Online attitudes toward mental illness anti-stigma efforts: A content analysis

Reddit has emerged as an accessible, anonymous platform for public discourse surrounding mental illness, yet little research has examined how users perceive and evaluate existing anti-stigma initiatives. This study addresses this gap by analyzing public discourse around destigmatization efforts, including both corporate-led campaigns (i.e., Bell Lets Talk) and broader community-based discussions. We conducted an interpretive content analysis of Reddit posts and comments identified through an a priori search protocol registered on the Only Science Framework. We drew a criterion-based purposive sample from r/mentalhealth and general Reddit using keywords related to anti-stigma discourse (e.g., anti-stigma, destigmatizing, and #BellLetsTalk). Fifty posts met inclusion criteria, yielding 581 coded references. Posts predominantly addressed mental health in general terms rather than specific diagnoses, with public stigma (n=28 posts) and structural stigma (n=16 posts) most discussed; internalized stigma was rarely a primary focus. #BellLetsTalk posts located outside the mental health community generated substantially greater engagement than posts within r/mentalhealth, with several threads exceeding 300 comments. Four themes emerged during the qualitative analysis: (1) anti-stigma efforts are unhelpful (n=381), (2) hopeful sentiments about anti-stigma efforts, (3) the mixed role of media, and (4) future directions for anti-stigma efforts.