From social curse to social cure: A self-help group community intervention for people affected by leprosy in Nepal

Abstract

Leprosy is endemic in Nepal and disproportionately affects the most marginalized. Leprosy related stigma can be characterized as a social curse, because those affected are excluded from group life and social participation which has severe implications for psychological health. The Nepal Leprosy Trust run a community-based self-help group intervention that aims to develop a new empowered identity to re-establish access to multiple group memberships' through social participation. In this applied cross-sectional study, informed by the Social Identity Model of Identity Change, we assess this intervention. Participants (N = 98) were members of self-help groups in 10 rural villages in Nepal, and completed measures of self-help group identification, access to multiple groups, internalized stigma and wellbeing. Mediation models indicated that self-help group identification was indirectly linked to reduced stigma and increased well-being through access to multiple groups. Supporting the Social Identity Model of Identity Change, we present novel evidence that group-based interventions can offer new valued identities that link to social cure resources, even in the most adverse circumstances.