Evaluating the Effectiveness of Social Media–Based Interventions in Reducing Mental Health Stigma: A Qualitative Study in Tehran

Abstract

This study aimed to explain users’, people with lived experience, family members’, and mental health professionals’ perceptions of the mechanisms, outcomes, and limitations of social media–based interventions intended to reduce mental health stigma. A qualitative descriptive-interpretive design was employed. The participants were 24 residents of Tehran who were selected through purposive maximum-variation sampling. They included 12 individuals with lived experience of mental health problems, 7 mental health professionals or professional content creators, and 5 family members or social advocates. Data were collected exclusively through individual semi-structured interviews. Interviews continued until theoretical saturation was reached; preliminary saturation occurred after the twenty-first interview, followed by three additional interviews to ensure informational adequacy. All interviews were transcribed verbatim and analyzed through inductive thematic analysis using NVivo version 14. Credibility and trustworthiness were enhanced through participant checking, peer review, documentation of the analytical process, maximum-variation sampling, and maintaining an audit trail. Four main categories emerged: “improving mental health literacy and cognitively reconstructing stigma,” “digital social contact and humanization of mental health experiences,” “empowerment for controlled disclosure, peer support, and help-seeking,” and “fragility of intervention effects in the face of distrust, trivialization, and platform-related risks.” Participants believed that accessible scientific information, authentic recovery narratives, and opportunities for reciprocal communication could challenge stereotypes, reduce fear, and decrease desired social distance. Nevertheless, misinformation, commercialized or performative portrayals of mental disorders, stigmatizing comments, privacy concerns, algorithmic repetition, and discontinuous exposure restricted intervention effectiveness. Social media–based interventions can contribute to reducing public stigma and facilitating help-seeking when they are scientifically credible, culturally appropriate, sustained over time, connected to professional services, and designed with meaningful participation from people with lived experience. However, social media interventions should not be considered substitutes for structural policies, face-to-face education, or accessible mental health services. Multilevel intervention design, professional content governance, active moderation, and assessment of long-term behavioral outcomes are required to achieve sustainable stigma reduction.