Honest, Open, Proud: Concept and Efficacy of a peer-led Program to Provide Support with Disclosure Decisions and Coping with Stigma

Background: Due to the stigma associated with mental disorders, many people with mental illness face the difficult choice whether to disclose their illness to others. (Non-)Disclosure is a key reaction in coping with stigma. Disclosure as well as non-disclosure have risks and benefits, depending on the environment and the individual.

Methods: "Honest, Open, Proud" (HOP; German: "In Würde zu sich stehen"/IWS) is a peer-led group program to support people with mental illness in their disclosure decisions. It is not HOP's aim to make participants disclose, but to support a well-informed and empowered decision.

Results: Currently three RCTs, with several others underway, show HOP's positive effects in terms of reductions in stigma stress, disclosure distress, self-stigma, or depressive symptoms. Adolescent participants reported better quality of life, recovery, and attitudes to help-seeking. Adaptations for different diagnoses and age groups have been developed.

Conclusions: HOP appears to be a feasible and effective program to support people with mental illness in their disclosure decisions and in their coping with stigma. Future developments and public health implications are discussed.