BACKGROUND
Public stigma against depression contributes to low employment rates among individuals with depression and the self-stigmatization of individuals with depression. Contact-based educational (CBE) interventions, either using in-person contact or video-based contact, have been shown to reduce stigma against mental illness effectively. In-person contacts can stimulate empathy in participants but are challenging to arrange, while video-based contacts are cost-effective but encounter difficulty stimulating empathy towards the patient.
OBJECTIVE
The purpose of this study was to develop and evaluate the usefulness of a Virtual-Reality Anti-Stigma (VRAS) application that mimics CBE interventions to reduce public stigma.
METHODS
Sixteen medical students were recruited and randomized 1:1 to intervention and control groups. Participants in the intervention group (VRAS group) used the VRAS application, while those in the Control group watched video material on depression. Participants’ depression stigma score was assessed using the Depression Stigma Scale (DSS) and Attitudinal Social Distance (ASD), both pre- and post-intervention. Feasibility was also assessed in both groups after the intervention. A qualitative study was conducted on the acquisition of knowledge about stigma in both groups.
RESULTS
Feasibility score was significantly higher in the VRAS group (mean 5.63, SD 0.74) than in the Control group (mean 3.88, SD 1.73; P=.03). This result indicates that the VRAS application promoted an understanding of stigma in participants. However, no significant differences were apparent between the VRAS and Control groups for DSS (VRAS: mean 35.13, SD 5.30; Control: mean 35.38, SD 4.50; P=.92) or ASD (VRAS: mean 12.25, SD 3.33; Control: mean 11.25, SD 1.91; P=.92). Stigma scores tended to decrease, but the stigma-reducing effects of the VRAS application were not significant for either DSS (pre: mean 33.00, SD 4.44; post: mean 35.13, SD 5.30; P=.12) or ASD (pre: mean 13.25, SD 3.92; post: mean 12.25, SD 3.33; P=.12). The descriptive studies suggested that the VRAS group showed better acquisition of correct knowledge about stigma than the Control group.
CONCLUSIONS
No significant differences in mean values of DSS or ASD were identified between the VRAS and Control groups. The descriptive studies suggested that the VRAS application offers a supportive tool for depression stigma education. However, further clinical trials with more cases are needed to verify the effectiveness of stigma reduction.
CLINICALTRIAL
University hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) UMIN000043020; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000049109