Reducing Help-Seeking Stigma in Young Adults at Elevated Suicide Risk

Although there exist interventions that therapeutically impact suicide risk, the connection
of individuals at elevated suicide risk to mental health care services remains an ongoing
challenge. One persistent barrier to mental health service utilization is help-seeking
stigma—that is, having negative beliefs about the implications of seeking help for mental
health problems (e.g., "Seeking help means that I am weak"). Thus, to enhance mental health
service use among at-risk individuals, efforts are needed to target help-seeking stigma.
Preliminary data from our research group indicate that a novel computerized intervention
based on cognitive therapy principles can demonstrably reduce help-seeking stigma and
increase connection to care among young adults with untreated psychiatric disorders. However,
this intervention has not been tested among individuals who are currently experiencing
suicidal ideation and are not engaged in mental health treatment. Testing the efficacy of
this computerized intervention among young adults at increased risk for suicide is necessary
to address the unique challenge of linking at-risk individuals to potentially life-saving
treatments. To this end, this study aims to test the efficacy of a brief web-based
intervention, cognitive bias modification for help-seeking stigma (CBM-HS), designed to
increase mental health help-seeking intentions and behaviors. A total of 78 young adults with
current suicidal ideation who are not currently in treatment and who report elevated levels
of help-seeking stigma will be randomly assigned to one of three conditions: (1) CBM-HS; (2)
CBM-Placebo (i.e., a sham CBM condition analogous to a placebo pill in a pharmaceutical
trial); or (3) psychoeducation. Participants will complete assessments at baseline,
mid-intervention, post-intervention, and 2-month follow-up to determine the efficacy of
CBM-HS in: (a) modifying stigma-related cognitions around mental health help-seeking and
service use and (b) increasing treatment initiation and engagement. Moreover, we will test if
reductions in stigma-related cognitions mediate the relationship between study condition and
subsequent help-seeking behaviors. Findings from the proposed pilot randomized controlled
trial have the potential to enhance connection to care among young adults at elevated suicide
risk. Importantly, the brief, web-based nature of the intervention enhances its
acceptability, feasibility, and scalability. Should CBM-HS demonstrate efficacy in reducing
help-seeking stigma and enhancing connection to care among at-risk individuals, it has the
potential to serve as a useful tool in suicide prevention efforts.