The stigma of psychiatric treatment and help-seeking intentions for depression

Department of Psychiatry, Leipzig University, Leipzig, Germany.
European Archives of Psychiatry and Clinical Neuroscience (Impact Factor: 3.53). 03/2009; 259(5):298-306. DOI: 10.1007/s00406-009-0870-y
Source: PubMed

ABSTRACT The stigma of mental illness has often been considered a potential cause for reluctant willingness to seek help for mental problems, but there is little evidence on this issue. We examine two aspects of stigma related to seeing a psychiatrist and their association with help-seeking intentions for depression: anticipated discrimination by others when seeking help and desire for social distance from those seeking help.
Representative population survey in Germany 2007 (n = 2,303), containing a depression vignette with a question on readiness to seek psychiatric care for this problem, a focus group developed scale anticipated discrimination when seeing a psychiatrist (ADSP), and a scale on desire for social distance from someone seeing a psychiatrist (SDSP). We further elicited previous contact to psychiatric treatment, depressive symptoms, and socio-demographic data.
Both scales had good internal consistency (Cronbach's alpha ADSP 0.87, SDSP 0.81). Exploratory factor analysis of all items revealed a distinct factor representing the social distance scale and three factors "anticipated discrimination", "anticipated job problems" and "anticipated shame" derived from the ADSP scale. In both the general population and in those with current depressive syndrome, personal desire for social distance significantly decreased willingness to seek psychiatric help, but anticipated discrimination by others did not. Other factors related to likely help-seeking were female gender and previous contact to psychiatric treatment or to psychotherapy.
Contrary to expectations, anticipated discrimination from others was unrelated to help-seeking intentions, while personal discriminatory attitudes seem to hinder help-seeking. Our findings point to self-stigmatization as an important mechanism decreasing the willingness to seek psychiatric help.

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Available from: Georg Schomerus, Aug 28, 2015
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    • "Also skepticism towards psychiatry as a legitimate science and towards those representing it as well negative stereotypes about psychiatrists may have played a role (Swami and Furnham 2011; Sartorius et al. 2010). Last but not least, an important obstacle against recommending a psychiatrist seems to be the fear of negative social consequences of being in psychiatric treatment (Schomerus et al. 2009). Despite the fact that in Italy patients must first see the G.P. before consulting a psychologist, the first has less frequently been recommended than the latter, which may be seen as a sign of a certain reservation about G.P.s, who in a nationwide survey in Italy had been found capable to understand and help patients with depression by only half of respondents. "
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    ABSTRACT: Purpose of the study is to investigate helpseeking preferences of the Sardinian public in case of depression. A telephone survey was conducted among the adult population, using quota sampling (N = 1,200). Respondents were presented with a vignette depicting a person with symptoms of major depressive disorder, followed by a fully structured interview. Psychologists were most frequently selected as source of professional help, followed by psychiatrists and G.P.s. Residents of small towns more frequently recommended mental health professionals than city residents. Public help-seeking preferences reflect the availability of services, beliefs about the appropriate treatment of depression and attitudes towards those providing it.
    Administration and Policy in Mental Health and Mental Health Services Research 10/2014; DOI:10.1007/s10488-014-0604-y · 3.44 Impact Factor
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    • "In line with Schomerus et al. (2009), we found that self-stigma was more closely correlated with decreased willingness for disclosure. This finding supports previous "
    10/2014; 11(1):1-18. DOI:10.5130/portal.v11i1.3295
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    • "Third, collective levels of stigma are predictive of individual stigmatising attitudes in a population (Mojtabai, 2010) and of individual self-stigma (Evans- Lacko et al. 2012). Studies on predictors of help-seeking have shown that both individual stigmatizsing attitudes and self-stigma are associated with lower willingness to seek help for mental health problems (Vogel et al. 2006; Schomerus et al. 2009), which could, in turn, increase the individual risk for suicide. Studies combining data on collective levels of stigma and individual level attitudes, help-seeking and suicidal behaviour are needed to establish this hypothetical link. "
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    ABSTRACT: Aims: There is substantial diversity in national suicide rates, which has mainly been related to socio-economic factors, as well as cultural factors. Stigma is a cultural phenomenon, determining the level of social acceptance or rejection of persons with mental illness in a society. In this study, we explore whether national suicide rates are related to the degree of mental illness stigma in that country. Methods: We combine the data on country-level social acceptance (Eurobarometer) with the data on suicide rates and socio-economic indicators (Eurostat) for 25 European countries. Results: In a linear regression model controlling for socio-economic indicators, the social acceptance of someone with a significant mental health problem in 2010 was negatively correlated with age standardised national suicide rates in the same year (β -0.46, p = 0.014). This association also held true when combining national suicide rates with death rates due to events of undetermined intent. Conclusions: Stigma towards persons with mental health problems may contribute to differences in suicide rates in a country. We hypothesise possible mechanisms explaining this link, including stigma as a stressor and social isolation as a consequence of stigma.
    Epidemiology and Psychiatric Sciences 02/2014; 24(02):1-6. DOI:10.1017/S2045796014000109 · 3.91 Impact Factor
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