New research finds most effective messaging for reducing mental illness stigma

April 24, 2021
Inspirational campaigns bring better results than those educating about mental illness. (Mark Stehle/AP Images for NAMI-NYC)

Inspirational campaigns bring better results than those educating about mental illness. (Mark Stehle/AP Images for NAMI-NYC)

Inspirational messaging about the competence of those with a mental illness is generally more effective in anti-stigma campaigns than messages that present information about the biological origins or psycho-social origins of a mental illness, according to a new study that is among the first to provide data about different types of stigma-reducing messaging.

Psychological research has shown that people tend to fear, negatively evaluate and seek social distance from individuals with mental illnesses, according to the study, published March 31 in Social Science Research. Campaigns aimed at reducing the stigma of mental illnesses exist in numerous communities and organizations, and they are often massive efforts disseminated broadly throughout an entire country, according to Amy Kroska, the lead author of the paper and professor at the University of California, Riverside. 

"It's a really mixed literature in the sense that some studies suggest they're [messages in campaigns] effective at reducing stigma, and others suggest they may not be, so that sparked an interest in me," Kroska said. "And I wondered if I could determine what would make one message more effective than the other."

The researchers note that some campaigns focus exclusively on medical information, and they often emphasize the nature and causes of mental illness. Other messages have combined information and inspirational messages by including details about the competence, accomplishments, and positive attributes of people with a mental illness.

Kroska was struck by the absence of data comparing the effectiveness of different kinds of messages, and so she and her co-author set out to fill this gap in knowledge.

The researchers examined the effects of three types of campaign messages: biological origin messaging, psycho-social origin messaging and inspirational/competence messaging. The biological origins message focused on how genetics and brain chemistry can be partial causes of depression and schizophrenia; the psycho-social origin messaging focused on how stressful life circumstances and personal trauma can be partial causes of depression and schizophrenia; and the inspirational/competence message focused on how people with depression and schizophrenia "can function at a high level, obtain advanced degrees and work in high-status occupations."

In their study, the researchers employed an online survey and collected data from a final sample consisting of 726 college students who received extra credit for completing the study. The researchers used a cover story to hide that they were studying the stigma of mental illness since knowing that piece of information may have influenced participant responses. Participants were told the study was gathering information about contemporary American culture and they were assessing participants' ability to remember information in cultural messages they read on their computer. 

The study separated the randomly selected sample into two groups, one that received messaging on depression and the other on schizophrenia. Both groups were then further broken down into three categories, one for each of the message conditions. The study also included a seventh condition, a control group, that did not receive a message about mental illness.

Participants in all of the conditions received messages about two health conditions unrelated to mental illness — osteoporosis and hypertension — but only the participants in the experimental conditions also received a message about mental illness, according to Kroska. 

The researchers investigated the effects of the three types of messaging on both perceived stigma and personal stigma. Perceived stigma measured how respondents thought most people feel about people with schizophrenia and depression; personal stigma measured how the respondents personally feel about people with schizophrenia.  

In terms of perceived stigma, none of the messages reduced the perceived stigma of depression, and only the competence message consistently reduced the perceived stigma of schizophrenia. 

In terms of personal stigma, the researchers found that only the competence message reduced personal stigma toward individuals with depression, and all three messages reduced personal stigma toward individuals with schizophrenia equally. 

Kroska explained these differences between depression and schizophrenia might be due to "illness familiarity" of depression among respondents since people are more familiar with depression than schizophrenia. 

"Because of that," she said, "they may be more receptive to new information about schizophrenia since they don't have crystallized ideas about individuals with schizophrenia in the way that they may have already for individuals with depression."

The study's finding that the competence message was overall more effective than the other messages aligns with a body of social psychological literature which essentially suggests that exposure to new status information affirming the competence of individuals in a cultural category may positively affect the way observers view the people in that category, especially if it's repeated, according to Kroska. 

"There is concern that, indeed, emphasizing the biological origins of a mental illness may not be effective, and in some cases may increase the perception that the illness is persistent and serious," Kroska said. "And that's, of course, counterproductive in the efforts to try to reduce the stigma of mental illness."

The study "Information vs. inspiration: Evaluating the effectiveness of mental illness stigma-reduction messages," published March 31 in Social Science Research, was co-authored by Amy Kroska, University of California, Riverside; and Sarah K. Harkness, University of Iowa.

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