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Mental IllnessNCT03218748

Honest, Open, Proud for Soldiers with Mental Illness

A study testing Honest, Open, Proud (HOP) in people with Mental Illness, run by University of Ulm at 3 sites in 2 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of the study is to evaluate the feasibility and efficacy of the group-based intervention "Honest, Open, Proud" among soldiers with mental illness. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Mental Illness
What is being tested?
Honest, Open, Proud (HOP)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
99 participants
Where
3 sitesin 2 countries
Study dates
15 Nov 2017to 1 Oct 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • At least one self-reported current axis I or axis II disorder according to DSM-5, which is not restricted to only substance-related disorder(s)
  • Age 18 or above
  • Ability to provide written informed consent
  • Fluent in German (needed for self-report measures)
  • At least a moderate level of self-reported disclosure-related distress/difficulty (score 4 or higher on the screening item 'In general, how distressed or worried are you in terms of secrecy or disclosure of your mental illness to others?', rated from 1, not at all, to 7, very much)
  • Current inpatient, day-clinic or outpatient treatment at the Center for Military Mental Health, Berlin, Germany
  • from April 2018 onwards we decided to also include non-military first responders (fire fighters or police officers) who are treated in the Center for Military Mental Health, Berlin, Germany

Who cannot join

  • Self-reported diagnosis of only a substance- or alcohol-related disorder, without non-substance related current psychiatric comorbidity. We will exclude people who only have a substance-/alcohol-related disorder because the disclosure of these disorders is not the topic of the HOP intervention
  • Intellectual disability
  • Organic disorders

Trial locations and contacts

3 sites in 2 countries.

3 sites in 2 countries

Germany2 sites
  • Center for Military Mental Health

    Berlin, 10115

  • Department of Psychiatry II, Section Pubic Mental Health, Ulm University, Bezirkskrankenhaus Günzburg

    Ulm, 89073

Other trials in Germany

United States1 site
  • Illinois Institute of Technology

    Chicago, Illinois, 60616

Other trials in United States

About this study

Official title: Adaptation and Evaluation of the Honest, Open, Proud Program for Soldiers with Mental Illness

The purpose of the study is to evaluate the feasibility and efficacy of the group-based intervention "Honest, Open, Proud" among soldiers with mental illness.

Read the detailed description

Soldiers with mental illness typically face a two-fold problem. On the one hand, they have to cope with the symptoms of their mental illness; on the other hand, they often have to deal with stigma and discrimination. Both due to fear of public stigma and due to self-stigma or shame, soldiers with mental illness may decide to keep their condition a secret or even to withdraw from other people altogether in order to minimize the risk of being labeled. Secrecy can help on the short term to protect individuals from public stigma, but usually it has negative long-term consequences such as social isolation, distress and avoidance of help-seeking. Disclosure, on the other hand, carries the risk to be discriminated by others, but can reduce the burden of secrecy, lead to support by others and reduce public stigma.

In this study investigators aim to test the efficacy (see our outcomes above) of Honest, Open, Proud run by soldiers with lived experience of mental illness.

Conditions
Mental Illness
Being tested
Honest, Open, Proud (HOP)
Keywords
Mental illness, Disclosure, stigma, soldiers, secrecy
Medical subject headings
Mental Disorders, Social Stigma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Honest, Open, Proud (HOP)Behavioural

    Also called Coming Out Proud (COP)

    Three lessons, one for each two-hour session plus one booster session

    1. Considering the pros and cons of disclosure: Discussion of one's idea of identity and mental illness, weighing the costs and benefits of (non-) disclosure
    2. Different ways to disclose: Discussion of different levels of (non-) disclosure, considering costs and benefits of each level, selecting persons to disclose to and how to test them out, anticipating responses of others to one's disclosure
    3. Telling one's story: Practice how to tell one's story, identifying peers who might be helpful with the coming out process
    4. Booster session Reviewing previous intentions to disclose one's mental illness, discussion whether one disclosed and evaluating this experience
Study groups in NCT03218748
Study groupRoleWhat they receive
Honest, Open, ProudExperimentalThe group program is about disclosure versus secrecy of one's mental illness. The groups are facilitated by two peers (soldiers with lived experience of mental illness). Each group runs for three weeks, one meeting per week, and two hours per meeting. There is one 2-hour booster session in week 6. Fidelity to manual: rated by a research assistant who is present during the group session
Receives: Behavioral: Honest, Open, Proud (HOP)
Control groupNo interventionTreatment as usual (TAU)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Stigma Stress Scale, 8 items

    (Rüsch et al. 2009a; Rüsch et al. 2009b)

    Measured: 3 weeks (T1)

  2. WHOQoL BREF; Domain psychological quality of life, 6 items

    (WHOQoL Group 1998)

    Measured: 6 weeks (T2)

Secondary outcomes (11)
  1. Empowerment Scale, Subscale 'Self-esteem', 9 items

    (Rogers et al. 1997)

    Measured: baseline, 3, 6 and 12 weeks (T3)

  2. Psychological Well-Being Scale, 18 items

    (Ryff 1989)

    Measured: baseline, 3, 6 and 12 weeks

  3. Internalized Stigma of Mental Illness Inventory, Brief Version, 10 items

    (Boyd et al. 2014)

    Measured: baseline, 3, 6 and 12 weeks

  4. Self-Stigma of Mental Illness Scale, Short Version, subscale Self-Concurrence, 5 items

    (Corrigan et al. 2012)

    Measured: baseline, 3, 6 and 12 weeks

  5. Secrecy and Social Withdrawal subscales of the Stigma Coping Orientation Scales, 12 items

    (Link et al. 1991)

    Measured: baseline, 3, 6 and 12 weeks

  6. Disclosure related distress ("In general, how distressed or worried are you in terms of secrecy or disclosure of your mental illness to others?', from 1, not at all, to 7, very much)

    (Rüsch et al. 2014a)

    Measured: baseline, 3, 6 and 12 weeks

  7. WHOQoL-BREF, 26 items

    (WHOQOL Group 1998)

    Measured: 3, 6 and 12 weeks

  8. Patient Health Questionnaire (PHQ-9), 9 items

    (Kroenke et al. 2001)

    Measured: baseline, 3, 6 and 12 weeks

  9. Shame about having a mental illness, 1 item

    (Rüsch et al. 2014b)

    Measured: baseline, 3, 6 and 12 weeks

  10. Attitudes to help-seeking, 2 items

    (Rüsch et al. 2013)

    Measured: baseline, 3, 6 and 12 weeks

  11. Attitudes to disclosure, 2 items

    (Rüsch et al. 2011)

    Measured: baseline, 3, 6 and 12 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Jul 2017
  2. Study start15 Nov 2017
  3. Primary completion1 Oct 2024
  4. Study completion1 Oct 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
99 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03218748
Sponsor's protocol ID
HOP Soldiers
Status last verified
Dec 2024
First submitted
12 Jul 2017
Last updated
11 Dec 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Rogers ES, Chamberlin J, Ellison ML, Crean T. A consumer-constructed scale to measure empowerment among users of mental health services. Psychiatr Serv. 1997 Aug;48(8):1042-7. doi: 10.1176/ps.48.8.1042.

    PubMed 9255837
  • Boyd JE, Otilingam PG, Deforge BR. Brief version of the Internalized Stigma of Mental Illness (ISMI) scale: psychometric properties and relationship to depression, self esteem, recovery orientation, empowerment, and perceived devaluation and discrimination. Psychiatr Rehabil J. 2014 Mar;37(1):17-23. doi: 10.1037/prj0000035.

    PubMed 24660946
  • Corrigan PW, Michaels PJ, Vega E, Gause M, Watson AC, Rusch N. Self-stigma of mental illness scale--short form: reliability and validity. Psychiatry Res. 2012 Aug 30;199(1):65-9. doi: 10.1016/j.psychres.2012.04.009. Epub 2012 May 10.

    PubMed 22578819
  • Rusch N, Abbruzzese E, Hagedorn E, Hartenhauer D, Kaufmann I, Curschellas J, Ventling S, Zuaboni G, Bridler R, Olschewski M, Kawohl W, Rossler W, Kleim B, Corrigan PW. Efficacy of Coming Out Proud to reduce stigma's impact among people with mental illness: pilot randomised controlled trial. Br J Psychiatry. 2014;204(5):391-7. doi: 10.1192/bjp.bp.113.135772. Epub 2014 Jan 16.

    PubMed 24434073
  • Link BG, Mirotznik J, Cullen FT. The effectiveness of stigma coping orientations: can negative consequences of mental illness labeling be avoided? J Health Soc Behav. 1991 Sep;32(3):302-20.

    PubMed 1940212
  • Rusch N, Corrigan PW, Heekeren K, Theodoridou A, Dvorsky D, Metzler S, Muller M, Walitza S, Rossler W. Well-being among persons at risk of psychosis: the role of self-labeling, shame, and stigma stress. Psychiatr Serv. 2014 Apr 1;65(4):483-9. doi: 10.1176/appi.ps.201300169.

    PubMed 24382666
  • Rusch N, Heekeren K, Theodoridou A, Dvorsky D, Muller M, Paust T, Corrigan PW, Walitza S, Rossler W. Attitudes towards help-seeking and stigma among young people at risk for psychosis. Psychiatry Res. 2013 Dec 30;210(3):1313-5. doi: 10.1016/j.psychres.2013.08.028. Epub 2013 Sep 4.

    PubMed 24012162
  • Rusch N, Evans-Lacko SE, Henderson C, Flach C, Thornicroft G. Knowledge and attitudes as predictors of intentions to seek help for and disclose a mental illness. Psychiatr Serv. 2011 Jun;62(6):675-8. doi: 10.1176/ps.62.6.pss6206_0675.

    PubMed 21632739
  • Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychol Med. 1998 May;28(3):551-8. doi: 10.1017/s0033291798006667.

    PubMed 9626712
  • Rusch N, Corrigan PW, Powell K, Rajah A, Olschewski M, Wilkniss S, Batia K. A stress-coping model of mental illness stigma: II. Emotional stress responses, coping behavior and outcome. Schizophr Res. 2009 May;110(1-3):65-71. doi: 10.1016/j.schres.2009.01.005. Epub 2009 Feb 23.

    PubMed 19237266
  • Rusch N, Corrigan PW, Wassel A, Michaels P, Olschewski M, Wilkniss S, Batia K. A stress-coping model of mental illness stigma: I. Predictors of cognitive stress appraisal. Schizophr Res. 2009 May;110(1-3):59-64. doi: 10.1016/j.schres.2009.01.006. Epub 2009 Mar 6.

    PubMed 19269140
  • Ryff, C. D. (1989): Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology (57): 1069-1081.

  • Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13. doi: 10.1046/j.1525-1497.2001.016009606.x.

    PubMed 11556941
  • Rusch N, Helms C, Horger J, Hohle B, Bernert H, Muschner P, Rose C, Corrigan PW, Mulfinger N, Zimmermann P, Willmund GD. The peer-led Honest, Open, Proud program to decrease the impact of mental illness stigma among German military personnel: randomized controlled trial. Soc Psychiatry Psychiatr Epidemiol. 2026 May;61(5):791-801. doi: 10.1007/s00127-025-02960-x. Epub 2025 Jul 22.

    PubMed 40696200

Questions about this trial

What is this clinical trial studying?

A study testing Honest, Open, Proud (HOP) in people with Mental Illness, run by University of Ulm at 3 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 11 Dec 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Germany, United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Stigma Stress Scale, 8 items (time frame: 3 weeks (T1)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03218748, which also lists 14 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Dec 2024.

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