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Stigma-reducing campaign may urge people to seek mental health care

Rebecca Collins

A social marketing campaign in California that aimed to decrease stigma surrounding mental health issues appears to have encouraged people to recognize and seek care for their symptoms of mental distress, according to a study by the RAND Corporation.

In 2013, California implemented a mental illness stigma and discrimination reduction campaign that uses approaches that increase education and encourages contact with people who have had mental health issues, Rebecca L. Collins, PhD, senior behavioral scientist at RAND Corporation, and colleagues explained in American Journal of Public Health. The campaign also targets stigma at institutional, social and individual levels, assuming that changes at each of these levels reinforces additional changes at the two other levels.

“Social marketing appears to be effective in reducing the stigma of mental illness,” Collins and colleagues wrote. “However, to our knowledge, no studies have examined whether stigma reduction campaigns might increase actual treatment use among adults with probable mental illness.”

To better understand the processes involved in successful social marketing of mental health treatment, researchers surveyed 1,954 California adults experiencing symptoms of probable mental illness in 2014 and 2016 during a major stigma reduction campaign. They evaluated cross-sectional associations of campaign exposure with stigma, treatment overall and two stages of treatment seeking — perceived need for treatment and use based on perceived need — using covariate-adjusted multivariable regression models.

Analysis revealed that campaign exposure predicted treatment use overall (OR = 1.82; 95% CI, 1.17-2.83) and was linked to perceived need for services (OR = 1.64; 95% CI, 1.09-2.47). However, exposure was not significantly tied to treatment use in models conditioned on perceiving a need (OR = 1.52; 95% CI, 0.78-2.96), according to the results.

After generating marginal probabilities, Collins and colleagues estimated that if all adults with probable mental illness were exposed to the campaign, 47% would receive mental health treatment; however, if the same adults were not exposed, 36% would receive treatment. In addition, they estimated that if all adults in California with probable mental illness were exposed to the campaign, 57% of them would perceive a need for mental health treatment; however, if they were not, 49% would perceive a need for treatment.

"California's unprecedented stigma reduction campaign holds promise for positive change. We found the first evidence that a social marketing effort may be useful for increasing the percentage of people with signs of mental illness who obtain treatment,” Collins said in a press release. "Any influence of the stigma reduction campaign also may have benefited from the broader climate in California and its support of those with mental health challenges.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.