Advancing research to eliminate mental illness stigma: an interventional study to improve community attitudes towards depression among University students in Singapore

Chong Min Janrius GOH,Wei Jie ONG,Gregory Tee Hng TAN,Ellaisha SAMARI,Kian Woon KWOK,Shazana SHAHWAN,Siow Ann CHONG,Jue Hua LAU,Mythily SUBRAMANIAM

doi:10.1186/s12888-021-03106-4

Abstract

BackgroundAfter decades of anti-stigma initiatives, the Advancing Research To Eliminate Mental Illness Stigma (ARTEMIS) intervention study is one of the first in Singapore to evaluate the effects of an anti-stigma intervention on attitudes towards depression in university students.Methods390 university students from a local university in Singapore were voluntarily recruited for the study. The ARTEMIS intervention comprises an educational and social contact component, as well as a question and answer (Q&A) session with experts in the area of mental health. The Community Attitudes towards Mental Illness (CAMI) scale was administered at baseline, post-intervention and at 3-months follow-up. A confirmatory factor analysis (CFA) was conducted.ResultsThe CFA identified a 3-factor model for the CAMI with a decent fit (RMSEA = 0.06, CFI = 0.93, TLI = 0.93, SRMR = 0.06). Favourable shifts in attitudes across the factors were observed immediately after the intervention (p < 0.001). Gender (β = − 1.19, 95% CI: − 2.10, − 0.27, p = 0.01) and nationality (β = − 1.23, 95% CI: − 2.35, − 0.11, p = 0.03) were identified as significant correlates for the community mental health ideology (CMHI) factor. Linear effects indicated that having a close social contact with mental illness observed a smaller decrease in authoritarianism scores from pre- to post-intervention (β = 0.85, 95% CI: 0.18, 1.53, p = 0.01); whereas quadratic effects found a greater decrease in scores from post-intervention to after 3-months for benevolence (β = − 0.34, 95% CI: − 0.52, − 0.16, p < 0.001) and CMHI (β = − 0.22, 95% CI: − 0.45, − 0.002, p = 0.048).ConclusionThe anti-stigma intervention shows promising short-term results across the CAMI dimensions even after adjusting for sociodemographic correlates. However, the intervention did not observe the sustained attitude shifts after 3-months. Recommendations for future anti-stigma interventions were also considered.

Highlights

After decades of anti-stigma initiatives, the Advancing Research To Eliminate Mental Illness Stigma (ARTEMIS) intervention study is one of the first in Singapore to evaluate the effects of an anti-stigma intervention on attitudes towards depression in university students
A nationwide mental health literacy study reported that people with mental illness (PMI) in Singapore face a considerable amount of stigma [1]
This paper examined the effectiveness of the ARTEMIS intervention on the 3-factor model of the community attitudes to mental illness (CAMI) scale towards depression

Summary

Introduction

After decades of anti-stigma initiatives, the Advancing Research To Eliminate Mental Illness Stigma (ARTEMIS) intervention study is one of the first in Singapore to evaluate the effects of an anti-stigma intervention on attitudes towards depression in university students. A nationwide mental health literacy study reported that people with mental illness (PMI) in Singapore face a considerable amount of stigma [1]. Mental illness stigma is a complex social phenomenon that often negatively impacts individuals experiencing mental illness. One of the many consequences of stigmatising attitudes towards mental illness is the impact it has on help-seeking and recovery [4]. People with depression facing these stigmatising attitudes, from the public or experiencing self-stigma, could delay treatment leading to a longer duration of untreated illness; which could have severe consequences such as poorer treatment response, lower rates of remission, increased rates of chronicity and increased frequency of relapse [6]

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