Real-World Effectiveness of the Peer-Led Honest, Open, Proud Programme for Self-Stigma Among Adults With Mental Illness: A Pragmatic, Multicentre, Randomised Controlled Trial
AI Summary
Honest, Open, Proud programme significantly reduced self-stigma at 6 weeks and at 6-month follow-up in a pragmatic multicentre RCT.
HOP produced additional improvements in stigma stress, depressive symptoms, help-seeking intentions, quality of life, recovery, shame, and social inclusion at 6 weeks.
The peer-led programme was cost-effective for quality of life gains, had no project-related adverse events, and should complement usual care in clinical and community settings.
Lancet Reg Health Eur. 2026 Jun 19;67:101751. doi: 10.1016/j.lanepe.2026.101751. eCollection 2026 Aug.
ABSTRACT
BACKGROUND: The stigma of mental illness is a key barrier to recovery, help-seeking and social inclusion of people with mental disorders. Faced with stigma and discrimination, many struggle with the decision whether to disclose their condition to others. Honest, Open, Proud (HOP) is a peer-led group programme that supports participants with disclosure decisions. This study examined HOP’s real-world effectiveness to reduce self-stigma and to improve secondary clinical and social outcomes as well as its cost-effectiveness.
METHODS: In this open-label, pragmatic parallel 2:1-randomised trial, we included working-age adults with mental illness across nine sites in Germany, recruited in clinical and community settings. Participants were randomly assigned to HOP and treatment as usual (TAU, 2/3), or to TAU alone (1/3). Outcomes were assessed by self-report pre (baseline), post (6 weeks) and at 6-month follow-up. The primary endpoint was self-stigma at 6 weeks. Intervention effects were analysed by intention-to-treat analysis. The trial was pre-registered on DRKS (https://drks.de/search/en/trial/DRKS00033314).
FINDINGS: From February to November 2024, 457 participants (mean age 42 years, 66% female, 92% German born) were included in the trial; 306 were randomised to HOP and TAU, and 151 to TAU alone. Compared to TAU, HOP participants showed significantly less self-stigma at week 6 (-1.83, 95%-CI -2.96 to -0.70, d = -0.24, p = 0.0015) and at 6-month follow-up (-1.20, 95%-CI -2.36 to -0.05, d = -0.16, p = 0.042). In terms of secondary outcomes, HOP had significant positive effects on stigma stress, depressive symptoms, help-seeking intentions, quality of life, recovery, shame, and social inclusion at 6 weeks. In an economic evaluation HOP was cost-effective in terms of quality of life gains. There were no project-related adverse events.
INTERPRETATION: HOP effectively reduces self-stigma among adults under real-world conditions and should be offered in addition to usual care in clinical and community settings.
FUNDING: Federal Department of Health, Germany (2523FSB22A, 2523FSB22B).
J Fam Psychol. 2026 Jun 29. doi: 10.1037/fam0001507. Online ahead of print.ABSTRACTParents of transgender and gender-diverse (TGD) youth navigate various fears within a sociopolitical context...
Psychol Trauma. 2026 Jun 29. doi: 10.1037/tra0002219. Online ahead of print.ABSTRACTOBJECTIVE: Intimate partner violence, which includes physical assault, sexual violation and coercion, economic abuse, as...
J Community Psychol. 2026 Jul;54(5):e70117. doi: 10.1002/jcop.70117.ABSTRACTAIMS: Historical oppression of Indigenous communities has led to high poverty, violence, and substance use. The pandemic amplified pre-existing...
J Community Psychol. 2026 Jul;54(5):e70107. doi: 10.1002/jcop.70107.ABSTRACTThe ongoing system of coloniality, sustained through dehumanisation, racialised violence, oppression, war, and genocidal acts of violence, has left...
J Interpers Violence. 2026 Jun 29:8862605261462151. doi: 10.1177/08862605261462151. Online ahead of print.ABSTRACTChild Sexual Abuse Material (CSAM) offending has increased in recent years. Rather than being...
