Stigma and Social Cover: A Mental Health Care Experiment in Refugee Networks
Winner of the Weiss/NEUDC Distinguished Paper Award, 2023

People may not seek mental health care due to stigma. But if stigma also prevents people from even learning about services, then its consequences may be far greater. I design a field experiment with 847 Syrian refugee friend groups in Jordan to measure willingness to share information about mental health services. First, I document significant local knowledge about who may be depressed, implying individuals may be able to efficiently target information. Despite being compensated to share, people hold back information: only 22% of friends receive information. The study’s main finding is that giving individuals social cover, by encouraging them to disclose that they are compensated to share information, raises sharing rates by 37%. Consistent with a social cover mechanism, these effects are strongest for senders who are prior mental health care users. In a follow-up experiment I show that senders can use the excuse of being paid without decreasing recipients’ interest in the services. In a reversal of the common prediction that financial incentives may crowd out prosocial behavior, I instead find that in this setting with stigma, increasing the visibility of financial incentives increases prosocial participation.