Racial differences in attitudes toward professional mental health treatment: the mediating effect of stigma.
ABSTRACT Stigma associated with mental illness continues to be a pervasive barrier to mental health treatment, leading to negative attitudes about treatment and deterring appropriate care seeking. Empirical research suggests that the stigma of mental illness may exert an adverse influence on attitudes toward mental health treatment and service utilization patterns by individuals with a mental illness, particularly African Americans. However, little research has examined the impact of stigma on racial differences in attitudes toward seeking mental health treatment. This study examined the hypothesis that stigma partially mediates the relationship between race and attitudes towards mental health treatment in a community-based sample of 101 African American and White older adults. Multiple regression analyses and classic path analysis was utilized to test the partial mediation model. Controlling for socio-demographic factors, African American older adults were more likely to have negative attitudes toward mental health treatment, and they also reported more public and internalized stigma than their White counterparts. As hypothesized, the relationship between race and attitudes toward mental health treatment was partially mediated by internalized stigma, suggesting that internalized stigma may cause older adults to develop negative attitudes about mental health treatment. The partial mediation model was not significant for public stigma, however. Implications for social work research and practice are discussed.
- SourceAvailable from: Amy Elizabeth SickelAdvances in Mental Health. 12/2014; 12(3):202-215.
- Advances in Mental Health 01/2014; 12(3):202-215.
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ABSTRACT: A covert perceptions task was used to assess negative evaluation of an individual seeking depression treatment. In Experiment 1, participants were randomly as-signed to read a narrative written by an ostensible depressed student struggling with several college-related problems who allocated a large percentage of money either to pay for depression treatment or to address another life problem. In Ex-periment 2, participants read the same narrative by the depressed student and then were randomly assigned to one of three conditions in which the depressed student either opted to not seek treatment, sought and received free treatment, or did not qualify for free treatment and paid out-of-pocket for treatment. Paying for treatment led to more negative evaluation of the depressed student than did foregoing treatment (Experiments 1 and 2), and foregoing treatment led to more negative evaluation than did obtaining free treatment (Experiment 2). Mediational analyses suggested that the increased negative evaluation of the depressed per-son who paid for treatment was due to a perception that the person was wasteful with money. Implications of the negative evaluation associated with paying for or foregoing treatment (versus seeking free treatment) are discussed in the context of rising health care cost and decreased funding for mental health treatment. TREATMENT SEEKING BEHAVIOR 879 One challenge facing mental health care professionals is convinc-ing those with mental health issues to seek treatment, particularly given the stigma associated with mental illness. Further complicat-ing the problem are concerns that research examining the issue of prejudice and mental health has primarily relied on explicit mea-sures of prejudice, which may not accurately assess the degree of genuine prejudice associated with having mental health issues be-cause of socially desirable responding (Stier & Hinshaw, 2007). In the present experiments, we examined situational factors inherent in treatment seeking that may contribute to the negative evaluation of individuals with mental illness. In addition, we developed and applied a covert perceptions task to identify with more subtlety the potential negative evaluation of those seeking mental health care.Journal of Social and Clinical Psychology 10/2012; 31:878-901. · 1.36 Impact Factor