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Honest, Open, Proud for Soldiers with Mental Illness

Not Applicable
Completed
Conditions
Mental Illness
Interventions
Behavioral: Honest, Open, Proud (HOP)
Registration Number
NCT03218748
Lead Sponsor
University of Ulm
Brief Summary

The purpose of the study is to evaluate the feasibility and efficacy of the group-based intervention "Honest, Open, Proud" among soldiers with mental illness.

Detailed Description

Soldiers with mental illness typically face a two-fold problem. On the one hand, they have to cope with the symptoms of their mental illness; on the other hand, they often have to deal with stigma and discrimination. Both due to fear of public stigma and due to self-stigma or shame, soldiers with mental illness may decide to keep their condition a secret or even to withdraw from other people altogether in order to minimize the risk of being labeled. Secrecy can help on the short term to protect individuals from public stigma, but usually it has negative long-term consequences such as social isolation, distress and avoidance of help-seeking. Disclosure, on the other hand, carries the risk to be discriminated by others, but can reduce the burden of secrecy, lead to support by others and reduce public stigma.

In this study investigators aim to test the efficacy (see our outcomes above) of Honest, Open, Proud run by soldiers with lived experience of mental illness.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
99
Inclusion Criteria
  • At least one self-reported current axis I or axis II disorder according to DSM-5, which is not restricted to only substance-related disorder(s)
  • Age 18 or above
  • Ability to provide written informed consent
  • Fluent in German (needed for self-report measures)
  • At least a moderate level of self-reported disclosure-related distress/difficulty (score 4 or higher on the screening item 'In general, how distressed or worried are you in terms of secrecy or disclosure of your mental illness to others?', rated from 1, not at all, to 7, very much)
  • Current inpatient, day-clinic or outpatient treatment at the Center for Military Mental Health, Berlin, Germany
  • from April 2018 onwards we decided to also include non-military first responders (fire fighters or police officers) who are treated in the Center for Military Mental Health, Berlin, Germany
Exclusion Criteria
  • Self-reported diagnosis of only a substance- or alcohol-related disorder, without non-substance related current psychiatric comorbidity. We will exclude people who only have a substance-/alcohol-related disorder because the disclosure of these disorders is not the topic of the HOP intervention
  • Intellectual disability
  • Organic disorders

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Honest, Open, ProudHonest, Open, Proud (HOP)The group program is about disclosure versus secrecy of one's mental illness. The groups are facilitated by two peers (soldiers with lived experience of mental illness). Each group runs for three weeks, one meeting per week, and two hours per meeting. There is one 2-hour booster session in week 6. Fidelity to manual: rated by a research assistant who is present during the group session
Primary Outcome Measures
NameTimeMethod
Stigma Stress Scale, 8 items3 weeks (T1)

(Rüsch et al. 2009a; Rüsch et al. 2009b)

WHOQoL BREF; Domain psychological quality of life, 6 items6 weeks (T2)

(WHOQoL Group 1998)

Secondary Outcome Measures
NameTimeMethod
Self-Stigma of Mental Illness Scale, Short Version, subscale Self-Concurrence, 5 itemsbaseline, 3, 6 and 12 weeks

(Corrigan et al. 2012)

WHOQoL-BREF, 26 items3, 6 and 12 weeks

(WHOQOL Group 1998)

Psychological Well-Being Scale, 18 itemsbaseline, 3, 6 and 12 weeks

(Ryff 1989)

Secrecy and Social Withdrawal subscales of the Stigma Coping Orientation Scales, 12 itemsbaseline, 3, 6 and 12 weeks

(Link et al. 1991)

Disclosure related distress ("In general, how distressed or worried are you in terms of secrecy or disclosure of your mental illness to others?', from 1, not at all, to 7, very much)baseline, 3, 6 and 12 weeks

(Rüsch et al. 2014a)

Empowerment Scale, Subscale 'Self-esteem', 9 itemsbaseline, 3, 6 and 12 weeks (T3)

(Rogers et al. 1997)

Internalized Stigma of Mental Illness Inventory, Brief Version, 10 itemsbaseline, 3, 6 and 12 weeks

(Boyd et al. 2014)

Attitudes to help-seeking, 2 itemsbaseline, 3, 6 and 12 weeks

(Rüsch et al. 2013)

Patient Health Questionnaire (PHQ-9), 9 itemsbaseline, 3, 6 and 12 weeks

(Kroenke et al. 2001)

Shame about having a mental illness, 1 itembaseline, 3, 6 and 12 weeks

(Rüsch et al. 2014b)

Attitudes to disclosure, 2 itemsbaseline, 3, 6 and 12 weeks

(Rüsch et al. 2011)

Trial Locations

Locations (3)

Illinois Institute of Technology

🇺🇸

Chicago, Illinois, United States

Center for Military Mental Health

🇩🇪

Berlin, Germany

Department of Psychiatry II, Section Pubic Mental Health, Ulm University, Bezirkskrankenhaus Günzburg

🇩🇪

Ulm, Germany

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