Effectiveness of Mental Health Support Group Participation on Illness Prognosis and Wellness: A Cohort Study of Participant Experiences in Zambia

Abstract

Background: Mental health disorders are a growing global crisis, disproportionately affecting vulnerable populations with limited access to care. In Zambia, services remain predominantly biomedical, under-resourced, and lacking formalized psychosocial interventions. Support groups, grounded in group psychotherapy and peer support theory, have shown promise in reducing symptom severity and improving quality of life. Aim: This study examined the effectiveness of mental health support groups on clinical and functional outcomes within this context. Methods and Materials:  A prospective cohort study design was used to examine the effectiveness of mental health support groups. A total of 263 participants from 21 groups were assessed at baseline and nine months using the alcohol use disorder identification test (AUDIT), Patient health questionnaire 9 items (PHQ-9), and world health organization quality of life brief (WHOQOL-BREF). Non-parametric analyses and regression models were applied to evaluate changes in symptom severity and predictors of wellness outcomes. Results: Symptom severity significantly decreased from baseline (M = 3.992, SD = 0.829) to follow-up (M = 2.209, SD = 1.691), with a large effect size (rrb = .888). Attendance correlated weakly but significantly with symptom reduction, while facilitator type showed minor associations with quality of life (p = 0.05). Regression analysis identified symptom severity at follow-up as the strongest predictor of wellness outcomes. Structured support groups demonstrated therapeutic value in reducing distress and enhancing coping. Conclusion: Findings highlight the need for tailored interventions for individuals with persistent high severity and suggest that integrating support groups into primary care could strengthen Zambia’s mental health system, reduce stigma, and expand access to psychosocial support.