Leveraging brief video interventions to increase treatment‐seeking among depressed youth: a randomized controlled trial

Youth with depressive symptoms often do not seek professional help, hindered in part by stigma and limited access to mental health care. Recent digital approaches have shown promise in reducing stigma and encouraging mental health treatment‐seeking intentions ¹ . Brief, social contact‐based videos have a particular potential to strongly influence youth, especially when delivered through the social media platforms that this population already broadly uses.

Social contact involves sharing personal stories of individuals who have experienced mental health challenges, which can help reduce stigma and encourage positive attitudes toward treatment ² . Leveraging the accessibility and engagement potential of social media provides a meaningful advantage in reaching young adults who might otherwise avoid or delay seeking help. Although such interventions have been shown to raise treatment‐seeking intentions, few studies have examined whether they produce actual behavior change, especially among youth most in need of support ³ .

We conducted a randomized controlled trial aimed to address this research gap by examining the impact of three brief 2.5‐3 min video interventions on treatment‐seeking intentions and behavior among young adults with depressive symptoms. The videos featured young women of different racial/ethnic backgrounds (Black, Latina and White), portrayed by professional actors, who shared a scripted personal story about their struggles with depression and recovery. These scripts were informed by interviews conducted with individuals with lived experience of depression, ensuring authenticity and cultural relevance. The video interventions were compared with a written vignette conveying identical content. The study tested whether the videos' emotional and visual appeal could foster not only intentions to seek help, but also formal steps toward mental health treatment.

We recruited young adults (ages 18‐25) with self‐reported depressive symptoms through Prolific, an online research platform. Participants qualified on the basis of a minimum score of 5 on the Patient Health Questionnaire‐9 (PHQ‐9). Of the 2,624 screened individuals, 1,559 met the inclusion criterion. After excluding 14 youth who failed attention or validity tests, 1,545 participants (63% female; mean age: 22.7±1.9 years) were randomly assigned to either one of the three video intervention groups (combined N=1,159) or the written vignette group (N=386). Demographic characteristics did not differ between the study groups.

Treatment‐seeking intentions were measured at baseline, immediately post‐intervention, and at 30‐day follow‐up using the Attitudes Toward Seeking Professional Psychological Help Scale ‐ Short Form ⁴ . Emotional engagement with the videos was assessed using the Emotional Engagement Scale ⁵ . At 30‐day follow‐up, treatment‐seeking behavior was evaluated by asking participants if they had contacted the provided referrals or sought treatment elsewhere. The post‐intervention assessment was completed by 1,533 participants (99.2%); the 30‐day follow‐up assessment by 1,264 participants (81.8%). Demographic characteristics did not differ between completers and non‐completers.

We found an effect of the video interventions on both treatment‐seeking intentions and actual behavior. For treatment‐seeking intentions, a 2 x 3 ANOVA revealed a significant group‐by‐time interaction (F_1,2=4.0, p=0.018). A significant change was observed between baseline and 30‐day follow‐up (F_1,1=8.0, p=0.005). Among the 1,098 participants not in therapy at baseline (71.1%; N=834 video, N=264 vignette), a significant association was found between study group and seeking treatment post‐intervention (χ²=5.8, p=0.016). Participants who sought help showed greater increases in intentions (baseline to post‐intervention: 0.71±1.4; baseline to 30‐day follow‐up: 0.96±1.7) compared to non‐help seekers (0.34±1.2 and 0.21±1.5, respectively) (t=2.4, p=0.016; t=3.8, p<0.001).

Emotional engagement emerged as a critical factor in driving these outcomes, with higher reported engagement correlating with greater increases in intentions (r=0.145, p<0.001) and a higher likelihood of seeking help (r=0.1, p<0.001). Notably, 84% of help seekers reported high emotional engagement with the video, compared to 61% of non‐help seekers (χ²=13.8, p<0.001).

These results align with Mayer's cognitive theory of multimedia learning, which posits that dual engagement of visual and auditory channels enhances cognitive processing and retention over time ⁶ . Video content thus appears to foster deeper cognitive and emotional processing than static text, contributing to sustained impact. Given the widespread adoption of social media among young adults, brief video interventions may provide a scalable, practical approach for disseminating mental health messages. Culturally resonant videos – featuring relatable characters from diverse backgrounds – may further enhance engagement, broadening the intervention's relevance and efficacy across diverse youth populations ⁷ .

The study focus on young adults with depressive symptoms, rather than the general population, highlights the value of targeting interventions for those in greatest need. Many public mental health campaigns aim to shift general attitudes but often fall short in prompting behavioral change among those who would benefit most ⁸ . By specifically addressing individuals already experiencing symptoms, our intervention successfully translated intentions into greater real‐world help‐seeking behavior. This targeted approach could be vital in closing the gap between mental health awareness and treatment uptake.

This pathway – from emotional engagement to intentions and ultimately to actual help‐seeking behavior – is a rare finding in stigma research. Few interventions have demonstrated a shift from intentions to real‐world behavior, as most research has focused solely on treatment‐seeking intentions ⁹ . The pathway underscores the critical role that emotional investment plays not just in shifting perceptions but also in overcoming barriers to action. The association between emotional engagement and increased treatment‐seeking intentions suggests that emotionally resonant videos effectively drive intentions, a crucial first step toward encouraging behavioral change. That participants moved beyond intentions to real‐world treatment‐seeking marks a significant contribution to the field, showcasing the potential of emotionally engaging interventions to transform mental health awareness into actionable outcomes for vulnerable populations.

Some limitations of this study need acknowledgement. Our online recruitment strategy may limit generalizability, and social desirability bias might affect self‐reported help‐seeking behavior. Additionally, the 30‐day follow‐up period, while informative, is relatively short. Extended follow‐up could better assess the long‐term sustainability of behavior changes and verify their effect. Future studies might also explore social media engagement metrics, such as “likes” and “shares”, as measures of intervention reach and impact.

In conclusion, our findings demonstrate the effectiveness of emotionally resonant, interpersonal video content in driving behavior change among young adults with depressive symptoms. Brief social contact‐based videos provide a practical and scalable approach to reducing mental health stigma and improving access to care. As youth increasingly rely on digital platforms, these results highlight the need for targeted, accessible interventions to bridge the gap between mental health awareness and action. Future research should focus on refining these digital strategies by exploring social media engagement metrics and conducting extended follow‐ups to maximize their long‐term impact and reach among vulnerable youth populations.