Co-creation of stigma reduction strategies for mental health promotion interventions among people in vulnerable situations

Abstract

This study explored co-created strategies to reduce mental health stigma with the context of mental health promotion interventions targeting individuals in vulnerable situations. Scenario-based workshops were conducted across six European countries-Denmark, Italy, Germany, the Netherlands, Lithuania, and Switzerland-with the participation of end-users, health professionals, decision-makers, and representatives of umbrella organisations. Transcripts from the workshops were qualitatively analysed, leading to the identification of six core strategies. The most emphasized was the promotion of non-stigmatizing communication. Additional strategies included fostering empowerment and social contact, providing education and raising awareness, tailoring intervention sites and actors, ensuring inclusive access and evaluation, and upholding ethical principles and practices. While several of these strategies align with established stigma-reduction approaches, the analysis also revealed innovative, group-targeted, and context-specific contributions, such as the use of digital tools for youth, intergenerational contact for older adults, and culturally sensitive communication for migrant populations. These findings underscore the importance of contextually grounded and co-created approaches that integrate multiple stakeholder perspectives. In contrast to most existing evidence drawn from clinical or therapeutic settings, this study provides practice-oriented insights for the public health promotion and prevention field, highlighting co-creation as a methodological commitment with relevance for policy, practice, and future research.