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

• Published in: BMC psychiatry Vol. 21; no. 1; p. 108
• Main Authors: Goh, Chong Min Janrius, Shahwan, Shazana, Lau, Jue Hua, Ong, Wei Jie, Tan, Gregory Tee Hng, Samari, Ellaisha, Kwok, Kian Woon, Subramaniam, Mythily, Chong, Siow Ann
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 18.02.2021; BioMed Central; BMC
• Subjects: Anti-stigma intervention; Attitude; Attitudes; CAMI; College campuses; Cross-Sectional Studies; Demographic aspects; Depression; Depression, Mental; Dperession; Factor analysis; Humans; Intervention; Mental depression; Mental disorders; Mental Disorders - therapy; Mental health; Mental health care; Prevention; Psychiatry; Questionnaires; Singapore; Social Stigma; Stigma; Students; Study and teaching; Surveys and Questionnaires; Universities; University students; Singapore; Singapore; University students; CAMI; ARTEMIS; Attitudes; Anti-stigma intervention; Dperession
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-021-03106-4

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. 390 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. The 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). The 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.