the study is to capture the entire process of how interventions can be produced by persons affected by leprosy, so that the process can be replicated in other places. To that end, the study will also produce guidelines on how other researchers and communities can produce their own interventions that work in their own contexts.