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The Perspectives Study: a randomised trial comparing filmed versus live social contact


There is now a large body of evidence supporting the use of social contact interventions to reduce stigma. In these interventions people with personal experience of mental illness share their experiences with an audience directly. Such interventions are increasingly being used with students and professionals in various medical and health disciplines. It is not currently known whether indirect social contact such as DVDs of service users talking about their experiences can be as effective as live interventions in reducing the stigma associated with mental illness. Filmed social contact may have practical and cost advantages. 


To compare the effectiveness of live and DVD modes for delivering mental health service user and carer perspectives as anti-stigma training interventions for nursing students. 


This study was a parallel groups randomised controlled trial of training interventions for student nurses with three conditions:

  1. a DVD of service users and carers discussing mental health related stigma;
  2. a service user and informal carer discussing their experiences; and
  3. a lecture delivered by a mental health nurse on stigma and mental illness (control). Participants were first year nursing students studying for a diploma or degree in general nursing and specialising in either adult nursing, child nursing or mental health nursing. Participants in the study were randomised by an independent Clinical Trials Unit who stratified the participants by whether they personally know a person with mental illness and the specialty of nursing they have chosen. The outcomes measured for this study included knowledge, attitudes (measured by the MICA-4) and intended behaviour towards people with mental illness. The student nurses were asked to complete the questionnaires containing these measures before and after receiving the interventions and four month later. 


A pilot trial was conducted in 2009. The main trial took place in October 2009 and 216 nursing students took part. There were no differences between the DVD and live groups except the DVD group had higher knowledge scores. The combined social contact group (DVD/live) had better attitudes (MICA) and intended behaviour scores than the lecture group, and the latter difference was maintained at four months. The DVD was the most cost-effective of the interventions, and the live session the most popular. This study supports the wider use of filmed social contact interventions to reduce stigma about mental illness. This study has now been published (Clement et al 2012) We have also conducted a systematic review examining the effective of simulated hallucinations on the stigma associated with schizophrenia which is a further approach attempting to convey the experience of mental illness to reduce stigma (Ando et al 2011).


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