Modifying attitudes to mental health using comedy as a delivery medium
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Beliefs about other people’s potential views or reactions may be powerful determinants of mental health help-seeking behaviours. United Kingdom Armed Forces (UK AF) have made considerable efforts to promote appropriate help seeking though it is often suggested that military personnel remain reluctant to seek help. This study evaluated a novel stigma-reduction method, stand-up comedy, in service personnel.
Personnel viewed a regular comedy show or a show containing mental health information. Pre, immediately post-show and 3 months later, military stigmatisation, potential discrimination, mental health knowledge, help-seeking and coping behaviour, talking about mental health, current mental health and alcohol use were measured.
Response rates were 81.3 % pre-show, 67.6 % post-show and 18.9 % at follow-up. Inclusion of mental health material did not appear to detract from show satisfaction. Post-show, intervention group (IG) participants reported significantly less stigmatisation and accurately answered mental health-related questions; in the small numbers followed up, neither difference was maintained, however, IG personnel were statistically significantly more likely to discuss mental health and to advise others about mental health; adjusted analyses suggested that this was related to factors other than the show.
In UK AF personnel, embedding mental health awareness within a comedy show format had a short-term positive effect upon military stigmatisation regarding mental health. The low rate of follow-up limited our ability to assess whether this effect was durable. If the longevity of change can be adequately assessed and demonstrated in further research, comedy could potentially form a component of a comprehensive stigma-reduction strategy.
KeywordsMilitary Stigmatisation Mental health Barriers to care Health promotion
We are indebted to the service personnel who freely gave their time to take part in the study; to the Wellcome Trust and MoD for their financial support and to Headquarters Land Forces who enabled the study and without whom it could not have taken place.
Conflict of interest
N.G. and M.F. are full-time members of the UK Armed Forces. N.J. is a full-time reservist. All N.G., M.F. and N.J. are currently seconded to King’s College London. M.T. is employed by Surrey County Council and worked with the Academic Department for Military Mental Health to co-ordinate the study. T.J. is a UK Ministry of Defence employee. J.R. is an independent professional comedian who donated his time to the Academic Department for Military Mental Health for the duration of the study. Although the UK Ministry of Defence facilitated this study, it gave no direction in the gathering, analysing and presentation of data. The MoD provided funding for military personnel from an annual budget that includes provision for conducting military research.
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