A combined team of Canada and Chile-based academics has reviewed close to 100 past studies, including almost 45,000 people aged 10 to 24 years, and says interventions have had a significant short-term association with improvements in stigma-related knowledge, attitudes, and behaviours, and help-seeking attitudes and intentions.
In their study, titled Interventions to Reduce Mental Health Stigma in Young People and led by McGill University’s Dr Pablo Martínez, the research team explain that “stereotypes, prejudice, or discrimination against individuals with mental illness, present considerable barriers to help-seeking among young people with mental health conditions”.
“This stigma affects individuals and communities across cultures and is linked to several negative consequences in personal, structural, health, social, and economic domains,” they state.
Educational approaches and social contact with individuals with mental illness are interventions to reduce stigma among young people and, the paper suggests, have been shown to positively influence stigma-related attitudes and knowledge in the short term, with educational approaches being more effective in school-age populations and social contact interventions being more effective in higher education students.
While previous meta-analyses on stigma interventions have not accounted for the correlation between mental health stigma measures within the same participants across studies, this systematic review of randomised clinical trials on interventions to reduce mental health stigma in young people uses 3-level multivariate meta-analyses to account for the correlations and to maximise data use.
The study’s findings align with previous systematic reviews supporting the immediate benefits of mental health stigma interventions.
“The noticeable decline in positive associations over time observed in these outcomes highlights the challenges in maintaining the benefits of stigma reduction interventions, suggesting that short-term interventions may not be sufficient to produce lasting changes and that ongoing anti-stigma efforts, booster sessions, or follow-up activities may be necessary to sustain and enhance the initial gains,” the paper states.
The limited impacts, the study claims, may be attributed to persistent structural barriers and cultural factors that deter readiness and ability to seek mental health support, including fears of stigma and concerns about confidentiality.
“These findings highlight an important gap in anti-stigma interventions for promoting help-seeking behaviours. Importantly, as informal sources of help may be key in helping young people access mental health care, more studies should consider informal help-seeking as an outcome,” the study states.
The researchers found that social contact and non-video-based interventions have larger effect sizes for stigma-related behaviours than educational and video-based approaches, respectively.
“These findings reinforce the value of incorporating direct, personal interactions with individuals with mental illness into anti-stigma programs compared with less personal methods,” the paper states.
The research team advocates the exploration of digital interventions, which it says are underrepresented in the review, and suggest it may offer scalable and accessible solutions for young people worldwide, especially in challenging health contexts such as the COVID-19 pandemic.
“While the findings are encouraging, they also underscore the need for more rigorous long-term studies and the integration of multifaceted intervention strategies.
“By addressing these gaps, future research may contribute to the development of more effective, sustainable solutions to combat mental health stigma and support the well-being of young people globally.”
