About

Melissa Ann Stockton, MSPH, Ph.D, is an Assistant Professor of Psychiatry at the University of Pennsylvania's Perelman School of Medicine. She is also an Associate Scholar at the Center for Global Health. Her research expertise includes social epidemiology, stigma, HIV, mental health, and implementation science. Dr. Stockton's work focuses on implementing and evaluating evidence-based interventions that address intersectional stigma and deliver high-quality psychological care to vulnerable populations. She has received a career developmental award (K01) to integrate an intervention targeting intersectional HIV-mental illness stigma into depression care and conduct a hybrid effectiveness-implementation pilot among depressed adults living with HIV in Malawi.

Research topics

• Medicine
• Psychology
• Psychiatry
• Clinical psychology
• Social psychology

Selected publications

• ‘You feel like it’s better to just die’: Death-centric stereotypes and stigma contribute to suicide risk for adolescents living with HIV in Malawi

  UNC Libraries · 2026-01-07

  articleOpen access

  Suicide is the second leading cause of death for adolescents worldwide. Adolescents living with HIV (ALWH) in Malawi are particularly at risk, due to stigmatization and a high comorbid prevalence of depression. Internalized stigma is an indicator of depression and suicidality, yet we have a limited understanding of the drivers and impacts of internalized stigma. In this analysis, we assessed how death-centric stereotypes and experienced stigma contribute to the development of internalized stigma and elevate suicide risk for ALWH in Malawi. This qualitative study recruited 68 total participants from three government healthcare facilities in Lilongwe, Malawi. We conducted 13 in-depth interviews and 10 focus group discussions with ALWH, caregivers of ALWH, adolescent peers without HIV, schoolteachers, HIV care providers, and mental health providers. We sought to understand how stigma manifests in key parts of an ALWH’s life and contributes to internalized stigma and suicidal ideation. Guided by thematic analysis, we organized the relevant data into four themes: death-centric stereotypes, experienced stigma, internalized stigma, and suicidality. Death-centric stereotypes were identified as HIV’s association with being a death sentence, obstructing one’s future, and weak physical and mental capacity. From these stereotypes originate specific manifestations of experienced stigma, including insults and mockery, reduced social and economic prospects for adulthood, caregiver lack of investment in vital resources, and exclusion from community activities. Stereotypes and experienced stigma contribute to internalized stigma which manifests as low self-esteem, loss of future-oriented mindset, and self-isolation. This stigmatization process, particularly when perpetuated by family, increased suicide risk for ALWH. This study describes how death-centric stereotypes dominate the public discourse around ALWH, influence stigmatizing behaviors towards ALWH that disenfranchise them in their daily lives, and contribute to the development of internalized stigma and suicidality. Suicide screening and prevention programming, with attention to culturally sensitive stigma reduction, is urgently needed for ALWH.

  PublisherDOI

• Integrating Safety Planning, Problem-Solving Therapy, and Peer Support for Suicide Prevention among Adolescents Living with HIV in Malawi: An Application of the ADAPT-ITT Adaptation Framework

  Cambridge Prisms Global Mental Health · 2026-05-18

  articleOpen access1st authorCorresponding

  There are few evidence-based suicide prevention interventions tailored for adolescents living with HIV (ALWH) in sub-Saharan Africa.The Safety Planning Intervention targets acute suicidal behavior through co-creation of actionable coping strategies for use at the onset of suicide-related distress.We utilized the ADAPT-ITT framework to adapt and integrate Safety Planning into an existing Friendship Bench + Peer Support model for depressed ALWH in Malawi.We conducted interviews with ALWH who reported suicidal ideation or behaviours, their caregivers, healthcare facility leadership, and police officers, and focus group discussions with healthcare facility staff, community and religious leaders, and teachers in Lilongwe.The study team produced adapted manuals, sought and integrated expert topical feedback, trained interventionists using a training-oftrainers model, and theater tested the protocol.Formative data yielded insights into acceptability, feasibility, delivery, content, and implementation of Safety Planning.The final Safety Planning + Friendship Bench + Peer Support program consists of one safety planning session, five problem-solving sessions with suicide risk assessment, and six peer support sessions.We revised the written Safety Plan to account for limited emergency services, modified the protocol for engaging guardians, integrated suicide assessment into the problem-solving sessions, and incorporated suicide prevention activities into the peer support sessions.

  PublisherOA PDFDOI

• Social support across the cancer care continuum in Malawi: Narratives from cancer survivors

  SSM - Qualitative Research in Health · 2026-04-02

  articleOpen access
  PublisherDOI

• Mental health counseling preferences amongst adolescents living with HIV, caregivers, and healthcare providers in Lilongwe, Malawi

  Journal of Health Psychology · 2026-04-06

  articleOpen access

  In Malawi, there is a need for resource-appropriate interventions that improve depression among adolescents living with HIV (ALWH) that incorporate their service delivery preferences. To understand these preferences, we thematically analyzed qualitative data from a formative study adapting an evidence-based depression intervention for ALWH in Malawi. Participants ( N = 42) included ALWH experiencing depression (age 13–19, BDI-II ⩾ 13), caregivers, healthcare providers, implementors, and participants of a similar counseling intervention. Findings revealed a preference for private, clinic-based individual counseling to maintain confidentiality and avoid stigma. While desired frequency for sessions varied, participants consistently wanted young (<40), mature, trustworthy, and non-judgmental counselors. Counseling sessions should address the relationship between HIV and depression and the socioeconomic stressors resulting from living with chronic, stigmatized diseases. Results emphasize the importance of confidentiality, flexibility, and choice when providing mental health services for ALWH, and the need to train lay counselors to navigate discussions around socioeconomic stressors.

  PublisherDOI

• Ingredients for success: Factors associated with successful integration of depression care into non-communicable disease clinics in Malawi: A mixed-methods analysis

  PLOS mental health. · 2026-01-06

  articleOpen access

  Depression is a leading cause of disability worldwide that disproportionately impacts low- and middle-income countries (LMICs). Evidence-based depression care options are often limited in LMICs and poorly integrated into existing healthcare systems. Improving such integration is crucial to improving patient outcomes and reducing disability. In Malawi, a cluster-randomized trial of implementation strategies to integrate depression care into non-communicable disease clinics was conducted at 10 healthcare facilities from 2019 to 2021. Some clinics were highly successful in integrating depression care while others were less successful in both arms. This post-hoc mixed-methods analysis (01/10/2023 and 31/05/2024) combined quantitative clinic performance indicators with qualitative endline key informant interview data to identify factors other than the tested implementation strategies that differentiated clinics that effectively integrated depression treatment from those that did not. Most participants reported several implementation barriers that were present across nearly all clinics. These pervasive barriers included access to resources, provider attitudes, and provider turnover. Differentiating factors, which when present allowed successful clinics to overcome pervasive barriers and when absent made the barriers difficult to overcome, included clinic coordinator engagement, management engagement, clinic ownership, and adequate training. Differentiating factors that facilitated implementation of depression care integration, even in the presence of commonly identified barriers, should be prioritized as targets for future implementation efforts.

  PublisherDOI

• Applying the Health Stigma and Discrimination Framework to psychosis stigma in Malawi

  UNC Libraries · 2025-06-04

  articleOpen access

  Psychotic disorders are highly stigmatized across the globe, negatively impacting people with psychosis and their families. However, little is known about stigma faced by people with psychosis in sub-Saharan Africa. We developed semi-structured qualitative guides based in a constructivist epistemology and formative research methodologies and conducted 36 in-depth interviews (IDIs) and two focus-group discussions (FGDs) with 12 people with lived experience (PWLE) with psychosis; 12 caregivers of PWLE; six traditional healers; six medical providers; six community leaders (1 FGD); and six religious leaders (1 FGD) in Blantyre, Malawi. We drew from the Health Stigma and Discrimination Framework to delineate the stigmatization process. Participants described key drivers of stigma as lack of awareness, prejudice, stereotypes, and fear. Manifestations included experienced, anticipated, witnessed, perceived, internalized and secondary stigma in the form of insults, gossip, abuse, physical violence, restraints, social exclusion, and employment-based discrimination from family and community. With respect to negative outcomes and health and social impacts, stigma impacted quality of care, resilience, mental health, morbidity, social inclusion and quality of life. In Malawi, stigma is pervasive challenge for PWLE, with severe implication for their health and social wellbeing. In partnership with PWLE, investment into the integration of evidence-based stigma reduction activities into existing psychosis management programs is warranted.

  PublisherDOI

• Friendship Bench intervention to address depression and improve HIV care engagement among adolescents living with HIV in Malawi: Study protocol for a pilot randomized controlled trial

  PLoS ONE · 2025-03-19 · 5 citations

  articleOpen accessCorresponding

  BACKGROUND: Adolescents in Sub-Saharan Africa are disproportionately affected by the HIV epidemic. Comorbid depression is prevalent among adolescents living with HIV (ALWH) and poses numerous challenges to HIV care engagement and retainment. We present a pilot trial designed to investigate feasibility, fidelity, and acceptability of an adapted and an enhanced Friendship Bench intervention (henceforth: AFB and EFB) in reducing depression and improving engagement in HIV care among ALWH in Malawi. METHODS: Design: Participants will be randomized to one of three conditions: the Friendship Bench intervention adapted for ALWH (AFB, n = 35), the Friendship Bench intervention enhanced with peer support (EFB, n = 35), or standard of care (SOC, n = 35). Recruitment is planned for early 2024 in four clinics in Malawi. Participants: Eligibility criteria (1) aged 13-19; (2) diagnosed with HIV (vertically or horizontally); (3) scored ≥ 13 on the self-reported Beck's Depression Inventory (BDI-II); (4) living in the clinic's catchment area with intention to remain for at least 1 year; and (5) willing to provide informed consent. Interventions: AFB includes 6 counseling sessions facilitated by young, trained non-professional counselors. EFB consists of AFB plus integration of peer support group sessions to facilitate engagement in HIV care. SOC for mental health in public facilities in Malawi includes options for basic supportive counseling, medication, referral to mental health clinics or psychiatric units at tertiary care hospitals for more severe cases. Outcomes: The primary outcomes are feasibility, acceptability, and fidelity of the AFB and EFB assessed at 6 months and 12 months and compared across 3 arms. The secondary outcome is to assess preliminary effectiveness of the interventions in reducing depressive symptoms and improving HIV viral suppression at 6 months and 12 months. DISCUSSION: This pilot study will provide insights into youth-friendly adaptations of the Friendship Bench model for ALWH in Malawi and the value of adding group peer support for HIV care engagement. The information gathered in this study will lead to a R01 application to test our adapted intervention in a large-scale cluster randomized controlled trial to improve depression and engagement in HIV care among ALWH. TRIAL REGISTRATION: ClinicalTrials.gov (NCT06173544).

  PublisherOA PDFDOI

• Applying the Health Stigma and Discrimination Framework to psychosis stigma in Malawi

  PLOS mental health. · 2025-05-06 · 5 citations

  articleOpen access1st authorCorresponding

  Psychotic disorders are highly stigmatized across the globe, negatively impacting people with psychosis and their families. However, little is known about stigma faced by people with psychosis in sub-Saharan Africa. We developed semi-structured qualitative guides based in a constructivist epistemology and formative research methodologies and conducted 36 in-depth interviews (IDIs) and two focus-group discussions (FGDs) with 12 people with lived experience (PWLE) with psychosis; 12 caregivers of PWLE; six traditional healers; six medical providers; six community leaders (1 FGD); and six religious leaders (1 FGD) in Blantyre, Malawi. We drew from the Health Stigma and Discrimination Framework to delineate the stigmatization process. Participants described key drivers of stigma as lack of awareness, prejudice, stereotypes, and fear. Manifestations included experienced, anticipated, witnessed, perceived, internalized and secondary stigma in the form of insults, gossip, abuse, physical violence, restraints, social exclusion, and employment-based discrimination from family and community. With respect to negative outcomes and health and social impacts, stigma impacted quality of care, resilience, mental health, morbidity, social inclusion and quality of life. In Malawi, stigma is pervasive challenge for PWLE, with severe implication for their health and social wellbeing. In partnership with PWLE, investment into the integration of evidence-based stigma reduction activities into existing psychosis management programs is warranted.

  PublisherDOI

• “People Who Get Me…Don’t Judge..Don’t Give Me Nasty Looks, Because i’m Here for a Reason”: Perspectives of Health Services from Youth in Botswana

  Journal of Adolescent Health · 2025-02-07

  articleOpen access
  PublisherOA PDFDOI

• A pilot pragmatic trial of a “what matters most”-based intervention targeting intersectional stigma related to being pregnant and living with HIV in Botswana

  UNC Libraries · 2025-10-31

  articleOpen access
  PublisherDOI

Frequent coauthors

• Laura Nyblade

  RTI International

  113 shared

• Gamji Rabiu Abu-Ba’are

  University of Rochester Medical Center

  83 shared

• LaRon E. Nelson

  Unity Health Toronto

  82 shared

• Kwasi Torpey

  University of Ghana

  79 shared

• Khalida Saalim

  RTI International

  75 shared

• Richard Vormawor

  Yale University

  70 shared

• Richard Panix Amoh-Otu

  Kumasi Centre for Collaborative Research in Tropical Medicine

  65 shared

• Prince Adu

  Ohio University

  64 shared

Education

• Postdoctoral, Psychiatry

  Columbia University/New York State Psychiatric Institute

  2022

• PhD, Epidemiology

  The University of North Carolina at Chapel Hill Gillings School of Global Public Health

  2020

• MSPH, Epidemiology

  University of North Carolina at Chapel Hill

  2018

• BA, International Affairs

  George Washington University

  2014

Awards & honors

• K01 Career Development Award