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

Background 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. Methods 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. Results 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 (beta=-1.19, 95% CI: -2.10, -0.27, p=0.01) and nationality (beta=-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 (beta=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 (beta=-0.34, 95% CI: -0.52, -0.16, p < 0.001) and CMHI (beta=-0.22, 95% CI: -0.45, -0.002, p=0.048). Conclusion 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.

Automated summary

The ARTEMIS intervention in Singapore has shown positive short-term effects on attitudes towards mental illness, especially with immediate favorable shifts observed post-intervention. However, gender and nationality were identified as significant correlates for community mental health ideology. It is worth noting that sustained attitude shifts were not observed after 3 months post-intervention.