"It Is Hard to Be a Woman With Schizophrenia": Randomized Controlled Trial of a Brief Video Intervention to Reduce Public Stigma in Young Adults

Objective: Women with schizophrenia encounter specific gender related stressors that may affect their recovery process. They are more susceptible to victimization and tend to experience more shame and stigma about their illness. Confronting stigma early in the illness could enhance treatment seeking. No studies have examined the efficacy of stigma-reducing interventions focused on public stigma toward women living with schizophrenia or have tested the effect of gender specific content therein. Methods: We compared the efficacy at post-intervention and 30-day follow-up of 2 brief (similar to 80-second) videos, with and without genderrelated content, and a non-intervention control, in 1,181 young adults, between September and November 2021. The videos feature an empowered young woman living with schizophrenia who describes struggling with her psychotic illness to attain recovery and hope. Results: A 3 x 3 group-by-time analysis of variance showed decreased mean stigma scores over time in the two intervention arms relative to controls across all 5 public stigma domains: social distance (F = 17.1, P <.001), stereotyping (F = 25.0, P <.001), separateness (F = 8.3, P <.001), social restriction (F = 16.6, P <.001), and perceived recovery (F = 7.8, P <.001). Linear mixed modeling showed a greater intervention effect for women in the gender-related video group in social distance, stereotyping, and separateness. Conclusions: Greater stigma reduction among women in the gender related video group underscores the importance of tailoring the narrative to specific experiences related to socio-demographic characteristics, especially among members of marginalized groups. This attenuation may result in greater identification and solidarity with the presenter. Future studies should explore other socially oppressed groups, including Black, Latinx, Asian, and LGBTQ+ communities.