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Completed

NCT Number: NCT03218748

Honest, Open, Proud for Soldiers with Mental Illness

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.

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Key information

Conditions

Mental Illness Behavior Mental Disorders Social Behavior Social Stigma

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Center for Military Mental Health, Berlin, Germany

Loading trial locations.

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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

Treatment and study plan

Honest, Open, Proud (HOP)

Behavioral

Three lessons, one for each two-hour session plus one booster session

  • Considering the pros and cons of disclosure:

Discussion of one's idea of identity and mental illness, weighing the costs and benefits of (non-) disclosure

  • Different ways to disclose:

Discussion of different levels of (non-) disclosure, considering costs and benefits of each level, selecting persons to disclose to and how to test them out, anticipating responses of others to one's disclosure

  • Telling one's story:

Practice how to tell one's story, identifying peers who might be helpful with the coming out process

  • Booster session Reviewing previous intentions to disclose one's mental illness, discussion whether one disclosed and evaluating this experience

Other names: Coming Out Proud (COP)

Primary outcomes

  1. Stigma Stress Scale, 8 items

    Time frame: 3 weeks (T1)

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

  2. WHOQoL BREF; Domain psychological quality of life, 6 items

    Time frame: 6 weeks (T2)

    (WHOQoL Group 1998)

Secondary outcomes

  1. Empowerment Scale, Subscale 'Self-esteem', 9 items

    Time frame: baseline, 3, 6 and 12 weeks (T3)

    (Rogers et al. 1997)

  2. Psychological Well-Being Scale, 18 items

    Time frame: baseline, 3, 6 and 12 weeks

    (Ryff 1989)

  3. Internalized Stigma of Mental Illness Inventory, Brief Version, 10 items

    Time frame: baseline, 3, 6 and 12 weeks

    (Boyd et al. 2014)

  4. Self-Stigma of Mental Illness Scale, Short Version, subscale Self-Concurrence, 5 items

    Time frame: baseline, 3, 6 and 12 weeks

    (Corrigan et al. 2012)

  5. Secrecy and Social Withdrawal subscales of the Stigma Coping Orientation Scales, 12 items

    Time frame: baseline, 3, 6 and 12 weeks

    (Link et al. 1991)

  6. 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)

    Time frame: baseline, 3, 6 and 12 weeks

    (Rüsch et al. 2014a)

  7. WHOQoL-BREF, 26 items

    Time frame: 3, 6 and 12 weeks

    (WHOQOL Group 1998)

  8. Patient Health Questionnaire (PHQ-9), 9 items

    Time frame: baseline, 3, 6 and 12 weeks

    (Kroenke et al. 2001)

  9. Shame about having a mental illness, 1 item

    Time frame: baseline, 3, 6 and 12 weeks

    (Rüsch et al. 2014b)

  10. Attitudes to help-seeking, 2 items

    Time frame: baseline, 3, 6 and 12 weeks

    (Rüsch et al. 2013)

  11. Attitudes to disclosure, 2 items

    Time frame: baseline, 3, 6 and 12 weeks

    (Rüsch et al. 2011)

Sponsors and collaborators

Lead sponsor

University of Ulm

Other

Collaborators

  • Center for Military Mental Health, Berlin, Germany
  • Illinois Institute of Technology, Chicago, USA

Registry information

Official study title

Adaptation and Evaluation of the Honest, Open, Proud Program for Soldiers with Mental Illness

Important dates

Study start
2017
Primary completion
2024
Study completion
2024
First posted
Jul 17, 2017
Registry last updated
Dec 11, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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