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


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
    • "This limited detection may relate to patient reluctance to volunteer emotional concerns because of the belief that distress is inevitable, or that nothing can be done to assist [6] meaning that health professionals must often rely on non-verbal cues to identify distress, a difficult task in the absence of specific training [7]. Stigma about mental illness may be another reason that patients are reluctant to disclose emotional concerns or accept referral if this is offered [8,9]. Limited access to suitably qualified professionals to provide psychosocial care may undermine clinician enthusiasm about detecting distress -why identify a problem if it cannot be addressed? "

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    • "Misunderstanding and misconception of mental health professions result in negative stereotypes and prejudice. A major problem is stigmatic attitudes toward mental health care, especially psychiatric care (Sartorius et al., 2010; Schomerus, Matschinger, & Angermeyer, 2009; Schultze, 2007; von Sydow & Reimer, 1998). Mental illness is perceived negatively in society (Guimon, 2010). "
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    ABSTRACT: The aim of this study was to explore predictors of help-seeking intentions for mental health problems. This study examined warmth and competence stereotypes about mental health care providers, in relation to help-seeking intentions. A total of 338 adults participated in the study. They were asked to rate their stereotypes about psychologists, psychiatrists, family doctors, clergypersons, and astrologers, and intentions to seek help for mental health problems on a number of Likert-type scales. The results showed that the stereotypes about helping professionals in the mental health care field were significant predictors of intentions to seek help. Higher perceptions about the competence of a family doctor, psychologist, clergyman and astrologer and higher perceptions about warmth of a psychiatrist indicated potential clients’ willingness to seek their help. Differences in predictors of the help-seeking intentions between different mental health care provider professions revealed a complex network of beliefs based on professional stereotypes about mental health care providers. © 2015, Mediterranean Center of Social and Educational Research. All rights reserved.
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