The British Journal of Psychiatry
Efficacy of Coming Out Proud to reduce stigma’s impact among people with mental illness: pilot randomised controlled trial
Nicolas Rüsch, Elvira Abbruzzese, Eva Hagedorn, Daniel Hartenhauer, Ilias Kaufmann, Jan Curschellas, Stephanie Ventling, Gianfranco Zuaboni, René Bridler, Manfred Olschewski, Wolfram Kawohl, Wulf Rössler, Birgit Kleim, Patrick W. Corrigan
  • Declaration of interest

    P.W.C. developed the Coming Out Proud programme.



Facing frequent stigma and discrimination, many people with mental illness have to choose between secrecy and disclosure in different settings. Coming Out Proud (COP), a 3-week peer-led group intervention, offers support in this domain in order to reduce stigma’s negative impact.


To examine COP’s efficacy to reduce negative stigma-related outcomes and to promote adaptive coping styles (Current Controlled Trials number: ISRCTN43516734).


In a pilot randomised controlled trial, 100 participants with mental illness were assigned to COP or a treatment-as-usual control condition. Outcomes included self-stigma, empowerment, stigma stress, secrecy and perceived benefits of disclosure.


Intention-to-treat analyses found no effect of COP on self-stigma or empowerment, but positive effects on stigma stress, disclosure-related distress, secrecy and perceived benefits of disclosure. Some effects diminished during the 3-week follow-up period.


Coming Out Proud has immediate positive effects on disclosure- and stigma stress-related variables and may thus alleviate stigma’s negative impact.


  • Funding

    This study was supported by Sanatorium Kilchberg, the Psychiatric University Hospital Zürich, the Zürich Impulse Program for the Sustainable Development of Mental Health Services ( as well as the National Institute of Mental Health, USA.

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