#  BEST Lab research shows that mental health interventions among youth may be less effective in high-stigma communities 

 





January 01, 2022

 

 

 One question that is especially important to clinical psychologists is whether our mental health interventions are equally effective across diverse social contexts. However, it has proven difficult to answer this question because most intervention studies are conducted in a single community, precluding the possibility of linking contextual variation with intervention outcomes. To overcome this challenge, researchers recently developed a novel method called spatial meta-analysis. This approach retains many aspects of a traditional meta-analysis, with the added step that studies are geo-located, allowing researchers to characterize each included study in terms of the social context in which it was conducted.

 In this study, BEST Lab researchers and colleagues re-analyzed a large meta-analysis of youth psychotherapy randomized controlled trials conducted by John Weisz and colleagues. These interventions have been conducted across communities that differ in their level of racial prejudice, which we measured by aggregating individual racial attitudes assessed in a number of national surveys to the community level in which the interventions were conducted. This enabled us to examine contextual forms of stigma as a moderator of intervention efficacy among studies with majority White vs. majority-Black samples. We found that for studies with majority-Black youth, higher levels of racial prejudice in the community were associated with lower intervention effect sizes, controlling for other contextual factors. In contrast, there was no association for the non-stigmatized comparison group of majority-White youth, providing evidence of result specificity. Further, there was an interaction between community-level racial prejudice and time since intervention: In low-stigma communities, the intervention effect size for studies with majority-Black youth increased over time relative to those in the control condition. In contrast, in high-stigma communities, the intervention effect size continued to decrease over time, suggesting that any minimal initial benefits accrued from the intervention eroded in these high-stigma environments. Taken together, these results provide novel evidence that contextual forms of stigma may undermine intervention efficacy, indicating the need to develop more effective interventions in high-stigma communities, even as we continue to target stigma and prejudice at their source.

 You can [read more about this study](http://doi.org/10.1016/j.jaac.2021.07.808) in the Journal of the American Academy of Child & Adolescent Psychiatry.



 

 

 



 

 

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