The Impact of a Culturally Meaningful Storytelling Intervention on Stigma and Attitudes about Mental Health Treatment

Background and Purpose: Despite research that suggests Black Americans are 20% more likely to experience psychological distress, only 1 in 3 seek treatment. Stigma has been identified as one of the most powerful barriers to mental healthcare in the Black community. The fear of being de-valued or discriminated against is a salient deterrent from seeking mental health care, especially in communities of color where racial stigma also impacts mental health and perceptions of service utilization.

Methods: To address this issue, our research team partnered with This Is My Brave Inc. to develop and evaluate a special virtual series entitled: “This is My Brave (TIMB): Stories from the Black Community” which highlighted the voices of Black and Brown Americans living with mental illness and/or addiction. Storytellers bravely share their experiences with illness and treatment as well as messages of hope and recovery, with the goal of reducing stigma, improving attitudes, and encouraging critical conversations about Black mental health. We utilized a pre-post survey design administered electronically to viewers of the series (n=100 BIPOC and n=144 Non-Hispanic White) and conducted semi-structured interviews with a random selection of viewers. ANCOVAs were used to assess relationships within the sample of BIPOC and Non-Hispanic White/Caucasian and between variables (personal stigma, perceived stigma, anti-racism, attitudes towards treatment seeking, discrimination, and difference).

Results: Significant differences in the desired direction (decreases in stigma measures and improvements in anti-racism and attitudes towards treatment seeking) between pre- and post-test scores were found for personal stigma (t(243) = 8.96, p<.001), perceived stigma (t(243) = 8.36, p<.001), discrimination (t(243) = 7.01, p<.001), difference (t(243) = 5.28, p<.001), anti-racism (t(243) = -3.68, p<.001), overall attitudes towards mental health treatment (t(243) = -5.63, p<.001), and beneficial attitudes towards treatment (t(243) = -6.08, p<.001). Importantly, while scores on our key variables improved among the total sample, we identified significant interaction effects, such that BIPOC viewers showed a greater rate of improvement on attitudes and reduction in stigma. Interviews provided additional context surrounding the importance of targeted messaging in communities of color.

Conclusions and Implications: This study provides strong preliminary evidence of the impact of storytelling, a culturally meaningful approach, to addressing stigma and improving attitudes about seeking mental health treatment, particularly for communities of color, and should be further studied in academic and community settings. Given their scalability, low cost and easy administration, these types of programs could be beneficial additions to academic curricula, practitioner training programs, and large-scale targeted public stigma reduction campaigns. This work will help advocates, educators and mental health practitioners better understand ways to diminish stigma in communities of color and aid in the elimination of access disparities in care for under-represented populations.