Mental illness stigma research has grown substantially over the past two decades, and there are now standardized and validated measures to assess mental illness stigma. While antistigma interventions have been shown to shift knowledge and attitudes regarding mental illness in the short run (immediately post-intervention and within 30 days), significant gaps persist in the assessment of antistigma interventions in terms of their ability to show sustained changes in knowledge and attitudes beyond 3 to 6 months post-intervention.
Given the persistent nature of stigmatizing beliefs11 and the recurrence risk associated with mental illness, antistigma interventions will need to have long lasting effects in changing knowledge and attitudes in order to effectively address public health inequities related to mental illness stigma.
In a commentary published in the Journal of Clinical Psychiatry, Aderonke Pederson, MD from the Depression Clinical and Research Program at Mass General, discusses video-based mental health stigma reducing interventions. Stigma worsens mental health outcomes and has been associated with delayed treatment-seeking behavior and low utilization of mental health services. Thus, designing effective interventions that can address and potentially reduce stigma is an important endeavor toward closing current public health gaps stemming from the stigmatization of mental illness.
Dr. Pederson refers to the work of Patrick Corrigan, PsyD, a foremost expert on antistigma interventions, who has laid out five key principles for the development of antistigma interventions. Interventions must be targeted (designed for a specific target population), local (considering the differing needs of urban vs. rural settings), credible (reflecting sociodemographic factors, such as race, ethnicity, gender, or socioeconomic status), continuous (given the fleeting effects of a single vs. repetitive exposure to antistigma interventions), and contact itself (removing the social distance between individuals with stigma and individuals with lived experience of mental illness).
In the current literature, Dr. Pederson notes, most studies do not adopt all five principles in designing antistigma interventions, Dr. Pederson also notes that future research must assess change in behavior as an outcome, a factor that is critical to ensuring the public health and policy impact of antistigma interventions. What we want to see is a measurable change in actual use of mental health services (such as adherence to visits with a mental health clinician), rather than change based solely on knowledge or subjective attitudes toward the use of mental health services.
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Pederson AB. Developing mental illness stigma–reducing interventions: why are the post-intervention assessment period and behavior change significant? J Clin Psychiatry. 2023;84(1):22com14684.
Rivera KJ, Zhang JY, Mohr DC, Wescott AB, Pederson AB. A Narrative Review of Mental Illness Stigma Reduction Interventions Among African Americans in The United States. J Ment Health Clin Psychol. 2021; 5(2):20-31.
