Look Around, It's Not Just You: The Moderating Effect of a Social Media Campaign on Mental Health Stigma of African American Youth

Background/Purpose: Racial/ethnic disparities exist in the prevalence of diagnoses and the use of mental health services. African American youth compared to white youth are 2.25xs more likely to be diagnosed with a mental illness but 1.5xs less likely to seek care and 2.5xs more likely to drop out of care. One strategy to advocate for increased awareness and equitable access to care is social media. The Look Around (LA) campaign was designed to reduce stigma and increase awareness of/willingness to seek help for mental health concerns. We examined the amount of change from pre to posttest in youth response to questions asking about mental health stigma, awareness, and help seeking attitudes: (a) in all youth, (b) in African American youth compared to other racial/ethnic groups, and (c) we examined those that had high levels of change to low levels of change on attendance, teacher-rated mental health screening scores, and self-rated mental health screening scores.

Methods: Using a single group, pre and posttest survey research design, we collected data from 11, 478 6^th-12^th grade youth in a single county where LA was distributed using television, radio, movie theatre ads, and messages on YouTube, Twitter, Instagram, and Facebook. Online school-based surveys asked students about their attitudes regarding mental health stigma, awareness, and willingness to seek help at school. Using multilevel nested regression models to control for the autocorrelated nature of students nested in schools, we tested the amount of change in student stigma and attitudes towards increased awareness and help seeking behaviors underlying mental health issues. Moderation models revealed that African American youth (1,773) compared to all other categories had significantly lower levels of change from pre to posttest  

Results: Google analytics and other access data suggest 126,946 youth attended movies, 6,042 unique youth viewed YouTube and Instagram videos, and 104,140 youth visited Facebook and related LA informational advertisements. There was significant change in the attitudes of all youth from pre to posttest (d=0.45). Race—specifically, African American youth—moderated the amount of change such that African American youth attitudes were less likely to change compared to youth in other racial categories (R²=.40). Lastly, students with below average levels of change differed significantly on teacher and self-rated mental health screening scores and self-rated peer relations.  

Conclusions/Implications: Social media and advertisement campaigns to address mental health stigma and increase awareness and acceptance of help seeking behaviors appears to be effective, though the study here is not causal. The effect of social media efforts to impact stigma, awareness and help seeking appear to be moderated by race, with African American youth demonstrating less change over time. Increased efforts to support African American youth in school settings to access mental health supports must go beyond social media campaigns and should include screening and efforts to use screening scores to identify risk factors and address them at a universal and targeted level.