(PS10-56) Evaluating Stigma of Seeking Help as a Moderator between Functional Impairment and Interest in App-based Interventions Among Suicidal Individuals

Abstract Text: Digital mental health interventions have emerged as promising tools for those with a history of suicide, providing accessible and scalable support. That said, engagement with these tools varies, and a lack of research has examined factors impacting interest in app-based interventions. Factors such as functional impairment may impact perceived effectiveness of app-based care. Furthermore, stigma surrounding mental health and mental health treatment may further moderate this relationship, potentially dissuading those with greater impairment from using digital supports. Understanding how stigma interacts with functional impairment to shape interest in different digital intervention types—daily notifications, self-guided programs, and distress-based notifications—could provide substantial insight into design and optimization of digital interventions for high-risk populations.

Participants (n=971; Mage = 39.04, SD = 14.31; 75.7% White; 63.6% female) with a past 5-year history of suicidal thoughts or behaviors completed assessments of functional impairment (SheeHan, 1983), stigma of seeking help (Vogel et al., 2006), and rated their likelihood of using three different formats of app-based interventions: daily notifications, self-guided, and distress-based notifications. We used PROCESS (Hayes, 2013) to examine the interaction between impairment and stigma on app use, controlling for age (daily and distress notifications), ethnicity (daily notifications), and sex (self-guided).

In predicting likely engagement with app-based daily notifications, impairment had a significant main effect [b = 0.02, t(957) = 6.15, p < .001], but not stigma [b = -0.001, t(957) = -0.18, p = 0.86). There was a significant interaction between impairment and stigma [b = .001, SE = .001, t(955) = 1.98, p = .048]. The effect of functional impairment was stronger at higher levels of stigma.

In predicting likely engagement with a self-guided app, impairment has significant main effect [b = 0.02, t(957) = 5.67, p < .001] but not stigma [b = -0.001, t(957) = -0.16, p = .874]. There was a significant interaction between impairment and stigma (b = .001, SE = .001, t(955) = 2.49, p = .013). The effect of functional impairment was stronger at higher levels of stigma.

In predicting likely engagement with app-based distress notifications, impairment had a significant main effect [b = 0.02, t(957) = 6.01, p < .001), but not stigma [b = -0.003, t(957) = -0.60, p = .546]. There was a significant interaction between impairment and stigma (b = .001, SE = .001, t(955) = 2.27, p = .024). The effect of functional impairment was stronger at higher levels of stigma.

Findings suggest that, as stigma increases, the effect of functional impairment on likelihood of using apps strengthens across app types. This may be due to differences in the perceptions of app-based interventions, such that individuals do not consider using apps “help seeking” in the same way as conventional models of care. This, in turn, may amplify interest in digital mental health interventions amongst those with high levels of impairment. These results highlight the potential of app-based intervention in high risk populations to improve access to care amongst those struggling with stigma and high need for support.