RCT of Brief Intervention Addressing Stigma Among Parents of Children With Mental Health Problems

Overview

The goal of this study is to test the efficacy of brief video interventions parental internalized stigma and stigma-related outcomes (e.g., treatment intentions, caregiver burden, secrecy) among parents (ages 25-50) of children ages 6-18 with depression, ADHD, or substance use problems. Timely identification and treatment of mental health problems in youth is a public health priority. However, many youth do not receive treatment, and stigma has been identified as the primary barrier to help-seeking. Parents experience stigma related to their children having mental health problems, which has been associated with reduced help-seeking and increased parental distress. Prior experiments have found brief video-based interventions (BVIs), 1-2 minute videos similar to those viewed by youth on social media platforms, based on the principle of "social contact" with individuals affected by a stigmatized condition, effective in reducing mental health stigma and increasing help-seeking. In this 4-arm RCT, we will recruit parents aged 25-50 using an online crowdsourcing platform, to test the efficacy of BVIs featuring a personal parent narrative of their experience with their child's a) depression, b) ADHD, or c) substance use, or d) a control condition that provides general written psychoeducational information without social contact.

Brief video-based interventions (BVIs) have been studied as a means of reducing stigma toward mental health problems and increasing help-seeking. "Contact-based interventions," in which a representative of a stigmatized group shares their personal stories, have been found one of the most effective anti-stigma interventions. Effective contact-based interventions target to a specific population, account for the specific interests of that population, and credibly provide stories that highlight recovery in a plausible manner to moderately disconfirm stereotypes. BVIs package contact-based stigma interventions into short (1-2 minute) messages in the style of social media content. Prior RCTs have tested BVIs targeting depression-related stigma in adolescents, featuring a young person describing experiences with depressive symptoms, that improved as they sought support from parents and professionals. Parents often experience stigma to their children's mental health problems and play a critical gate-keeping role for children accessing mental health treatment. Additionally, parental stigma is associated with child mental health outcomes, and potential mediators between parental stigma and child outcomes including parental wellbeing, attitudes toward the child, help-seeking, and self-efficacy. Thus, we hypothesize that BVIs targeted to parents of children with similar mental health conditions (e.g., depression, ADHD, or substance use) will have greater impact on reducing stigma and increasing treatment intentions than generic written psychoeducational content without a social contact component. We will measure distinct stigma-related outcomes relevant to parents of children with mental health problems: 1. Parental internalized stigma 2. Treatment intentions 3. Treatment engagement 4. Attitudes toward the child 5. Caregiver burden 6. Self-efficacy 7. secrecy coping (i.e., to avoid potential negative repercussions of stigma).