Reducing Stigma Towards Depression Among Adolescents
Condition: Stigma, Social
MeSH terms: Depression
Study type: Interventional

Summary: 
      The investigators conducted a randomized controlled study to test the utility of a brief
      video-based intervention to: 1) reduce stigma towards depression, and 2) increase
      treatment-seeking intentions among adolescents.
    

Detailed description: 
      Young people present with the higher prevalence of mental health disorders compared to
      individuals at any other age, with up to 20% of adolescents likely to experience mental
      health disorders. Around 50% of mental health conditions start before the age of 14 and the
      onset of 75% of cases is before the age of 18. Depression is the most common diagnosis and
      epidemiological studies suggest that at any one time 8% to 10% of adolescents have severe
      depression. This means that the major burden of assessing and managing adolescent depression
      falls on primary care practitioners. Depression is a principal cause of illness and
      disability in teenagers, and suicide is the third most common cause of death among older
      adolescents. Mental health problems can significantly affect the development of children and
      young people having an enduring impact on their health and social functioning in adulthood.
      However, 75% of adolescents with mental health problems are not in contact with mental health
      services,8 and the primary reason for the reluctance to seek help is stigma.

      Stigma refers to negative beliefs and stereotypes held toward a specific group of people and
      adversely affects people with mental illness. Public stigma refers to negative attitudes and
      beliefs that motivate individuals to fear, reject, avoid, and discriminate against people
      with mental illness. Individuals with mental illness expect to face prejudice and
      discrimination (anticipated stigma) and internalize public stereotypes of people with mental
      illness (self-stigma). Adolescents are particularly aware of how others perceive them and
      care greatly about what their peers think of them. Public stigma toward youngsters with
      mental illness has been identified as a barrier to seeking help; therefore, reducing public
      stigma among young people at risk for or even experiencing depression could enhance their
      receptivity to seeking help or treatment.

      Applying strategies to reduce stigma towards mental health care among adolescents with high
      levels of depression may prevent worsening of symptoms, ameliorate impaired functioning, and
      reduce risks for long-term psychiatric illness. Among possible strategies, studies19 have
      shown that social contact is the most effective type of intervention to reduce stigmatizing
      attitudes. Social contact involves interpersonal contact with members of the stigmatized
      group: members of the general public who meet and interact with individuals who suffer from
      depression are likely to lessen their stigma. Corrigan identified the most important
      ingredients of contact-based programs: an empowered presenter with lived experience who
      attains his/her goals (e.g., "I was able to fight the depression and go back to school").
      Although direct, in-person social contact, as well as indirect, video-based social contact
      have effectively improved attitudes toward mental issues and care, the latter can be
      implemented on a larger scale, use minimal resources and be easily disseminated.

      The purpose of this study is to: (1) examine adolescents' stigma-related attitudes towards
      depression; and (2) test the utility of a brief video-based intervention in reducing stigma
      towards depression and increasing help-seeking intentions.

      The investigators propose to randomly assign 1,000 individuals aged 14-18 in to either: (a)
      brief video-based intervention 1 ('Video 1'); (b) brief video-based intervention 2 ('Video
      2'); or (c) no intervention video control arm ('Control'). The intervention videos will focus
      on empowered presenters with depression. The presenters will be 16-year-old adolescent
      professional actors, one of them is a boy (Video 1), one is a girl (Video 2). They each will
      share his/her personal story regarding depression and describe how social support from
      family, friends, and professionals have helped them overcome their symptoms and recover. The
      third group will watch a same length video with unrelated contents. Assessments will occur at
      baseline and at post-intervention and will tap into demographic identifiers and attitudes
      around stigma and help-seeking questionnaires.

      Actors will be hired through the Child Study Center, and / or through the Standardized
      Patient Program of Teaching and Learning Center, Yale School of Medicine. Actors will be
      compensated and follow standardized patient best practices, including those specifically
      pertaining to under-age actors.
    

Intervention name(s): Video intervention
Intervention type(s): Behavioral
Intervention description(s): a 100-second video, presenting a personal story of a boy/girl dealing with depression
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized controlled trial
Masking: Single (Participant)
Primary purpose: Health Services Research