Developing a Personalized Normative Feedback Intervention to Increase Help-Seeking for Suicidal Thoughts

Suicide rates have increased for Black and Asian American emerging adults in California, untreated depression contributes to this concerning trend. A major deterrent to treatment utilization is stigma, which has been known to decrease help-seeking behaviors. Black and Asian American communities have been known to have higher levels of mental health stigma than their white counterparts. People with untreated depression and suicidal thoughts often turn to the internet for help, meaning online interventions can play a crucial role in nudging individuals toward help-seeking. Personalized Normative Feedback (PNF) is one such intervention that has been widely used to modify a range of health behaviors. The premise of PNF is that people generally hold exaggerated views about what their peers deem acceptable (i.e., perceived social norms), which in turn influences behavior. However, perceptions that are so often passively accepted can be challenged with gentle confrontation. PNF actively corrects these views by providing accurate information about what people actually think is acceptable, thus re-routing the social pressure toward conformity to the healthier behavior. Working closely with a community advisory board, we will conduct a survey to collect social norms data from Black (N=1000) and Asian American (N=1000) emerging adults aged (18-29) and explore the extent to which perceived social norms associate with help-seeking intentions and behaviors across the ethno-racial groups. We will identify Black (N=30) and Asian American (N=30) emerging adults with untreated depression and/or recent suicidal ideation but have expressed no intention to seek help, and invite them to complete the PNF. In addition to examining changes in perceptions and intentions to seek help from pre-test to post-test, we will conduct a one-month follow up to see if intentions materialized into actions. We will also conduct qualitative interviews to guide iterative modifications to the PNF, examining acceptability, safety, and feasibility. If efficacious, we expect to be able to administer this cost-effective, quick, and easy intervention to thousands of individuals to reduce stigma and increase help-seeking.