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Negative attitudes toward help seeking for mental illness in 2 population-based surveys from the United States and Canada
Open accessAbstract
OBJECTIVES: To determine the prevalence and sociodemographic correlates of negative attitudes toward help seeking for mental illness among the general population in the United States and Ontario. METHODS: Two contemporaneous population-based surveys (aged 15 to 54 years) were analyzed: the US National Comorbidity Survey (NCS) (n = 5877) and the Ontario Health Survey (OHS) (n = 6902). Multiple logistic regression analyses were used to examine the correlates of a derived negative attitudes composite variable obtained from questions assessing probability, comfort, and embarrassment related to help seeking for mental illness. RESULTS: Negative attitudes toward help seeking for mental illness were prevalent in both countries. Fifteen percent of OHS and 20% of NCS respondents stated they probably or definitely would not seek treatment if they had serious emotional problems. Almost one-half of recipients in both surveys stated they would be embarrassed if their friends knew about their use of mental health services. Negative attitudes toward help seeking were highest among socioeconomically challenged young, single, lesser-educated men in Ontario and the United States. In both countries, substance abuse or dependence and antisocial personality disorder were associated with greater negative attitudes, as was not having sought treatment in the past. CONCLUSIONS: Negative attitudes toward mental health service use are prevalent in Ontario and the United States. They are most common in young adults, especially those with lower education and socioeconomic resources, and those with substance abuse or dependence problems. This information can be used to target educational efforts aimed at improving willingness to seek care for mental health problems.
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“Recent studies suggest that mental health awareness and attitudes toward mental illness are slowly improving in the population (26).”
From An Ecological Study of a Universal Employee Depression Awareness and Stigma Reduction Intervention: “Right Direction” (2021) · cites this paper as [26]
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Changes in attitudes toward seeking mental health services: A 40-year cross-temporal meta-analysis
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Help-seeking behaviors and mental well-being of first year undergraduate university students
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Williams, J. L., Keaton, K., Phillips, R. W., Crossley, A. R., Glenn, J. M., & Gleason, V. L. (2023) · Community Mental Health Journal · doi:10.1007/s10597-023-01146-6 · Cited by 4
“For example, previous research has shown that attitudes toward mental health services tend to be especially negative among young people with low socioeconomic status (e.g., Jagdeo et al., 2009).”
ResultVerlinde, E., Poppe, A., DeSmet, A., Hermans, K., Maeseneer, J. D., Audenhove, C. V., & Willems, S. J. T. (2013) · Health & Social Care in the Community · doi:10.1111/hsc.12027 · Cited by 4
“Furthermore, studies show that people from lower social classes and young people are more reluctant and have a negative attitude towards seeking help for their mental illnesses (Jagdeo et al. 2009).”
BackgroundPlatell, M., Cook, A. G., Fisher, C. M., & Martin, K. (2020) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-020-00262-8 · Cited by 4
“…between past mental health service access and positive attitudes towards help-seeking have been demonstrated in previous literature (Bonabi et al. 2016; Dunbar et al. 2018; Jagdeo et al. 2009; Timlin-Scalera et al. 2003; Wilson and Deane 2001) but this pattern was not observed in our sample.”
ResultWhat do medical students think about medical doctors with mental health issues?
Zarzycki, M. Z., Goetz, Z., & Flaga-Łuczkiewicz, M. (2020) · Psychology Health & Medicine · doi:10.1080/13548506.2020.1724309 · Cited by 4
“This result goes in parallel with studies about stigmatization by medical students of people with mental illness in general (Jagdeo et al., 2009), (Janoušková et al., 2017) and (Pascucci et al., 2017).”
ResultDo mental health stigma and gender influence MBAs’ willingness to engage in coaching?
Millard, J. A., & Korotov, K. (2014) · International Journal of Mentoring and Coaching in Education · doi:10.1108/ijmce-01-2014-0001 · Cited by 3
Monitoring the effects of COVID ‐19 in emerging adults with pre‐existing mood and anxiety disorders
Osuch, E. A., Demy, J., Wammes, M., Tremblay, P. F., Vingilis, E. R., & Carter, C. (2021) · Early Intervention in Psychiatry · doi:10.1111/eip.13135 · Cited by 3
Beliefs and attitudes of psychiatric outpatients toward mental disorders and antidepressants
Akıncı, E., & SONMEZ, S. B. (2019) · Family practice and palliative care · doi:10.22391/fppc.613150 · Cited by 3
Students' Attitudes Towards Psychological Help-Seeking
Ramdass, M., Birbal, R., Joseph-Alleyne, G., & Harripaul, C. (2020) · Journal of Education and Development · doi:10.20849/jed.v4i3.818 · Cited by 4
Gerhards, S. K., Luppa, M., Zülke, A. E., Pabst, A., Claus, M., Bewernick, B. H., Elsaeßer, M., Zehender, N., Wagner, M., Peters, O., et al. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.03.189 · Cited by 2
Health Literacy in Non-Communicable Diseases
Zarcadoolas, C., & Kondilis, B. K. (2018) · Advances in medical technologies and clinical practice book series · doi:10.4018/978-1-5225-4074-8.ch003 · Cited by 2
Nallapaneni, N., Lanka, U. V. R., & Paritala, C. B. G. (2015) · International Journal of Innovative Research and Development · Cited by 2
Predictors of psychiatric treatment-seeking attitudes in older adults
Hay, B. R., & Schroder, H. S. (2025) · Aging & Mental Health · doi:10.1080/13607863.2024.2354347 · Cited by 1
“Education levels demonstrate mixed findings; education has been positively linked to pro-treat-ment attitudes among younger adults (Jagdeo et al., 2009).”
Zare, E., Karimi, M., Kaveh, M. H., Ghahremani, L., Sharma, M., & Kanekar, A. S. (2025) · International Journal of Adolescence and Youth · doi:10.1080/02673843.2025.2487443 · Cited by 1
“…Knickman et al., 2016; Vidourek et al., 2014), including negative attitudes towards professional psychological help (Aguirre Velasco et al., 2020; Jagdeo et al., 2009). fear of stigma and labelling (Clement et al., 2015; Schnyder et al., 2017), concerns about confidentiality, and limited mental…”
Brewster, N., Caplan, B., Chun, C., & González, A. (2025) · Journal of American College Health · doi:10.1080/07448481.2025.2550378 · Cited by 1
“Gender and annual income were included due to evidence of their relationship with help-seeking in previous literature, 47,48 while living situation was added due to its theorized relevance for family stigma: participants living in the same household as family members may feel the impact of family…”
Talbott, J. A. (2011) · Yearbook of Psychiatry and Applied Mental Health · doi:10.1016/s0084-3970(10)79335-x · Cited by 1
The Impact of Empathy Training on Perceptions of Substance Use Disorders
Magel, K. (2016) · Cited by 1
Nash, R. P., Wang, L. H.-C., Gaynes, B. N., & Flythe, J. E. (2023) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2023.10.016 · Cited by 2
Policy and Training Implications
Rathod, S., Kingdon, D., Pinninti, N. R., Turkington, D., & Phiri, P. (2015) · Wiley eBooks · doi:10.1002/9781118976159.ch12
Miller, T. N. (2016) · Summit (Simon Fraser University)
Shaping Attitudes Towards Psychological Services
Bobby, L. M. (2012) · Scholarship & Creative Works - Digital UNC a service of University Libraries (University of Northern Colorado)
Hein, C. L. (2018) · Lincoln (University of Nebraska)
Greidanus, E. (2010) · ERA: Education and Research Archive (University of Alberta) · doi:10.7939/r33w61
Help-seeking behaviours of university students in a Northern Ontario community
Nash, S. J. (2018) · Lu Zone Ul (Laurentian University)
Valdez, J. N. (2019) · Scholarship & Creative Works - Digital UNC a service of University Libraries (University of Northern Colorado)
McCreary, D. R., Barron, D. S., & Swami, V. (2019) · International Journal of Men s Social and Community Health · doi:10.22374/ijmsch.v2i1.24
“Finally, we included a measure of mental health help-seeking behavior because research has shown that men are less likely to seek mental health treatment, and that various aspects of masculinity are associated with that reluctance.(29,31,59) That the IHRMVS was not meaningfully correlated with any of these measures su…”
MethodHalme, M. (2021) · UTUPub (University of Turku)
Metadata
- Authors
- Jagdeo, A., Cox, B. J., Stein, M. B., & Sareen, J.
- Affiliations
- University of Manitoba (CA)
- Canada Research Chair in Mood and Anxiety Disorders and Professor, Departments of Psychiatry, Psychology and Community Health Sciences, Winnipeg, Manitoba
- University of California San Diego (US)
- Health Sciences Centre (CA)
- Corresponding author
- Sareen, Jitender
- Venue
- The Canadian Journal of Psychiatry
- Publisher
- SAGE Publications
- Published
- 2009-11
- Volume
- 54
- Issue
- 11
- Pages
- 757-766
- ISSN
- 0706-7437 (ISSN-L)
- 1497-0015
- OpenAlex
- W177164319
- Cited by
- 110
- References
- 45
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2023: 6 · 2022: 3 · 2021: 7 · 2020: 8 · 2019: 9 · 2018: 11 · 2017: 6 · 2016: 13 · 2015: 6 · 2014: 9 · 2013: 9 · 2012: 5
- FWCI
- 6.45
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The Canadian Journal of Psychiatry (publishedVersion, public-domain)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Canadian Institutes of Health Research (152348)
- National Institute of Mental Health (K24MH064122)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Gender Studies › Gender Roles and Identity Studies
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Keywords
- help-seeking, mental illness, negative attitudes, stigma, embarrassment, help-seeking barriers, substance abuse, antisocial personality disorder, socioeconomic status, young adults, mental health service utilization, sociodemographic correlates, United States, Ontario
- MeSH terms
- Adolescent, Adult, Age Factors, Attitude to Health, Mental Disorders, Canada, Educational Status, Female, Humans, Male, Mental Health Services, Middle Aged, Ontario, Sex Factors, Socioeconomic Factors, United States, Health Care Surveys, Young Adult
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