Alleviating Help-Seeking Stigma Among Depressed College Students Through Shadow Social Marketing: A Meso-Level Intervention to a Wicked Problem

Abstract

The current study addresses the issue of societal stigma attached to mental health issues of college students, which strongly suppress their attempts at help-seeking. ✓We design a meso-level midstream intervention to effect a behavior change of mentally depressed students, who, due to internalized societal stigma attached to mental health issues, strongly evade help-seeking. ✓We use theoretical arguments and formative research to design a shadow social marketing (SSM) meso-intervention to normalize help-seeking behavior of individuals suffering from mental health issues. ✓We perform field-testing of our intervention to ascertain its comparative efficacy against two competing micro-interventions. To address a complex problem that does not have a direct, clear-cut solution at either the micro or the macro level, we investigate, in this study, whether an SSM meso-intervention performs better than micro-interventions in alleviating social stigma attached to mental health issues. Its primary benefit is to establish a connection between the micro and the macro levels. Social marketing scholarship underscores a number of undesirable consequences of micro-level social marketing interventions that directly target individuals who suffer from mental depression, because their attempts at help-seeking are grossly suppressed by societal stigma attached to mental health issues. Our study contributes to the understanding of how the SSM meso-intervention could serve as a better alternative to direct interventions in normalizing help-seeking behaviour of affected individuals. We hope that changes of social norms at the community level can eventually lead to societal macro-level changes with modification and enhancement of institutional norms. We use an SSM approach to design a meso-level, midstream intervention to alleviate societal stigma that deters help-seeking of mentally depressed students in an educational institution. We use survey methods for data collection and Tobit regression for data analysis to empirically test our meso-intervention against two other micro-level interventions. Our hypothesis that stigmatized individuals are more likely to avail of wellbeing-related services offered by a platform based on an SSM, meso-intervention rather than by one that does not adopt such a strategy is empirically supported strongly ([Formula: see text]). A meso-level intervention is an essential prerequisite to bring about macro-level changes to address stigma attached to mental health issues. As a practical matter, changes of social norms at the community level have a strong potential for bringing about societal macro-level changes with modifications and enhancements of institutional norms and eventual micro-level help-seeking behavior.