Mental Health Stigma Reduction in the Midwest: Evidence from a Digital Campaign Using a Collective Impact Model

Abstract

INTRODUCTION: The COVID-19 pandemic has exacerbated mental health conditions in the midwestern United States. As of July 2021, one quarter of adults in Nebraska and Iowa have reported symptoms of anxiety or depression. This increase in mental health issues was compounded by barriers to accessing mental health care services brought on by the pandemic. Mental health stigma is often associated with a range of negative health outcomes, and stigma reduction is a key component of improving mental health outcomes. From September 2020 - May 2021, a digital media campaign was implemented to address mental health stigma reduction in the Omaha Metropolitan area. The campaign used evidence-based approaches with a collective impact framework. The goal of the present study is to evaluate the potential impact of the campaign.

METHODS: Two cross-sectional surveys using validated measures of mental health knowledge, attitudes, and reported and intended behaviors were conducted at baseline and a 10-month follow-up. Surveys were conducted within the Omaha & Council Bluffs intervention region and a control region in Iowa. Survey results were analyzed using IBM SPSS Statistics and R Studio Quantitative statistical software. Two sub analyses assessing changes overtime (from baseline to follow-up) and campaign awareness were conducted.

RESULTS: In the intervention group, significant positive shifts were observed in desires for social distance and perceptions toward treatment efficacy. Non-significant improvements were seen across measures of personal and community attitudes towards mental health conditions, confidence in providing support to others, and likelihood of disclosing a mental health condition. Trends were generally not replicated within the control group. At follow-up, respondents who reported campaign awareness showed fewer stigmatizing views compared to those not campaign aware, including lower desires for social distance, improved attitudes toward treatment, higher self-efficacy in their ability to support someone with a mental health condition, and significantly higher levels of providing support and taking steps to improve their own mental health.

CONCLUSIONS: Results of this evaluation suggest that the evidenced-based, multi-pronged stigma reduction approach implemented in the Greater Omaha and Council Bluffs area was able to create positive shifts in stigma reduction, in line with results seen in previous large-scale implementations of this approach. This evaluation provides additional evidence to support the potential effectiveness of scaling and adapting digital media campaigns for stigma reduction to different geographic locations.

Keywords: Health communications, mental health stigma, digital media campaigns, collective impact, evaluation