Reducing mental illness stigma in post-secondary students – Honest, Open, Proud - College

Abstract

Mental health concerns and low help-seeking rates pose significant challenges for postsecondary students. Self-stigma is a key barrier to service utilization, as many students worry about disclosing mental health issues due to anticipated stigmatizing responses. This randomizedcontrolled trial evaluated a web-based, peer-facilitated stigma reduction group designed to support post-secondary students in making disclosure decisions about mental health challenges (Honest, Open, Proud – College; HOP-C). Canadian post-secondary students (n = 63) endorsing mental health challenges were randomized to HOP-C or a waitlist control. We assessed HOP-C’s impact on stigma stress (primary outcome) and self-esteem, self-efficacy, social support, and help seeking intentions (secondary outcomes) at post-intervention (3 weeks post baseline) and post-booster (6 weeks post baseline). We also examined possible HOP-C change mechanisms (empowerment, self-stigma, and disclosure intentions/behaviours) and the feasibility and fidelity of the online format. HOP-C participants showed greater reductions in stigma stress at postintervention (difference = -.88, p = .04) and post-booster (difference = -1.25, p = .02) compared to waitlist. None of the secondary outcomes showed significant improvements. No significant effects emerged for secondary outcomes, and hypothesized mechanisms at post-intervention did not mediate stigma-stress improvements at post-booster. Program outcomes did not differ between HOP-C participants who chose to disclose after the program and those who did not. Our findings must be interpreted within the context of significant challenges with recruitment, retention, and intervention adherence. With refinements, HOP-C delivered via videoconferencing may offer a low-cost strategy to improve stigma-related outcomes among post-secondary studies.