Preliminary effectiveness study of the Cope Notes digital mental Health program.

BACKGROUND: Cope Notes is a subscription-based EMI that uses Short Message Service (SMS) technology to deliver daily text messages that promote hope, reduce stigma, and encourage coping and the use of positive psychology strategies. AIM: We aimed to evaluate the preliminary effectiveness of Cope Notes, a brief ecological momentary intervention (EMI). METHODS: We conducted a longitudinal study where participants (N = 64) completed measures of depression, anxiety, perceived stress, coping, emotional intelligence, label avoidance, attitudes towards treatment-seeking, and readiness for change before the intervention, 1 month post-intervention, and 2 months post-intervention. This study includes mixed repeated measures ANOVAs to analyze over time. RESULTS: Findings show that participants with severe depression experienced a significant decrease in anxiety and depressive symptoms, and perceived stress (p < .001) and showed a significant increase in emotional intelligence at 1 month post-intervention. Participants with mild to moderate depression experienced a significant increase in overall coping and problem-focused coping. CONCLUSIONS: While further investigation of Cope Notes' feasibility and acceptability is warranted, these findings support that the Cope Notes EMI holds promise as a low-cost, impactful mental health solution for populations with limited access to care and those experiencing self-stigma preventing help-seeking.

Factors predicting help seeking for mental illness among college students.

BACKGROUND: Evidence supports the contribution of various stigma-related constructs to help-seeking. These constructs have yet to be tested in a single model among college students, a group highly affected by mental illness. AIMS: Using data from 153 college students, this study examines factors contributing to help seeking for mental illness. METHOD: Using path analysis, the current study evaluated a model of the relationship between level of familiarity, personal stigma, desired social distance, label avoidance, attitudes towards treatment seeking and intentions to seek treatment. RESULTS: Findings support a model of help-seeking describing the relationship between familiarity with mental illness, personal stigma, social distance, label avoidance, attitudes and intentions to seek treatment. CONCLUSIONS: Findings suggest label avoidance, attitudes towards treatment seeking and intentions to seek treatment might be augmented through interventions aimed at increasing college students' levels of familiarity, or intimate contact, with individuals with mental illness. Additional implications for practice and further research are addressed.

Mental illness stigma and disclosure in college students.

OBJECTIVE: The aim of this study was to investigate the relationship between mental illness identity, shame, secrecy, public stigma, and disclosure amongst college students. Participants included 1393 college students from five postsecondary institutions. METHODS: Structural equation modeling was used to examine two path models predicting disclosure and desire to join a program aiding with disclosure. RESULTS: Variables found to be significant in predicting disclosure included mental illness identity and public stigma. In turn, desire for disclosure predicted desire to join a program aiding in disclosure. Gender and race/ethnic differences were observed, with men and Whites more likely to want to disclose a mental illness or join a program aiding with disclosure compared with women and non-Whites, respectively. CONCLUSIONS: These findings suggest that some college students may find programs aiding in disclosure useful in assisting them to achieve their desire to be "out" with their mental illness.

Does humor influence the stigma of mental illnesses?

Public stigma is a barrier for people with mental illness. Humor may have the potential to decrease stigmatizing attitudes in the context of disclosure. Participants completed measures on stigmatizing attitudes and humor style and were then randomized to one of three conditions (self-disclosure comedy sketch, the same comedy sketch with no disclosure, and a control comedy sketch). After reviewing the comedy sketch, the participants repeated the attitude measures and provided perceptions of the comic. Humor styles and perceptions significantly interacted with condition to reduce stigma. Perceptions of the self-disclosed comic were associated with reduced stigma. People exhibiting affiliative humor style (i.e., they enjoy making others laugh) were shown to have significantly greater stigma changes in the disclosed condition compared with the nondisclosed and control conditions. Affiliative humor endorsers also interacted with the nondisclosed condition, suggesting that mental health comedy might generally reduce stigma in people who use humor to improve relationships.

How does direct to consumer advertising affect the stigma of mental illness?

Stigma interferes with life goals of people with mental illness. Direct-to-consumer advertising (DTCA) may impact stigmatizing attitudes. The purpose of this study is to examine the effects of psychiatric medication DTCA on the stigmatizing and affirming attitudes of the general population versus individuals self-identified with mental illness. Participants (n = 272) were randomly assigned to watch a DTCA about Cymbalta, an antidepressant, embedded in two other advertisements for non-pharmaceutical products. Participants completed measures of stigmatizing and affirming attitudes before and after viewing this DTCA. Results indicate that the Cymbalta DTCA worsened the attitudes of the general public. These participants were less likely to offer help, endorse recovery, and agree with self-determination attitudes towards people with mental illness following viewing the DTCA. The self-identified group reported less blame, less dangerousness, less social avoidance, more pity, and greater willingness to help after viewing the DTCA. Moreover, there was significant improvement in their endorsement of recovery. Results suggest that DTCAs about psychiatric medication may increase the public's stigma towards people with mental illness but reduce stigma among individuals who identify as having a mental illness. Findings are somewhat limited by selection biases and self-report. Implications for further development of DTCAs are considered.

Examining the Effects of Digital Stories to Address Mental Illness and Sexual and Gender Minority-Related Stigma.

INTRODUCTION: Sexual and gender minority (SGM) individuals living with mental illness often experience stigma associated with marginalized identities of sexual orientation, gender identity, and mental illness (MI). Sharing stories of lived experiences is an effective approach to reducing various forms of stigma; however, it is unclear whether stories shared by SGM living with mental illness (SGM MI) can reduce MI- and SGM-related stigma. METHODS: Using a randomized controlled trial design, participants watched digital stories of self-identified SGM individuals living with a mental illness, non-SGM individuals living with mental illness, or a control condition (TedTalks on environmental issues and growing up in China) to examine the use of representative digital stories in addressing SGM- and MI-related stigma. RESULTS: In a sample of 218 participants, digital stories of SGM MI effectively reduced MI-related stigma (personal stigma (from 33.19 to 31.90) and discrimination (from 8.33 to 7.57)), but were ineffective at reducing SGM-related personal stigma (negative attitudes toward lesbians and gay men, transphobia, or genderism; p > .05). CONCLUSION: Our study highlights the need to develop culturally adapted anti-stigma programs in collaboration with individuals with lived intersectional SGM and MI experiences.

Reducing self-stigma by coming out proud.

Self-stigma has a pernicious effect on the lives of people with mental illness. Although a medical perspective might discourage patients from identifying with their illness, public disclosure may promote empowerment and reduce self-stigma. We reviewed the extensive research that supports this assertion and assessed a program that might diminish stigma's effect by helping some people to disclose to colleagues, neighbors, and others their experiences with mental illness, treatment, and recovery. The program encompasses weighing the costs and benefits of disclosure in deciding whether to come out, considering different strategies for coming out, and obtaining peer support through the disclosure process. This type of program may also pose challenges for public health research.

A Qualitative Evaluation of an Adapted Assertive Community Treatment Program: Perspectives During COVID-19.

The Pinellas County Empowerment Team (PCET) was an adapted assertive community treatment (ACT) program created to meet the needs of Pinellas County residents with serious behavioral health concerns and high frequency of hospitalization (medical and psychiatric) and incarceration. Recent research demonstrates that individuals participating in ACT programs can transition to lower-intensity services. To understand the needs and barriers in transitioning PCET clients to lower-intensity services and the unique experiences during the coronavirus (COVID-19) pandemic, the researchers conducted a qualitative evaluation which includes a case record review and in-depth interviews with clients of PCET and staff members. Our findings indicated several barriers to transitioning PCET clients, including a lack of sufficient behavioral health support outside the ACT program and some clients' concerns regarding their abilities once out of the program.

Challenging the Stigma of Mental Illness Among College Students.

PURPOSE: This study investigated the impact of contact- and education-based antistigma interventions on mental illness stigma, affirming attitudes, discrimination, and treatment seeking among college students. METHODS: Data were collected from 198 students of a Chicago University campus in spring of 2014. Participants were randomly assigned to one of three conditions: a contact-based antistigma presentation, education-based presentation, or control condition. Measures of stigma, discrimination, affirming attitudes, and treatment seeking were administered at preintervention and postintervention. RESULTS: A 3 × 2 analysis of variance was completed for each measure to examine condition by trial interactions. Both contact- and education-based interventions demonstrated a significant impact on personal stigma, perceptions of empowerment, discrimination, attitudes towards treatment seeking, and intentions to seek treatment from formal sources. No difference in effect was demonstrated between the contact- and education-based conditions. CONCLUSIONS: These findings suggest that these two approaches should be considered for challenging mental illness stigma among college students.