Reducing discrimination against service users with psychosis through brief contact-based video interventions: a randomised controlled trial

Abstract

Background/Aims Internationally, mental health service users, particularly those with psychosis, face discriminatory attitudes and behaviours from the public. It is crucial for mental health services to deliver interventions that alleviate the stigma directed toward their patients. This study evaluates the efficacy of a brief indirect contact-based intervention designed for this purpose in Singapore. Methods A randomised controlled trial was conducted among 168 participants, who were allocated to video intervention, transcript intervention and active control groups. Stigmatising behaviour levels were measured at pre-intervention, post-intervention and at a 30-day follow up. Group differences in attitudes were analysed using a 3x3 two-way mixed subjects ANOVA, with significance set at P<0.05. Results There were no significant differences in declared discriminatory behaviour between the investigated conditions (P=0.23). The video intervention did not produce superior results to the transcript, while the results of both interventions did not differ significantly from those of the control condition. Additionally, no significant interaction of each condition with time was observed at the post-intervention and follow-up periods (P=0.5). Conclusions Individual contact-based interventions may not sustainably reduce discrimination towards mental health service users. Services should prioritise strategies to specifically target the societal mechanisms that maintain stigmatising behaviour towards people with psychosis.