Association between mental health-related stigma and active help-seeking: systematic review and meta-analysis
Open accessAbstract
Background: Mental disorders create high individual and societal costs and burden, partly because help-seeking is often delayed or completely avoided. Stigma related to mental disorders or mental health services is regarded as a main reason for insufficient help-seeking. Aims: To estimate the impact of four stigma types (help-seeking attitudes and personal, self and perceived public stigma) on active help-seeking in the general population. Method: A systematic review of three electronic databases was followed by random effect meta-analyses according to the stigma types. Results: Twenty-seven studies fulfilled eligibility criteria. Participants' own negative attitudes towards mental health help-seeking (OR = 0.80, 95% CI 0.73–0.88) and their stigmatising attitudes towards people with a mental illness (OR = 0.82, 95% CI 0.69–0.98) were associated with less active help-seeking. Self-stigma showed insignificant association (OR = 0.88, 95% CI 0.76–1.03), whereas perceived public stigma was not associated. Conclusions: Personal attitudes towards mental illness or help-seeking are associated with active help-seeking for mental problems. Campaigns promoting help-seeking and fighting mental illness-related stigma should target these personal attitudes rather than broad public opinion.
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Men in low-income and humanitarian contexts face considerable barriers to engagement with mental health services.
“Men in low-income and humanitarian contexts face considerable barriers to engagement with mental health services. A systematic review and meta-analysis of mental health-related stigma and help-seeking found that the interplay of societal norms and attitudes towards care were a driving force behind limited help-seeking behaviors for men [13].”
From Masculinity and mental health treatment initiation for former political prisoners in Yangon, Myanmar – a qualitative investigation (2021) · cites this paper as [13]
The ‘Influence of stigma type on help-seeking’ section finds that negative attitudes toward seeking help and personal stigma were associated with less active help-seeking. It does not establish societal norms as a driving cause of limited help-seeking specifically for men; ‘Strengths and limitations’ says all included studies were in high-income countries and cautions against generalising to low-income settings. The cited findings therefore do not support the low-income and humanitarian context in which the citing sentence places them. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe interplay of societal norms and attitudes towards care is a driving force behind limited help-seeking behaviors for men.
“A systematic review and meta-analysis of mental health-related stigma and help-seeking found that the interplay of societal norms and attitudes towards care were a driving force behind limited help-seeking behaviors for men [13].”
From Masculinity and mental health treatment initiation for former political prisoners in Yangon, Myanmar – a qualitative investigation (2021) · cites this paper as [13]
The Discussion (page not provided) reports that negative attitudes toward help-seeking and personal stigma are associated with less active help-seeking in the general population. It does not establish this finding specifically for men or identify an interplay of societal norms and attitudes as a driving force; perceived public stigma showed no significant association. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThese same brain areas show accelerated breakdown of monoamine neurotransmitters, increased neuro-inflammation, reduced grey matter, and heightened reactivity to mood-relevant stimuli in individuals with depression.
“These same brain areas show accelerated breakdown of monoamine neurotransmitters, 309 increased neuro-inflammation, 310 reduced grey matter, 311 and heightened reactivity to mood-relevant stimuli 312 in individuals with depression.”
From Time for united action on depression: a Lancet–World Psychiatric Association Commission (2022) · cites this paper as [309]
Stigma, including public stigma and self-stigma, are the main barriers to seeking professional help.
“Previous results have revealed that stigma, including public stigma and self-stigma, are the main barriers to seeking professional help [39,40,41].”
From Mental health literacy intervention on help-seeking in athletes: a systematic review (2020) · cites this paper as [39]
Many factors influence help-seeking including stigma, attitudes, knowledge, financial resources, perceived need, and structural barriers/facilitators.
“There are many factors that influence help-seeking including stigma, attitudes, knowledge, financial resources, perceived need, and structural barriers/facilitators [12, 17–19].”
From Explaining adults’ mental health help-seeking through the lens of the theory of planned behavior: A scoping review (2022) · cites this paper as [17]
Recasting psychiatric conditions in terms of "misfiring circuits" rather than disorders of behavior might reduce stigma, a key barrier to seeking treatment.
“Regarding patients, it’s worth considering that recasting psychiatric conditions in terms of “misfiring circuits” rather than disorders of behavior might reduce stigma, a key barrier to seeking treatment [52].”
From Translational opportunities for circuit-based social neuroscience: advancing 21st century psychiatry (2021) · cites this paper as [52]
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- Authors
- Schnyder, N., Panczak, R., Groth, N., & Schultze-Lutter, F.
- Affiliations
- University of Bern (CH)
- Corresponding author
- Schnyder, Nina
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2017-04
- Volume
- 210
- Issue
- 4
- Pages
- 261-268
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2585744943
- Cited by
- 716
- References
- 119
- Citations by year
- 2026: 78 · 2025: 127 · 2024: 103 · 2023: 96 · 2022: 101 · 2021: 82 · 2020: 67 · 2019: 26 · 2018: 27 · 2017: 6 · 2016: 1 · 2012: 1
- FWCI
- 5.32
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion)
- Funders
- University of Bern
- 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, help-seeking attitudes, personal stigma, self-stigma, perceived public stigma, help-seeking delay, mental illness
- MeSH terms
- Humans, Health Knowledge, Attitudes, Practice, Patient Acceptance of Health Care, Persons with Psychiatric Disorders, Social Stigma
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