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  • Review Article
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The psychological consequences of mental health awareness efforts

Abstract

Public health campaigns that raise awareness about mental health problems are designed to decrease stigma, increase help-seeking and improve mental health literacy. However, there is some theoretical concern that, alongside benefits, such campaigns might negatively impact how some individuals interpret, label and respond to mental health problems. In this Review, we summarize the extant evidence for the positive and negative psychological impacts of mental health awareness efforts. We integrate theoretical literature with studies using experimental designs in which mental health awareness content is manipulated in a controlled environment that might provide preliminary insights into potential causal relationships. We find that awareness materials can change cognitions and beliefs relating to one’s own mental health and to mental health more generally (such as self-diagnosis and beliefs about recovery). These effects can vary depending on individual characteristics (such as existing symptoms, stability of self-concept and suggestibility), the message being presented, identification with the messenger, and whether there is personalized information about one’s own symptoms. We discuss the implications of this work for adolescent populations and directions for future research.

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Fig. 1: Possible impacts of mental health awareness campaigns.

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References

  1. Hahn, J. S., Chua, K.-C., Jones, R. & Henderson, C. The Every Mind Matters campaign: changes in mental health literacy and its associations with campaign awareness. Eur. J. Public Health 33, 1008–1013 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  2. Henderson, C., Potts, L. & Robinson, E. J. Mental illness stigma after a decade of Time to Change England: inequalities as targets for further improvement. Eur. J. Public Health 30, 497–503 (2020).

    Article  Google Scholar 

  3. Hoover, S. & Bostic, J. Schools as a vital component of the child and adolescent mental health system. Psychiat. Serv. 72, 37–48 (2021).

    Article  Google Scholar 

  4. Lever, N. et al. Using the whole school, whole community, whole child model to support mental health in schools. J. Sch. Health 94, 200–203 (2024).

    Article  PubMed  Google Scholar 

  5. March, A., Stapley, E., Hayes, D., Town, R. & Deighton, J. Barriers and facilitators to sustaining school-based mental health and wellbeing interventions: a systematic review. Int. J. Environ. Res. Public Health 19, 3587 (2022).

    Article  Google Scholar 

  6. Draganidis, A., Fernando, A. N., West, M. L. & Sharp, G. Social media delivered mental health campaigns and public service announcements: a systematic literature review of public engagement and help-seeking behaviours. Soc. Sci. Med. 359, 117231 (2024).

    Article  PubMed  Google Scholar 

  7. Foulkes, L. & Andrews, J. L. Are mental health awareness efforts contributing to the rise in reported mental health problems? A call to test the prevalence inflation hypothesis. N. Ideas Psychol. 69, 101010 (2023).

    Article  Google Scholar 

  8. Booth, R. G., Allen, B. N., Bray Jenkyn, K. M., Li, L. & Shariff, S. Z. Youth mental health services utilization rates after a large-scale social media campaign: population-based interrupted time-series analysis. JMIR Ment. Health 5, e27 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  9. Durlak, J. A., Mahoney, J. L. & Boyle, A. E. What we know, and what we need to find out about universal, school-based social and emotional learning programs for children and adolescents: a review of meta-analyses and directions for future research. Psychol. Bull. 148, 765–782 (2022).

    Article  Google Scholar 

  10. Werner-Seidler, A. et al. School-based depression and anxiety prevention programs: an updated systematic review and meta-analysis. Clin. Psychol. Rev. 89, 102079 (2021).

    Article  PubMed  Google Scholar 

  11. Ecclestone, K. Resisting images of the ‘diminished self’: the implications of emotional well-being and emotional engagement in education policy. J. Educ. Policy 22, 455–470 (2007).

    Article  Google Scholar 

  12. Wright, K. Student wellbeing and the therapeutic turn in education. Aust. Educ. Dev. Psychol. 31, 141–152 (2014).

    Article  Google Scholar 

  13. Cuijpers, P. Universal prevention of depression at schools: dead end or challenging crossroad? Evidence-based Ment. Health 25, 96–98 (2022).

    Article  Google Scholar 

  14. Foulkes, L. & Stringaris, A. Do no harm: can school mental health interventions cause iatrogenic harm? BJPsych Bull. 47, 267–269 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  15. Guzman-Holst, C., Streckfuss Davis, R., Andrews, J. L. & Foulkes, L. Scoping review: potential harm from school-based group mental health interventions. Child Adolesc. Ment. Health 30, 208–222 (2025).

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kearney, C. A. The perniciousness and promise of school-based mental health service delivery for youth. Res. Child. Adolesc. Psychopathol. 53, 609–624 (2025).

    Article  PubMed  Google Scholar 

  17. Beeker, T. et al. Psychiatrization of society: a conceptual framework and call for transdisciplinary research. Front. Psychiatry 12, 645556 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  18. Underhill, R. & Foulkes, L. Self-diagnosis of mental disorders: a qualitative study of attitudes on Reddit. Qual. Health Res. 35, 779–792 (2025).

    Article  PubMed  Google Scholar 

  19. Lane, R. “He doesn’t really have bipolar …”. The rise of strategic essentialism and diagnostic possessiveness in bipolar disorder. SSM Ment. Health 5, 100299 (2024).

    Article  Google Scholar 

  20. Dakin, B. C., McGrath, M. J., Rhee, J. J. & Haslam, N. Broadened concepts of harm appear less serious. Soc. Psychol. Personal. Sci. 14, 72–83 (2023).

    Article  Google Scholar 

  21. Haslam, N. Concept creep: psychology’s expanding concepts of harm and pathology. Psychol. Inq. 27, 1–17 (2016).

    Article  Google Scholar 

  22. Tam, M. T., Wu, J. M., Zhang, C. C., Pawliuk, C. & Robillard, J. M. A systematic review of the impacts of media mental health awareness campaigns on young people. Health Prom. Pract. 25, 907–920 (2024).

    Article  Google Scholar 

  23. Walsh, D. A. B. & Foster, J. L. H. A call to action. A critical review of mental health related anti-stigma campaigns. Front. Public Health 8, 569539 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  24. Evans-Lacko, S., Corker, E., Williams, P., Henderson, C. & Thornicroft, G. Effect of the time to change anti-stigma campaign on trends in mental-illness-related public stigma among the English population in 2003–13: an analysis of survey data. Lancet Psychiatry 1, 121–128 (2014).

    Article  PubMed  Google Scholar 

  25. Ronaldson, A. & Henderson, C. Investigating changes in mental illness stigma and discrimination after the Time To Change programme in England. BJPsych Open 10, e199 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  26. Reavley, N. J. & Jorm, A. F. Public recognition of mental disorders and beliefs about treatment: changes in Australia over 16 years. Br. J. Psychiatry 200, 419–425 (2012).

    Article  PubMed  Google Scholar 

  27. Jorm, A. F., Christensen, H. & Griffiths, K. M. The impact of Beyond Blue: the national depression initiative on the Australian public’s recognition of depression and beliefs about treatments. Aust. NZ J. Psychiatry 39, 248–254 (2005).

    Article  Google Scholar 

  28. Donovan, R. J., Drane, C. F., Santini, Z. I. & Jalleh, G. Impact on help-seeking behaviours of a campaign perceived to decrease stigma and increase openness around mental health. Health Prom. J. Aust. 35, 1378–1385 (2024).

    Article  Google Scholar 

  29. Aftab, A. & Druss, B. G. Addressing the mental health crisis in youth — sick individuals or sick societies? JAMA Psychiatry 80, 863 (2023).

    Article  PubMed  Google Scholar 

  30. Ahuvia, I. L. & Link, B. G. The mental illness self-labeling model: a conceptual model for studying the effects of mental-illness self-labeling on clinical outcomes. Clin. Psychol Sci. 13, 1031–1050 (2025).

    Article  Google Scholar 

  31. Bantjes, J., Hunt, X. & Stein, D. J. Anxious, depressed, and suicidal: crisis narratives in university student mental health and the need for a balanced approach to student wellness. Int. J. Environ. Res. Public Health 20, 4859 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  32. Coppock, V. Psychiatrised childhoods. Glob. Stud. Child. 10, 3–11 (2020).

    Article  Google Scholar 

  33. Corzine, A. & Roy, A. Inside the black mirror: current perspectives on the role of social media in mental illness self-diagnosis. Discov. Psychol. 4, 40 (2024).

    Article  Google Scholar 

  34. Malla, A. & Gold, I. Public discourse on mental health: a critical view. J. Psychiatry Neurosci. 49, E126–E131 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  35. Monteith, S. et al. Implications of online self-diagnosis in psychiatry. Pharmacopsychiatry 57, 45–52 (2024).

    Article  PubMed  Google Scholar 

  36. Samuel, L., Kuijpers, K. & Bleakley, A. TherapyTok for depression and anxiety: a quantitative content analysis of high engagement Tiktok videos. J. Adolesc. Health 74, 1184–1190 (2024).

    Article  PubMed  Google Scholar 

  37. Tsou, J. Y. Hacking on the looping effects of psychiatric classifications: what is an interactive and indifferent kind? Int. Stud. Phil. Sci. 21, 329–344 (2007).

    Article  Google Scholar 

  38. Coppock, V. Liberating the mind or governing the soul? Psychotherapeutic education, children’s rights and the disciplinary state. Educ. Inq. 2, 385–399 (2011).

    Article  Google Scholar 

  39. Foulkes, L. & Stapley, E. Want to improve school mental health interventions? Ask young people what they actually think. J. Phil. Educ. 56, 41–50 (2022).

    Article  Google Scholar 

  40. Frawley, A., Wakeham, C., McLaughlin, K. & Ecclestone, K. Constructing a crisis: mental health, higher education and policy entrepreneurs. Sociol. Res. Online 29, 351–369 (2024).

    Article  Google Scholar 

  41. Sullivan, G. M. & Feinn, R. Using effect size — or why the P value is not enough. J. Graduate Med. Educ. 4, 279–282 (2012).

    Article  Google Scholar 

  42. Grant, S. et al. Effectiveness of school-based depression prevention interventions: an overview of systematic reviews with meta-analyses on depression outcomes. J. Consult. Clin. Psychol. 93, 194–212 (2025).

    Article  PubMed  Google Scholar 

  43. Hayes, D. et al. Universal, school-based, interventions to improve emotional outcomes in children and young people: a systematic review and meta-analysis. Front. Child Adolesc. Psychiatry 4, 1526840 (2025).

    Article  PubMed  PubMed Central  Google Scholar 

  44. Deighton, J. et al. Effectiveness of School Mental Health Awareness Interventions: Universal Approaches in English Secondary Schools (UK Department for Education, 2025).

  45. Harvey, L. J., White, F. A., Hunt, C. & Abbott, M. Investigating the efficacy of a dialectical behaviour therapy-based universal intervention on adolescent social and emotional well-being outcomes. Behav. Res. Ther. 169, 104408 (2023).

    Article  PubMed  Google Scholar 

  46. Kuyken, W. et al. Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Evidence-based Ment. Health 25, 99–109 (2022).

    Article  Google Scholar 

  47. Andrews, J. L. et al. Evaluating the effectiveness of a universal eHealth school-based prevention programme for depression and anxiety, and the moderating role of friendship network characteristics. Psychol. Med. 53, 5042–5051 (2023).

    Article  PubMed  Google Scholar 

  48. Foulkes, L., Andrews, J. L., Reardon, T. & Stringaris, A. Research recommendations for assessing potential harm from universal school-based mental health interventions. Nat. Ment. Health 2, 270–277 (2024).

    Article  Google Scholar 

  49. Bridgland, V. M. E., Jones, P. J. & Bellet, B. W. A meta-analysis of the efficacy of trigger warnings, content warnings, and content notes. Clin. Psychol. Sci. 12, 751–771 (2024).

    Article  Google Scholar 

  50. Miller, E. J., Crane, C., Medlicott, E., Robson, J. & Taylor, L. Non-positive experiences encountered by pupils during participation in a mindfulness-informed school-based intervention. Sch. Ment. Health 15, 851–872 (2023).

    Article  Google Scholar 

  51. Garmy, P., Berg, A. & Clausson, E. K. A qualitative study exploring adolescents’ experiences with a school-based mental health program. BMC Public Health 15, 1074 (2015).

    Article  PubMed  PubMed Central  Google Scholar 

  52. Lindholm, S. K. & Zetterqvist Nelson, K. “Apparently I’ve got low self-esteem”: schoolgirls’ perspectives on a school-based public health intervention. Child. Soc. 29, 473–483 (2015).

    Article  Google Scholar 

  53. Stapley, E. et al. A qualitative study of English school children’s experiences of two brief, universal, classroom-based mental health and wellbeing interventions: mindfulness and relaxation. Contemp. School Psychol. https://doi.org/10.1007/s40688-025-00567-2 (2025).

  54. Ahuvia, I. L. Refining the prevalence inflation hypothesis: disentangling overinterpretation from self-fulfilling prophecies. N. Ideas Psychol. 75, 101106 (2024).

    Article  Google Scholar 

  55. Ndour, A. & Foulkes, L. The romanticisation of mental health problems in adolescents and its implications: a narrative review. Eur. Child. Adolesc. Psychiatry 34, 2297–2326 (2025).

    Article  PubMed  PubMed Central  Google Scholar 

  56. Acheson, R. & Papadima, M. The search for identity: working therapeutically with adolescents in crisis. J. Child. Psychother. 49, 95–119 (2023).

    Article  Google Scholar 

  57. Chan, D. & Sireling, L. ‘I want to be bipolar’…a new phenomenon. Psychiatrist 34, 103–105 (2010).

    Article  Google Scholar 

  58. Fellowes, S. Self-diagnosis in psychiatry and the distribution of social resources. R. Inst. Phil. Suppl. 94, 55–76 (2023).

    Article  Google Scholar 

  59. Haslam, N. & Tse, J. S. Public awareness of mental illness: mental health literacy or concept creep? Australasian Psychiatry 33, 18–20 (2025).

    Article  PubMed  Google Scholar 

  60. Rutter, L. A. et al. “I haven’t been diagnosed, but I should be” — insight into self-diagnoses of common mental health disorders: cross-sectional study. JMIR Form. Res. 7, e39206 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  61. Brinkmann, S. Languages of suffering. Theory Psychol. 24, 630–648 (2014).

    Article  Google Scholar 

  62. David, A. S. & Deeley, Q. Dangers of self-diagnosis in neuropsychiatry. Psychol. Med. 54, 1057–1060 (2024).

    Article  PubMed  Google Scholar 

  63. Hofmann, B., Reid, L., Carter, S., Rogers, W. et al. Overdiagnosis, one concept, three perspectives, and a model. Eur. J. Epidemiol. 36, 655–656 (2021).

    Article  Google Scholar 

  64. Hasan, F., Foster, M. M. & Cho, H. Normalizing anxiety on social media increases self-diagnosis of anxiety: the mediating effect of identification (but not stigma). J. Health Commun. 28, 563–572 (2023).

    Article  PubMed  Google Scholar 

  65. Jones, P. J. & McNally, R. J. Does broadening one’s concept of trauma undermine resilience? Psychol. Trauma 14, S131–S139 (2022).

    Article  PubMed  Google Scholar 

  66. Hardman, C. A. et al. “Food addiction is real”. The effects of exposure to this message on self-diagnosed food addiction and eating behaviour. Appetite 91, 179–184 (2015).

    Article  PubMed  Google Scholar 

  67. Sandra, D. A. et al. Inform and do no harm: nocebo education reduces false self-diagnosis caused by mental health awareness. Psychol. Med. 55, e330 (2025).

    Article  Google Scholar 

  68. Merckelbach, H., Jelicic, M. & Pieters, M. Misinformation increases symptom reporting: a test–retest study. JRSM Short Rep. 2, 1–6 (2011).

    Article  Google Scholar 

  69. Van Helvoort, D., Otgaar, H. & Merckelbach, H. Worsening of self-reported symptoms through suggestive feedback. Clin. Psychol. Sci. 8, 359–365 (2020).

    Article  Google Scholar 

  70. Jelicic, M., Frederix, M. & Merckelbach, H. Brief report: writing about chronic fatigue increases somatic complaints. Psychol. Top. 22, 405–412 (2013).

    Google Scholar 

  71. Whitted, W. M. et al. Seeing is believing: the effect of subtle communication in social media on viewers’ beliefs about depression and anxiety symptom trajectories. J. Clin. Psychol. 80, 1050–1064 (2024).

    Article  PubMed  Google Scholar 

  72. Kemp, J. J., Lickel, J. J. & Deacon, B. J. Effects of a chemical imbalance causal explanation on individuals’ perceptions of their depressive symptoms. Behav. Res. Ther. 56, 47–52 (2014).

    Article  PubMed  Google Scholar 

  73. Ruddock, H. K. et al. Believing in food addiction: helpful or counterproductive for eating behavior? Obesity 24, 1238–1243 (2016).

    Article  PubMed  Google Scholar 

  74. Siegel, J. T., Flores-Medel, E., Martinez, D. A. & Berger, D. E. Can mental health anti-stigma messages have untoward effects on some people with depression?: an exploratory study. J. Health Commun. 24, 821–828 (2019).

    Article  PubMed  Google Scholar 

  75. Dolan, P., Hallsworth, M., Halpern, D., King, D. & Vlaev, I. MINDSPACE: Influencing Behaviour for Public Policy (Institute for Government, 2010).

  76. Dolan, P. et al. Influencing behaviour: the mindspace way. J. Econ. Psychol. 33, 264–277 (2012).

    Article  Google Scholar 

  77. Kassin, S. M. Deposition testimony and the surrogate witness: evidence for a ‘messenger effect’ in persuasion. Personal. Soc. Psychol. Bull. 9, 281–288 (1983).

    Article  Google Scholar 

  78. Rooney, T., Sharpe, L., Todd, J., Richmond, B. & Colagiuri, B. The relationship between expectancy, anxiety, and the nocebo effect: a systematic review and meta-analysis with recommendations for future research. Health Psychol. Rev. 17, 550–577 (2023).

    Article  PubMed  Google Scholar 

  79. Stein, M. V., Heller, M., Chapman, S., Rubin, G. J. & Terhune, D. B. Trait responsiveness to verbal suggestions predicts nocebo responding: a meta-analysis. Br. J. Health Psychol. 30, e12774 (2025).

    Article  PubMed  Google Scholar 

  80. Marcotulli, D., Foulkes, L. & Stringaris, A. Editorial perspective: how spreading mental health information can be (un-) helpful — a dynamic systems approach. Child Psychol. Psychiatry https://doi.org/10.1111/jcpp.70055 (2025).

  81. Ormel, J., Hollon, S. D., Kessler, R. C., Cuijpers, P. & Monroe, S. M. More treatment but no less depression: the treatment-prevalence paradox. Clin. Psychol. Rev. 91, 102111 (2022).

    Article  PubMed  Google Scholar 

  82. Saunders, R. et al. Effectiveness of psychological interventions for young adults versus working age adults: a retrospective cohort study in a national psychological treatment programme in England. Lancet Psychiatry 12, 650–659 (2025).

    Article  PubMed  Google Scholar 

  83. Sawyer, S. M., Azzopardi, P. S., Wickremarathne, D. & Patton, G. C. The age of adolescence. Lancet Child Adolesc. Health 2, 223–228 (2018).

    Article  PubMed  Google Scholar 

  84. Erikson, E. H. Identity, Youth and Crisis (W. W. Norton, 1968).

  85. Sebastian, C., Burnett, S. & Blakemore, S.-J. Development of the self-concept during adolescence. Trends Cogn. Sci. 12, 441–446 (2008).

    Article  PubMed  Google Scholar 

  86. Munawar, K., Kuhn, S. K. & Haque, S. Understanding the reminiscence bump: a systematic review. PLoS ONE 13, e0208595 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  87. McAdams, D. P. Narrative identity: what is it? what does it do? how do you measure it? Imag. Cogn. Personal. 37, 359–372 (2018).

    Article  Google Scholar 

  88. Granic, I., Morita, H. & Scholten, H. Beyond screen time: identity development in the digital age. Psychol. Inq. 31, 195–223 (2020).

    Article  Google Scholar 

  89. Foster, A. & Ellis, N. TikTok-inspired self-diagnosis and its implications for educational psychology practice. Educ. Psychol. Pract. 40, 491–508 (2024).

    Article  Google Scholar 

  90. O’Connor, C., Kadianaki, I., Maunder, K. & McNicholas, F. How does psychiatric diagnosis affect young people’s self-concept and social identity? A systematic review and synthesis of the qualitative literature. Soc. Sci. Med. 212, 94–119 (2018).

    Article  PubMed  Google Scholar 

  91. Farnood, A., Johnston, B. & Mair, F. S. A mixed methods systematic review of the effects of patient online self-diagnosing in the ‘smart-phone society’ on the healthcare professional–patient relationship and medical authority. BMC Med. Inf. Decis. Mak. 20, 253 (2020).

    Article  Google Scholar 

  92. Harness, J. & Getzen, H. TikTok’s sick-role subculture and what to do about it. J. Am. Acad. Child Adolesc. Psychiatry 61, 351–353 (2021).

    Article  PubMed  Google Scholar 

  93. McGrath, J. J. et al. Age of onset and cumulative risk of mental disorders: a cross-national analysis of population surveys from 29 countries. Lancet Psychiatry 10, 668–681 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  94. Casey, B. J. et al. The storm and stress of adolescence: insights from human imaging and mouse genetics. Dev. Psychobiol. 52, 225–235 (2010).

    Article  PubMed  PubMed Central  Google Scholar 

  95. Silvers, J. A. Adolescence as a pivotal period for emotion regulation development. Curr. Opin. Psychol. 44, 258–263 (2022).

    Article  PubMed  Google Scholar 

  96. Steare, T., Gutiérrez Muñoz, C., Sullivan, A. & Lewis, G. The association between academic pressure and adolescent mental health problems: a systematic review. J. Affect. Disord. 339, 302–317 (2023).

    Article  PubMed  Google Scholar 

  97. Foulkes, L., Leung, J. T., Fuhrmann, D., Knoll, L. J. & Blakemore, S.-J. Age differences in the prosocial influence effect. Dev. Sci. 21, e12666 (2018).

    Article  PubMed  PubMed Central  Google Scholar 

  98. Knoll, L. J., Magis-Weinberg, L., Speekenbrink, M. & Blakemore, S.-J. Social influence on risk perception during adolescence. Psychol. Sci. 26, 583–592 (2015).

    Article  PubMed  Google Scholar 

  99. Alho, J. et al. Transmission of mental disorders in adolescent peer networks. JAMA Psychiatry 81, 882 (2024).

    Article  PubMed  PubMed Central  Google Scholar 

  100. Rooney, T., Sharpe, L., Todd, J., Tang, B. & Colagiuri, B. The nocebo effect across health outcomes: a systematic review and meta-analysis. Health Psychol. 43, 41–57 (2023).

    Article  PubMed  Google Scholar 

  101. Ehlers, A., Margraf, J., Roth, W. T., Taylor, C. B. & Birbaumer, N. Anxiety induced by false heart rate feedback in patients with panic disorder. Behav. Res. Ther. 26, 1–11 (1988).

    Article  PubMed  Google Scholar 

  102. Pauli, P. et al. Anxiety induced by cardiac perceptions in patients with panic attacks: a field study. Behav. Res. Ther. 29, 137–145 (1991).

    Article  PubMed  Google Scholar 

  103. Story, T. J. & Craske, M. G. Responses to false physiological feedback in individuals with panic attacks and elevated anxiety sensitivity. Behav. Res. Ther. 46, 1001–1008 (2008).

    Article  PubMed  Google Scholar 

  104. Wild, J., Clark, D. M., Ehlers, A. & McManus, F. Perception of arousal in social anxiety: effects of false feedback during a social interaction. J. Behav. Ther. Exp. Psychiatry 39, 102–116 (2008).

    Article  PubMed  PubMed Central  Google Scholar 

  105. Lazarov, A., Dar, R., Liberman, N. & Oded, Y. Obsessive–compulsive tendencies and undermined confidence are related to reliance on proxies for internal states in a false feedback paradigm. J. Behav. Ther. Exp. Psychiatry 43, 556–564 (2012).

    Article  PubMed  Google Scholar 

  106. Makkar, S. R. & Grisham, J. R. Effects of false feedback on affect, cognition, behavior, and postevent processing: the mediating role of self-focused attention. Behav. Ther. 44, 111–124 (2013).

    Article  PubMed  Google Scholar 

  107. Hacking, I. in Causal Cognition (eds Sperber, D. et al.) 351–383 (Oxford Univ. Press, 1996).

  108. Link, B. G., Cullen, F. T., Struening, E., Shrout, P. E. & Dohrenwend, B. P. A modified labeling theory approach to mental disorders: an empirical assessment. Am. Sociol. Rev. 54, 400 (1989).

    Article  Google Scholar 

  109. Scheff, T. J. The labelling theory of mental illness. Am. Sociol. Rev. 39, 444 (1974).

    Article  PubMed  Google Scholar 

  110. Ecclestone, K. & Hayes, D. The Dangerous Rise of Therapeutic Education (Routledge, 2009).

  111. Corneille, O. & Lush, P. Sixty years after Orne’s American Psychologist article: a conceptual framework for subjective experiences elicited by demand characteristics. Personal. Soc. Psychol. Rev. 27, 83–101 (2023).

    Article  Google Scholar 

  112. Iarygina, O., Hornbæk, K. & Mottelson, A. Demand characteristics in human–computer experiments. Int. J. Human–Computer Stud. 193, 103379 (2025).

    Article  Google Scholar 

  113. Nichols, A. L. & Maner, J. K. The good-subject effect: investigating participant demand characteristics. J. Gen. Psychol. 135, 151–166 (2008).

    Article  PubMed  Google Scholar 

  114. Orne, M. T. On the social psychology of the psychological experiment: with particular reference to demand characteristics and their implications. Am. Psychol. 17, 776–783 (1962).

    Article  Google Scholar 

  115. Ju, R., Jia, M. & Cheng, J. Promoting mental health on social media: a content analysis of organizational tweets. Health Commun. 38, 1540–1549 (2023).

    Article  PubMed  Google Scholar 

  116. Saha, K. et al. A computational study of mental health awareness campaigns on social media. Transl. Behav. Med. 9, 1197–1207 (2019).

    Article  PubMed  PubMed Central  Google Scholar 

  117. Milton, A., Ajmani, L., DeVito, M. A. & Chancellor, S. “I see me here”: mental health content, community, and algorithmic curation on TikTok. In Proc. 2023 CHI Conf. Human Factors in Computing Systems (eds Schmidt, A. et al.) 480 (ACM, 2023).

  118. Montero-Marin, J. et al. School-based mindfulness training in early adolescence: what works, for whom and how in the MYRIAD trial? Evidence-based Ment. Health 25, 117–124 (2022).

    Article  Google Scholar 

  119. Stallard, P. et al. Classroom based cognitive behavioural therapy in reducing symptoms of depression in high risk adolescents: pragmatic cluster randomised controlled trial. BMJ 345, e6058 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  120. Bonell, C., Jamal, F., Melendez-Torres, G. J. & Cummins, S. ‘Dark logic’: theorising the harmful consequences of public health interventions. J. Epidemiol. Community Health 69, 95–98 (2015).

    Article  PubMed  Google Scholar 

  121. Guttman, N. & Salmon, C. T. Guilt, fear, stigma and knowledge gaps: ethical issues in public health communication interventions. Bioethics 18, 531–552 (2004).

    Article  PubMed  Google Scholar 

  122. Stratil, J. M., Baltussen, R., Scheel, I., Nacken, A. & Rehfuess, E. A. Development of the WHO-INTEGRATE evidence-to-decision framework: an overview of systematic reviews of decision criteria for health decision-making. Cost. Eff. Resour. Alloc. 18, 8 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  123. Kirsch, I. Response expectancy as a determinant of experience and behavior. Am. Psychol. 40, 1189–1202 (1985).

    Article  Google Scholar 

  124. Kirsch, I. Response expectancy and the placebo effect. Int. Rev. Neurobiol. 138, 81–93 (2018).

    Article  PubMed  Google Scholar 

  125. Kirsch, I. Response expectancy theory and application: a decennial review. Appl. Prevent. Psychol. 6, 69–79 (1997).

    Article  Google Scholar 

  126. Crichton, F., Chapman, S., Cundy, T. & Petrie, K. J. The link between health complaints and wind turbines: support for the nocebo expectations hypothesis. Front. Public Health 2, 220 (2014).

    Article  PubMed  PubMed Central  Google Scholar 

  127. Crichton, F. & Petrie, K. J. Accentuate the positive: counteracting psychogenic responses to media health messages in the age of the internet. J. Psychosom. Res. 79, 185–189 (2015).

    Article  PubMed  Google Scholar 

  128. Crichton, F. & Petrie, K. J. Health complaints and wind turbines: the efficacy of explaining the nocebo response to reduce symptom reporting. Environ. Res. 140, 449–455 (2015).

    Article  PubMed  Google Scholar 

  129. Frey, J., Black, K. J. & Malaty, I. A. TikTok Tourette’s: are we witnessing a rise in functional tic-like behavior driven by adolescent social media Use? PRBM 15, 3575–3585 (2022).

    Article  Google Scholar 

  130. Zea Vera, A. et al. The phenomenology of tics and tic-like behavior in TikTok. Pediatric Neurol. 130, 14–20 (2022).

    Article  Google Scholar 

  131. Fremer, C. et al. Mass social media-induced illness presenting with Tourette-like behavior. Front. Psychiatry 13, 963769 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  132. Müller-Vahl, K. R., Pisarenko, A., Jakubovski, E. & Fremer, C. Stop that! It’s not Tourette’s but a new type of mass sociogenic illness. Brain 145, 476–480 (2022).

    Article  PubMed  Google Scholar 

  133. Niesten, I. J. M., Merckelbach, H., Dandachi-FitzGerald, B. & Jelicic, M. The iatrogenic power of labeling medically unexplained symptoms: a critical review and meta-analysis of ‘diagnosis threat’ in mild head injury. Psychol. Conscious. 10, 454–474 (2023).

    Google Scholar 

  134. Renwick, L. et al. Mental health literacy in children and adolescents in low- and middle-income countries: a mixed studies systematic review and narrative synthesis. Eur. Child Adolesc. Psychiatry 33, 961–985 (2024).

    Article  PubMed  Google Scholar 

  135. Van Den Broek, M. et al. Interventions to increase help-seeking for mental health care in low- and middle-income countries: a systematic review. PLoS Glob. Public Health 3, e0002302 (2023).

    Article  PubMed  PubMed Central  Google Scholar 

  136. Clay, J., Eaton, J., Gronholm, P. C., Semrau, M. & Votruba, N. Core components of mental health stigma reduction interventions in low- and middle-income countries: a systematic review. Epidemiol. Psychiat. Sci. 29, e164 (2020).

    Article  Google Scholar 

  137. Nwokoroku, S. C., Neil, B., Dlamini, C. & Osuchukwu, V. C. A systematic review of the role of culture in the mental health service utilisation among ethnic minority groups in the United Kingdom. Glob. Ment. Health 9, 84–93 (2022).

    Article  Google Scholar 

  138. Eylem, O. et al. Stigma for common mental disorders in racial minorities and majorities a systematic review and meta-analysis. BMC Public. Health 20, 879 (2020).

    Article  PubMed  PubMed Central  Google Scholar 

  139. Kapadia, D. Stigma, mental illness & ethnicity: time to centre racism and structural stigma. Sociol. Health Illness 45, 855–871 (2023).

    Article  Google Scholar 

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L.F., I.W., C.G.H. and D.S. researched data for the article. L.F., C.G.H., J.L.A., M.I. and D.S. contributed substantially to discussion of the content. All authors wrote the article and reviewed and/or edited the manuscript before submission.

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Foulkes, L., Winterburn, I., Sandra, D. et al. The psychological consequences of mental health awareness efforts. Nat Rev Psychol (2026). https://doi.org/10.1038/s44159-026-00532-7

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