Optimizing Culturally Grounded Mental Illness Recovery Narratives for Anti-Stigma Messaging on Social Media: A Three-Wave Longitudinal Study

Understanding how the effectiveness of mental health anti-stigma campaigns change over time is essential for designing sustainable and equitable interventions. Yet little is known about how these campaigns produce long-term impacts within interactive social media environments. This study conducted a three-wave longitudinal experiment to examine the effectiveness of social media-based mental illness recovery messages in reducing stigma and promoting professional help-seeking among African American, Hispanic, and Asian American adults (N = 577). Grounded in narrative persuasion, stigma, and social media affordance theories, the study tested the effects of message form (narrative vs. non-narrative), narrative point of view (first-person vs. third-person), and evaluability affordances (present vs. absent: likes, comments, shares) over a three-week period. While narrative messages alone did not significantly reduce stigma or increase behavioral intentions, evaluability affordances shaped stigma trajectories, with visible engagement cues linked to increased self-stigma, an unintended effect reflected in rising self-doubt stigma over time. Findings suggest that narrative persuasion on social media is dynamic and context-dependent, emphasizing the need for culturally sensitive and sustained anti-stigma interventions.