Long-term effects of filmed social contact or internet-based self-study on mental health-related stigma: a 2-year follow-up of a randomised controlled trial
There is a critical need to clarify the long-term effects of anti-stigma interventions. The study aimed to assess the long-term effects of repeated filmed social contact or internet-based self-study on mental health-related stigma through a randomised controlled trial with 2-year follow-up.
We randomly allocated 259 university or college students to a filmed social contact group, an internet-based self-study group, or a control group. The filmed social contact and internet-based self-study groups each received a 30-min initial intervention followed by emailed interventions every 2 months over a 12-month period. The Japanese version of the Reported and Intended Behaviour Scale (RIBS-J) and the Mental Illness and Disorder Understanding Scale (MIDUS) were used to assess behaviour, behavioural intentions (attitudes), and knowledge regarding mental health.
Of the 259 original participants, 187 completed the 24-month follow-up assessment. Mean scores for the RIBS-J future domain and MIDUS peaked at 1 month after initial intervention. Compared with baseline, at 24-month follow-up, we found a significant difference in RIBS-J future domain scores between the filmed social contact and control groups at 24-month follow-up (B = 0.95, 95% CI = 0.01,1.90, p = 0.049), while MIDUS scores in the filmed social contact group (B = − 4.59, 95%CI = − 6.85, − 2.33, p < 0.001) and the internet-based self-study group (B = − 4.51, 95%CI = − 6.86, − 2.15, p < 0.001) significantly decreased compared with the control group.
While outcome scores peaked at 1 month after initial intervention, results suggest that filmed social contact might have a long-term effect on behavioural intentions, and both filmed social contact and internet-based self-study may contribute to improved knowledge of mental health.
KeywordsFilmed social contact Internet-based self-study Long-term effect Randomised controlled trial Stigma
This work was supported by grants to SK from the Japan Ministry of Education, Culture, Sports, Science and Technology (MEXT; grant number 17H05921); the Mitsubishi Foundation; and the Pfizer Health Research Foundation. This work was also supported in part by UTokyo Center for Integrative Science of Human Behaviour (CiSHuB) and the International Research Center for Neurointelligence (WPI-IRCN) at The University of Tokyo Institutes for Advanced Study (UTIAS). Some support for this work was also provided to SK by the University of Tokyo Center for Integrative Science of Human Behaviour (CiSHuB) and the International Research Center for Neurointelligence (WPI-IRCN) at The University of Tokyo Institutes for Advanced Study (UTIAS). GT is supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South London at King’s College London NHS Foundation Trust. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. GT acknowledges financial support from the Department of Health via the National Institute for Health Research (NIHR) Biomedical Research Centre and Dementia Unit awarded to South London and Maudsley NHS Foundation Trust in partnership with King’s College London and King’s College Hospital NHS Foundation Trust. GT is supported by the European Union Seventh Framework Programme (FP7/2007–2013) Emerald project. GT also receives support from the National Institute of Mental Health of the National Institutes of Health under award number R01MH100470 (Cobalt study). GT is also supported by the UK Medical Research Council in relation the Emilia and Indigo Partnership awards.
Compliance with ethical standards
The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.
Conflict of interest
The authors have no conflicts of interest to declare.
- 4.Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, Morgan C, Rusch N, Brown JS, Thornicroft G (2014) What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med 45:11–27. https://doi.org/10.1017/s0033291714000129 CrossRefPubMedGoogle Scholar
- 7.Ashton LJ, Gordon SE, Reeves RA (2017) Key ingredients-target groups, methods and messages, and evaluation-of local-level, public interventions to counter stigma and discrimination: a lived experience informed selective narrative literature review. Community Ment Health J 54:312–333. https://doi.org/10.1007/s10597-017-0189-5 CrossRefPubMedGoogle Scholar
- 8.Janoušková M, Tušková E, Weissová A, Trančík P, Pasz J, Evans-Lacko S, Winkler P (2017) Can video interventions be used to effectively destigmatize mental illness among young people? A systematic review. Eur Psychiatry 41:1–9. https://doi.org/10.1016/j.eurpsy.2016.09.008 CrossRefPubMedGoogle Scholar
- 9.Thornicroft G, Mehta N, Clement S, Evans-Lacko S, Doherty M, Rose D, Koschorke M, Shidhaye R, O’Reilly C, Henderson C (2016) Evidence for effective interventions to reduce mental-health-related stigma and discrimination. Lancet 387:1123–1132. https://doi.org/10.1016/s0140-6736(15)00298-6 CrossRefPubMedGoogle Scholar
- 10.Mehta N, Clement S, Marcus E, Stona A-C, Bezborodovs N, Evans-Lacko S, Palacios J, Docherty M, Barley E, Rose D, Koschorke M, Shidhaye R, Henderson C, Thornicroft G (2015) Evidence for effective interventions to reduce mental health-related stigma and discrimination in the medium and long term: systematic review. Br J Psychiatry 207:377–384. https://doi.org/10.1192/bjp.bp.114.151944 CrossRefPubMedPubMedCentralGoogle Scholar
- 12.Yamaguchi S, Wu S-I, Biswas M, Yate M, Aoki Y, Barley EA, Thornicroft G (2013) Effects of short-term interventions to reduce mental health-related stigma in university or college students: a systematic review. J Nerv Ment Dis 201:490–503. https://doi.org/10.1097/NMD.0b013e31829480df CrossRefPubMedGoogle Scholar
- 15.Winkler P, Janoušková M, Kožený J, Pasz J, Mladá K, Weissová A, Tušková E, Evans-Lacko S (2017) Short video interventions to reduce mental health stigma: a multi-centre randomised controlled trial in nursing high schools. Soc Psychiatry Psychiatr Epidemiol 52:1549–1557. https://doi.org/10.1007/s00127-017-1449-y CrossRefPubMedGoogle Scholar
- 19.Yamaguchi S, Mino Y, Uddin S (2011) Strategies and future attempts to reduce stigmatization and increase awareness of mental health problems among young people: a narrative review of educational interventions. Psychiatry Clin Neurosci 65:405–415. https://doi.org/10.1111/j.1440-1819.2011.02239.x [doi]CrossRefPubMedGoogle Scholar
- 21.Koike S, Yamaguchi S, Ojio Y, Ohta K, Shimada T, Watanabe K, Thornicroft G, Ando S (2018) A randomised controlled trial of repeated filmed social contact on reducing mental illness-related stigma in young adults. Epidemiol Psychiatr Sci 27:199–208. https://doi.org/10.1017/s2045796016001050 CrossRefPubMedGoogle Scholar
- 22.Clement S, van Nieuwenhuizen A, Kassam A, Flach C, Lazarus A, de Castro M, McCrone P, Norman I, Thornicroft G (2012) Filmed v. live social contact interventions to reduce stigma: randomised controlled trial. Br J Psychiatry 201:57–64. https://doi.org/10.1192/bjp.bp.111.093120 CrossRefPubMedGoogle Scholar
- 25.Evans-Lacko S, Rose D, Little K, Flach C, Rhydderch D, Henderson C, Thornicroft G (2011) Development and psychometric properties of the reported and intended behaviour scale (RIBS): a stigma-related behaviour measure. Epidemiol Psychiatr Sci 20:263–271. https://doi.org/10.1017/S2045796011000308 CrossRefPubMedGoogle Scholar
- 30.Chisholm K, Patterson P, Torgerson C, Turner E, Jenkinson D, Birchwood M (2016) Impact of contact on adolescents’ mental health literacy and stigma: the SchoolSpace cluster randomised controlled trial. BMJ Open 6:e009435. https://doi.org/10.1136/bmjopen-2015-009435 CrossRefPubMedPubMedCentralGoogle Scholar
- 32.Reavley NJ, Mackinnon AJ, Morgan AJ, Alvarez-Jimenez M, Hetrick SE, Killackey E, Nelson B, Purcell R, Yap MBH, Jorm AF (2012) Quality of information sources about mental disorders: a comparison of Wikipedia with centrally controlled web and printed sources. Psychol Med 42:1753–1762. https://doi.org/10.1017/S003329171100287X CrossRefPubMedGoogle Scholar