People tend to care about what others think and often change our behaviors accordingly. But what if people do not have an accurate understanding of what others really think? Stigma is pervasive, especially in the Black and Asian American communities, which can prevent people from seeking help. This study explores whether correcting misperceptions (by showing what people really think) about depression and suicide can increase help-seeking behaviors among Black and Asian emerging adults who have untreated depression and 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 use survey data we collected on social norms from Black and Asian American emerging adults aged (18-29) and explore the extent to which presenting these social norms can increase help-seeking intentions and behaviors. This study will identify Black (N=80) and Asian American (N=80) emerging adults with untreated depression and/or recent suicidal ideation but have expressed no intention to seek help, and within each racial group, randomly assign half to a PNF treatment and half to the control condition. This study will test whether the PNF intervention will decrease stigma, increase intention to seek treatment, and one month later, test whether the intervention led to help-seeking behaviors. This study will also collect survey data on the acceptability, safety, and feasibility of PNF. If efficacious, the researchers expect to be able to administer this cost-effective, quick, and easy intervention to thousands of individuals to reduce stigma and increase help-seeking.

Inclusion Criteria:

• Adults aged 18-29
• Asian American
• Black American
• Suicidal ideation
• Depression
• Not currently in treatment
• English speaking