Perceived Stigma and Help-Seeking Behavior: Longitudinal Evidence From the Healthy Minds Study

Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA 02115, USA.
Psychiatric services (Washington, D.C.) (Impact Factor: 2.41). 10/2009; 60(9):1254-6. DOI: 10.1176/
Source: PubMed


Despite considerable policy interest in the association between perceived public stigmatization of mental illness and use of mental health services, limited empirical evidence, particularly from longitudinal data, documents this relationship. This study used longitudinal data to estimate the association between perceived public stigmatization and subsequent mental health care seeking.
A Web-based survey was used to collect data from a random sample of undergraduate and graduate students at a university at baseline and two years later (N=732). Logistic regression models assessed the association between students' perceived public stigma at baseline and measures of subsequent help seeking for mental health problems (perceived need for help and use of mental health services) at follow-up.
No significant associations were found between perceived public stigma and help-seeking behavior over the two-year period.
In this population of college students, perceived stigma did not appear to pose a substantial barrier to mental health care.

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    • "This discrepancy could be due to several reasons, such students not recognising either mental health or mental well-being difficulties in themselves, or the existence of barriers to students seeking help for such issues. Research has shown that amongst the general student population public stigma relating to mental health issues may not be a barrier to seeking help (Golberstein, Eisenberg, and Gollust 2009), but personal stigma may be, such that an individual's own views relating to mental health may be a barrier to help-seeking but they do not perceive that others would view them negatively (Lally et al. 2013). Amongst students training to be health professionals , perceptions of difficulties relating to professional regulations, such as fitness to practice and lack of confidentiality, appear to result in a reluctance to seek help for mental health difficulties or a public stigma associated with doing so (Chew-Graham, Rogers, and Yassin 2003; Givens and Tjia 2002). "
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    ABSTRACT: Despite relatively high levels of psychological distress, many students in higher education do not seek help for difficulties. This study explored undergraduate student understanding of the concepts of mental health and mental well-being and where undergraduate students would seek help for mental well-being difficulties. Semi-structured interviews were carried out with 20 undergraduate students from 5 different subject areas. Interviews were transcribed and thematically analysed. Results highlighted that the majority of participants viewed mental health and mental well-being as two distinct concepts but their views did not affect where they would seek help for mental well-being difficulties. Medical students reported public stigma relating to help seeking for mental well-being difficulties. Undergraduate students are most likely to seek help for mental well-being difficulties from peers, but whether this experience is useful is less clear. How such an approach impacts upon the individual from whom assistance is sought is also not well understood.
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    • "However, it is also possible that students may feel comfortable filling out an anonymous survey but still hesitate to discuss their symptoms with a live clinician over a virtual medium. This is a public health challenge that may be related to the stigma regarding psychiatric illnesses [37], the lack of insight into the need for help [38], or concerns about potential administrative sanctions, such as mandatory leave or dismissal from school [17]. "
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    ABSTRACT: Background. A steady rise in the prevalence of depression among college students has negatively affected student quality of life. This study investigates the feasibility and acceptability of a Web-based model, including Skype, to screen and provide psychiatric consultation to depressed college students. Methods. Students completed the 9-item Patient Health Questionnaire (PHQ-9) online; those who screened positive (PHQ-9 ≥ 10) or endorsed any level of suicidal ideation were offered Web-based psychiatric consultation using Skype. After the consultation, students filled out a 7-item satisfaction questionnaire to report on the acceptability of this Web-based method. Results. A total of 972 students consented to the online depression screening and 285 screened positive. Of those, 69 students consented and 17 students successfully completed the psychiatric consultation via Skype. Thirteen (76.4%) students found the interview useful in helping them understand their depression. Fifteen (88.2%) students thought that psychologists and psychiatrists could successfully see patients via videoconferencing. Conclusions. Current online technologies can provide depression screening and psychiatric consultation to college students; those who participated reported a positive experience. Future studies will need to address the low levels of participation among college students and attract students who are underserved, as well as use a videoconferencing platform that adequately protects data confidentiality.
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    • "However, they were more likely to endorse the helpfulness of a close friend for social phobia. These findings are contrary to the null findings from earlier studies which did not examine stigma-help seeking associations specifically for different disorders (Golberstein et al., 2009; Schomerus et al., 2009; Yap et al., 2011), suggesting that it may be informative to examine these associations separately for specific disorders. Overall, the current findings indicate that the associations between weak-notsick stigma and help seeking are similar for personally-held beliefs and those perceived in others: such beliefs seem to be a barrier to professional help seeking in young people. "
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    ABSTRACT: To reduce stigma and improve help seeking by young people for mental illness, we need a better understanding of the associations between various dimensions of stigma and young people's help-seeking intentions and helpfulness beliefs for various sources of help and for different disorders. This study assessed stigmatizing attitudes and help-seeking intentions and helpfulness beliefs via a national telephone survey of 3021 youths aged 15-25. Five stigma scales were used: social distance, personally held weak-not-sick and dangerousness beliefs, and weak-not-sick and dangerousness beliefs perceived in others. Respondents were presented with a vignette of a young person portraying depression, depression with suicidal thoughts, depression with alcohol abuse, post-traumatic stress disorder, social phobia, or psychosis. Beliefs that mental illness is a sign of personal weakness and preference for social distance were associated with less intention to seek professional help and less endorsement of their helpfulness. In contrast, dangerousness/unpredictability beliefs were associated with more intention to seek professional help and more endorsement of their helpfulness. Findings highlight the importance of examining the associations between different dimensions of stigma with different sources of help, specifically for various mental disorders, to better inform future efforts to reduce stigma and increase help seeking in young people.
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