Stigma as a barrier to recognizing personal mental illness and seeking help: a prospective study among untreated persons with mental illness
Open accessAbstract
It is unclear to what extent failure to recognize symptoms as potential sign of a mental illness is impeding service use, and how stigmatizing attitudes interfere with this process. In a prospective study, we followed a community sample of 188 currently untreated persons with mental illness (predominantly depression) over 6 months. We examined how lack of knowledge, prejudice and discrimination impacted on self-identification as having a mental illness, perceived need, intention to seek help, and help-seeking, both with respect to primary care (visiting a general practitioner, GP) and specialist care (seeing a mental health professional, MHP). 67% sought professional help within 6 months. Fully saturated path models accounting for baseline depressive symptoms, previous treatment experience, age and gender showed that self-identification predicted need (beta 0.32, p < 0.001), and need predicted intention (GP: beta 0.45, p < 0.001; MHP: beta 0.38, p < 0.001). Intention predicted service use with a MHP after 6 months (beta 0.31, p < 0.01; GP: beta 0.17, p = 0.093). More knowledge was associated with more self-identification (beta 0.21, p < 0.01), while support for discrimination was associated with lower self-identification (beta - 0.14, p < 0.05). Blaming persons with mental illness for their problem was associated with lower perceived need (beta - 0.16, p < 0.05). Our models explained 37% of the variance of seeking help with a MHP, and 33% of help-seeking with a GP. Recognizing one's own mental illness and perceiving a need for help are impaired by lack of knowledge, prejudice, and discrimination. Self-identification is a relevant first step when seeking help for mental disorders.
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Reluctance to access help due to the fear of being judged or labeled is a significant barrier for individuals to access mental health support.
“Reluctance to access help due to the fear of being judged or labeled is a significant barrier for individuals to access mental health support [17].”
From Providing Self-Led Mental Health Support Through an Artificial Intelligence–Powered Chat Bot (Leora) to Meet the Demand of Mental Health Care (2023) · cites this paper as [17]
Some research suggests help-seeking intentions are associated with behaviours, but these are not always correlated.
“Although some research suggests help-seeking intentions are associated with behaviours, (38) these are not always correlated.”
From The impact of digital interventions on help-seeking behaviour for mental health problems: a systematic literature review (2022) · cites this paper as [38]
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- Authors
- Schomerus, G., Stolzenburg, S., Freitag, S., Speerforck, S., Janowitz, D., Evans-Lacko, S., Muehlan, H., & Schmidt, S.
- Affiliations
- Universitätsmedizin Greifswald (DE)
- Universität Greifswald (DE)
- London School of Economics and Political Science (GB)
- Corresponding author
- Schomerus, Georg
- ORCID
- Venue
- European Archives of Psychiatry and Clinical Neuroscience
- Published
- 2018-04-20
- Volume
- 269
- Issue
- 4
- Pages
- 469-479
- ISSN
- 0003-9373 (ISSN-L)
- 0940-1334
- 1433-8491
- OpenAlex
- W2802373219
- Cited by
- 214
- References
- 55
- Citations by year
- 2026: 18 · 2025: 32 · 2024: 38 · 2023: 38 · 2022: 20 · 2021: 29 · 2020: 18 · 2019: 16 · 2018: 3 · 2017: 1
- FWCI
- 22.21
- Type
- journal article
- Language
- en
- Open access
- green
- orcid.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Archives of Psychiatry and Clinical Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- London School of Economics and Political Science Research Online (London School of Economics and Political Science) (submittedVersion)
- Funders
- Deutsche Forschungsgemeinschaft (SCHO 1337/4-1, SCHM 2683/4-1)
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Social Sciences › Gender Studies › Gender Roles and Identity Studies
- Keywords
- mental health stigma, help-seeking, untreated mental illness, depression, perceived need for help, help-seeking intentions, prejudice and discrimination, mental health literacy, primary care, mental health professionals, blame attribution
- MeSH terms
- Adult, Depressive Disorder, Female, Follow-Up Studies, Humans, Health Knowledge, Attitudes, Practice, Male, Mental Health Services, Middle Aged, Patient Acceptance of Health Care, Social Stigma, General Practice, Diagnostic Self Evaluation
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