Randomized Controlled Trial of a Brief Video Intervention to Reduce Self-Stigma of Mental Illness

Doron Amsalem, MD ; Samantha E. Jankowski, MA ; Philip Yanos, PhD ; Lawrence H. Yang, PhD ; John C. Markowitz, MD ; R. Tyler Rogers, MA ; T. Scott Stroup, MD ; Lisa B. Dixon, MD, MPH ; Leah G. Pope, PhD

J Clin Psychiatry 2024;85(1):23m15034

ABSTRACT

Objective: Self-stigma, a phenomenon wherein individuals internalize self-directed negative stereotypes about mental illness, is associated with negative outcomes related to recovery. This randomized controlled study assessed the efficacy of a brief social contact–based video intervention in reducing self-stigma in a large sample of individuals ages 18–35 endorsing an ongoing mental health condition. We hypothesized that the brief video would reduce self-stigma.

Methods: In January and February 2023, we recruited and assigned 1,214 participants to a brief video-based intervention depicting a young individual living with mental illness sharing his personal story or to a non-intervention control. In the 2-minute video, informed by focus groups, a young individual described struggles with mental illness symptoms; this was balanced with descriptions of living a meaningful and productive life. Self-stigma assessments (Stereotype Endorsement, Alienation, Stigma Resistance, Perceived Devaluation Discrimination, Secrecy, and Recovery Assessment Scale) were conducted pre- and post-intervention and at 30-day follow-up.

Results: A 2 ✕ 3 group-by-time analysis of variance showed that mean self-stigma scores decreased in the intervention arm relative to control across 5 of 6 self-stigma domains: Stereotype Endorsement (P = .006), Alienation (P < .001), Stigma Resistance (P = .004), Secrecy (P < .001), and Recovery Assessment Scale (P < .001). Cohen d effect sizes ranged from 0.22 to 0.46 for baseline to post-intervention changes. Baseline and 30-day follow-up assessments did not significantly differ.

Conclusions: A 2-minute social contact–based video intervention effectively yielded an immediate but not a lasting decrease in self-stigma among young individuals with ongoing mental health conditions. This is the first study to examine the effect of a video intervention on self-stigma. Future trials of self-stigma treatment interventions should explore whether combining existing interventions with brief videos enhances intervention effects.

Trial Registration: NCT05878470

J Clin Psychiatry 2024;85(1):23m15034

Author affiliations are listed at the end of this article.

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