Skip to main content Accessibility help
×
Home
Hostname: page-component-ffbbcc459-jtd8l Total loading time: 0.499 Render date: 2022-03-06T09:33:48.935Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true }

Shame, perceived knowledge and satisfaction associated with mental health as predictors of attitude patterns towards help-seeking

Published online by Cambridge University Press:  18 July 2013

N. Rüsch*
Affiliation:
Section of Public Mental Health, Department of Psychiatry II, University of Ulm, Parkstrasse 11, 89073 Ulm, German Department of Psychiatry II, University of Ulm, Germany
M. Müller
Affiliation:
Section of Public Mental Health, Department of Psychiatry II, University of Ulm, Parkstrasse 11, 89073 Ulm, German
V. Ajdacic-Gross
Affiliation:
Section of Public Mental Health, Department of Psychiatry II, University of Ulm, Parkstrasse 11, 89073 Ulm, German
S. Rodgers
Affiliation:
Section of Public Mental Health, Department of Psychiatry II, University of Ulm, Parkstrasse 11, 89073 Ulm, German
P.W. Corrigan
Affiliation:
Illinois Institute of Technology, Chicago, USA
W. Rössler
Affiliation:
Section of Public Mental Health, Department of Psychiatry II, University of Ulm, Parkstrasse 11, 89073 Ulm, German
*
* Address for correspondence: Dr N. Rüsch, Section of Public Mental Health, Department of Psychiatry II, University of Ulm, Parkstrasse 11, 89073 Ulm, Germany. (Email: nicolas.ruesch@uni-ulm.de)

Abstract

Aims.

To examine stigma- and knowledge-related barriers to help-seeking among members of the general population.

Methods.

In a representative survey of young to middle-aged Swiss adults (n = 8875), shame about a potential own mental illness, perceived knowledge about and satisfaction with one's mental health, psychiatric symptoms and attitudes towards help-seeking were assessed.

Results.

A latent profile analysis of all participants yielded two groups with different attitudes towards help-seeking. Relative to the majority, a one-in-four subgroup endorsed more negative attitudes towards seeking professional help, including psychiatric medication, and was characterized by more shame, less perceived knowledge, higher satisfaction with their mental health, younger age, male gender and lower education. Among participants with high symptom levels (n = 855), a third subgroup was reluctant to seek help in their private environment and characterized by high symptoms as well as low satisfaction with their mental health.

Conclusions.

Shame as an emotional proxy of self-stigma as well as poor subjective mental health literacy may be independent barriers to help-seeking. Interventions to increase mental health service use could focus on both variables and on those individuals with more negative views about professional help, in the general public as well as among people with a current mental illness.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Angermeyer, MC, Dietrich, S (2006). Public beliefs about and attitudes towards people with mental illness: a review of population studies. Acta Psychiatrica Scandinavica 113, 163179.CrossRefGoogle ScholarPubMed
Angst, J, Dobler-Mikola, A, Binder, J (1984). The Zurich study – a prospective epidemiological study of depressive, neurotic and psychosomatic syndromes. I. Problem, methodology. European Archives of Psychiatry and Neurological Sciences 234, 1320.CrossRefGoogle ScholarPubMed
Angst, J, Gamma, A, Rössler, W, Ajdacic-Gross, V, Klein, DN (2009). Long-term depression versus episodic major depression: results from the prospective Zurich study of a community sample. Journal of Affective Disorders 115, 112121.CrossRefGoogle ScholarPubMed
Barney, LJ, Griffiths, KM, Jorm, AF, Christensen, H (2006). Stigma about depression and its impact on help-seeking intentions. Australian and New Zealand Journal of Psychiatry 40, 5154.CrossRefGoogle ScholarPubMed
Clement, S, Brohan, E, Jeffery, D, Henderson, C, Hatch, SL, Thornicroft, G (2012). Development and psychometric properties the barriers to access to care evaluation scale (BACE) related to people with mental ill health. BMC Psychiatry 12, 36.CrossRefGoogle ScholarPubMed
Codony, M, Alonso, J, Almansa, J, Bernert, S, de Girolamo, G, de Graaf, R, Haro, JM, Kovess, V, Vilagut, G, Kessler, RC (2009). Perceived need for mental health care and service use among adults in Western Europe: results of the ESEMeD project. Psychiatric Services 60, 10511058.CrossRefGoogle ScholarPubMed
Compton, MT (2010). Clinical Manual of Prevention in Mental Health. American Psychiatric Publishing: Washington, DC.Google Scholar
Corrigan, PW, Rüsch, N (2002). Mental illness stereotypes and clinical care: do people avoid treatment because of stigma? Psychiatric Rehabilitation Skills 6, 312334.CrossRefGoogle Scholar
Corrigan, PW, Watson, AC (2002). The paradox of self-stigma and mental illness. Clinical Psychology: Science and Practice 9, 3553.Google Scholar
Corrigan, PW, Morris, SB, Michaels, PJ, Rafacz, JE, Rüsch, N (2012). Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatric Services 63, 963973.CrossRefGoogle ScholarPubMed
Corrigan, PW, Kosyluk, KA, Rüsch, N (2013). Reducing self-stigma by coming out proud. American Journal of Public Health 103, 794800.CrossRefGoogle ScholarPubMed
de Girolamo, G, Dagani, J, Purcell, R, Cocchi, A, McGorry, PD (2012). Age of onset of mental disorders and use of mental health services: needs, opportunities and obstacles. Epidemiology and Psychiatric Sciences 21, 4757.CrossRefGoogle ScholarPubMed
Derogatis, LR (1977). SCL-90: Administration, Scoring, and Procedures Manual – I for the R(evised) Version and Other Instruments of the Psychopathology Rating Scale Series. Johns Hopkins University: Baltimore.Google Scholar
Edlund, MJ, Wang, PS, Berglund, PA, Katz, SJ, Lin, E, Kessler, RC (2002). Dropping out of mental health treatment: patterns and predictors among epidemiological survey respondents in the United States and Ontario. American Journal of Psychiatry 159, 845851.CrossRefGoogle ScholarPubMed
Evans-Lacko, S, Little, K, Meltzer, H, Rose, D, Rhydderch, H, Henderson, C, Thornicroft, G (2010). Development and psychometric properties of the Mental Health Knowledge Schedule (MAKS). Canadian Journal of Psychiatry 55, 440448.CrossRefGoogle Scholar
Evans-Lacko, S, Brohan, E, Mojtabai, R, Thornicroft, G (2012). Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries. Psychological Medicine 42, 17411752.CrossRefGoogle ScholarPubMed
Griffiths, KM, Christensen, H, Jorm, AF, Evans, K, Groves, C (2004). Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression: randomised controlled trial. British Journal of Psychiatry 185, 342349.CrossRefGoogle ScholarPubMed
Hardt, J (2008). The Symptom Checklist-27-plus (SCL-27-plus): a modern conceptualization of a traditional screening instrument. Psychosocial Medicine 5, Doc08.Google ScholarPubMed
Henderson, C, Evans-Lacko, S, Thornicroft, G (2013). Mental illness stigma, help seeking, and public health programs. American Journal of Public Health 103, 777780.CrossRefGoogle ScholarPubMed
Huxley, P (1996). Mental illness in the community: the Goldberg-Huxley model of the pathway to psychiatric care. Nordic Journal of Psychiatry 50 (Suppl. 37), 4753.CrossRefGoogle Scholar
Jagdeo, A, Cox, BJ, Stein, MB, Sareen, J (2009). Negative attitudes toward help seeking for mental illness in 2 population-based surveys from the United States and Canada. Canadian Journal of Psychiatry 54, 757766.CrossRefGoogle ScholarPubMed
Jorm, AF (2012). Mental health literacy: empowering the community to take action for better mental health. American Psychologist 67, 231243.CrossRefGoogle ScholarPubMed
Jorm, AF, Wright, A (2007 a). Beliefs of young people and their parents about the effectiveness of interventions for mental disorders. Australian and New Zealand Journal of Psychiatry 41, 656666.CrossRefGoogle ScholarPubMed
Jorm, AF, Medway, J, Christensen, H, Korten, AE, Jacomb, PA, Rodgers, B (2000). Public beliefs about the helpfulness of interventions for depression: effects on actions taken when experiencing anxiety and depression symptoms. Australian and New Zealand Journal of Psychiatry 34, 619626.CrossRefGoogle ScholarPubMed
Jorm, AF, Griffiths, KM, Christensen, H, Parslow, RA, Rogers, B (2004). Actions taken to cope with depression at different levels of severity: a community survey. Psychological Medicine 34, 293299.CrossRefGoogle ScholarPubMed
Jorm, AF, Wright, A, Morgan, AJ (2007 b). Where to seek help for a mental disorder? National survey of the beliefs of Australian youth and their parents. Medical Journal of Australia 187, 556560.Google ScholarPubMed
King, D, Knapp, M, Patel, A, Amaddeo, F, Tansella, M, Schene, A, Koeter, M, Angermeyer, M, Becker, T (2013). The impact of non-adherence to medication in patients with schizophrenia on health, social care and societal costs: analysis of the QUATRO study. Epidemiology and Psychiatric Sciences, 110. doi:10.1017/S2045796013000097.Google ScholarPubMed
Lanfredi, M, Rossi, G, Rossi, R, van Bortel, T, Thornicroft, G, Quinn, N, Zoppei, S, Lasalvia, A (2013). Depression prevention and mental health promotion interventions: is stigma taken into account? An overview of the Italian initiatives. Epidemiology and Psychiatric Sciences, 112. doi:10.1017/S2045796013000085.Google ScholarPubMed
Lasalvia, A, Zoppei, S, van Bortel, T, Bonetto, C, Cristofalo, D, Wahlbeck, K, Bacle, SV, van Audenhove, C, van Weeghel, J, Reneses, B, Germanavicius, A, Economou, M, Lanfredi, M, Ando, S, Sartorius, N, Lopez-Ibor, JJ, Thornicroft, G (2013). Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. Lancet 381, 5562.CrossRefGoogle ScholarPubMed
Lauber, C, Nordt, C, Falcato, L, Rössler, W (2001). Lay recommendations on how to treat mental disorders. Social Psychiatry and Psychiatric Epidemiology 36, 553556.CrossRefGoogle ScholarPubMed
Link, BG (1987). Understanding labeling effects in the area of mental disorders: an assessment of the effects of expectations of rejection. American Sociological Review 52, 96112.CrossRefGoogle Scholar
Lo, Y, Mendell, NR, Rubin, DB (2001). Testing the number of components in a normal mixture. Biometrika 88, 767778.CrossRefGoogle Scholar
Luoma, JB, Kohlenberg, BS, Hayes, SC, Fletcher, L (2012). Slow and steady wins the race: a randomized clinical trial of acceptance and commitment therapy targeting shame in substance use disorders. Journal of Consulting and Clinical Psychology 80, 4353.CrossRefGoogle ScholarPubMed
MacKinnon, DP, Fairchild, AJ, Fritz, MS (2007). Mediation analysis. Annual Review of Psychology 58, 593614.CrossRefGoogle ScholarPubMed
McLachlan, G, Peel, D (2000). Finite Mixture Models. Wiley: New York.CrossRefGoogle ScholarPubMed
Müller, M, Vetter, S, Buchli-Kammermann, J, Stieglitz, RD, Stettbacher, A, Riecher-Rössler, A (2010). The Self-screen-Prodrome as a short screening tool for pre-psychotic states. Schizophrenia Research 123, 217224.CrossRefGoogle ScholarPubMed
Muthén, LK, Muthén, BO (2002). How to use a Monte Carlo study to decide on sample size and determine power. Structural Equation Modeling 4, 599620.CrossRefGoogle Scholar
Muthén, LK, Muthén, BO (2011). Mplus User's Guide. Muthén & Muthén: Los Angeles.Google Scholar
Nylund, KL, Asparouhov, T, Muthén, B (2007). Deciding on the number of classes in latent class analysis and growth mixture modeling: a Monte Carlo simulation study. Structural Equation Modeling 14, 535569.CrossRefGoogle Scholar
Phelan, JC, Yang, LH, Cruz-Rojas, R (2006). Effects of attributing serious mental illnesses to genetic causes on orientations to treatment. Psychiatric Services 57, 382387.CrossRefGoogle Scholar
Riedel-Heller, SG, Matschinger, H, Angermeyer, MC (2005). Mental disorders – who and what might help? Help-seeking and treatment preferences of the lay public. Social Psychiatry and Psychiatric Epidemiology 40, 167174.CrossRefGoogle ScholarPubMed
Rose, D, Willis, R, Brohan, E, Sartorius, N, Villares, C, Wahlbeck, K, Thornicroft, G (2011). Reported stigma and discrimination by people with a diagnosis of schizophrenia. Epidemiology and Psychiatric Sciences 20, 193204.CrossRefGoogle ScholarPubMed
Rüsch, N, Hölzer, A, Hermann, C, Schramm, E, Jacob, GA, Bohus, M, Lieb, K, Corrigan, PW (2006). Self-stigma in women with borderline personality disorder and women with social phobia. Journal of Nervous and Mental Disease 194, 766773.CrossRefGoogle ScholarPubMed
Rüsch, N, Corrigan, PW, Bohus, M, Jacob, GA, Brueck, R, Lieb, K (2007 a). Measuring shame and guilt by self-report questionnaires: a validation study. Psychiatry Research 150, 313325.CrossRefGoogle ScholarPubMed
Rüsch, N, Lieb, K, Göttler, I, Hermann, C, Schramm, E, Richter, H, Jacob, GA, Corrigan, PW, Bohus, M (2007 b). Shame and implicit self-concept in women with borderline personality disorder. American Journal of Psychiatry 164, 500508.CrossRefGoogle ScholarPubMed
Rüsch, N, Corrigan, PW, Wassel, A, Michaels, P, Larson, JE, Olschewski, M, Wilkniss, S, Batia, K (2009 a). Self-stigma, group identification, perceived legitimacy of discrimination and mental health service use. British Journal of Psychiatry 195, 551552.CrossRefGoogle ScholarPubMed
Rüsch, N, Corrigan, PW, Wassel, A, Michaels, P, Olschewski, M, Wilkniss, S, Batia, K (2009 b). Ingroup perception and responses to stigma among persons with mental illness. Acta Psychiatrica Scandinavica 120, 320328.CrossRefGoogle ScholarPubMed
Rüsch, N, Todd, AR, Bodenhausen, GV, Weiden, PJ, Corrigan, PW (2009 c). Implicit versus explicit attitudes toward psychiatric medication: implications for insight and treatment adherence. Schizophrenia Research 112, 119122.CrossRefGoogle ScholarPubMed
Rüsch, N, Corrigan, PW, Todd, AR, Bodenhausen, GV (2010). Implicit self-stigma in people with mental illness. Journal of Nervous and Mental Disease 198, 150153.CrossRefGoogle ScholarPubMed
Rüsch, N, Evans-Lacko, S, Henderson, C, Flach, C, Thornicroft, G (2011). Knowledge and attitudes as predictors of intentions to seek help and disclose a mental illness. Psychiatric Services 62, 675678.CrossRefGoogle ScholarPubMed
Schomerus, G, Angermeyer, MC (2008). Stigma and its impact on help-seeking for mental disorders: what do we know? Epidemiologia e Psichiatria Sociale 17, 3137.CrossRefGoogle ScholarPubMed
Schomerus, G, Matschinger, H, Angermeyer, MC (2009). The stigma of psychiatric treatment and help-seeking intentions for depression. European Archives of Psychiatry and Clinical Neuroscience 259, 298306.CrossRefGoogle Scholar
Schomerus, G, Auer, C, Rhode, D, Luppa, M, Freyberger, HJ, Schmidt, S (2012 a). Personal stigma, problem appraisal and perceived need for professional help in currently untreated depressed persons. Journal of Affective Disorders 139, 9497.CrossRefGoogle ScholarPubMed
Schomerus, G, Schwahn, C, Holzinger, A, Corrigan, PW, Grabe, HJ, Carta, MG, Angermeyer, MC (2012 b). Evolution of public attitudes about mental illness: a systematic review and meta-analysis. Acta Psychiatrica Scandinavica 125, 440452.CrossRefGoogle ScholarPubMed
Thornicroft, G (2007). Most people with mental illness are not treated. Lancet 370, 807808.CrossRefGoogle Scholar
Thornicroft, G (2012). No time to lose: onset and treatment delay for mental disorders. Epidemiology and Psychiatric Sciences 21, 5961.CrossRefGoogle ScholarPubMed
Vogel, DL, Wade, NG, Haake, S (2006). Measuring the self-stigma associated with seeking psychological help. Journal of Counseling Psychology 53, 325337.CrossRefGoogle Scholar
von Eye, A, Bergman, LR (2003). Research strategies in developmental psychopathology: dimensional identity and the person-oriented approach. Development and Psychopathology 15, 553580.CrossRefGoogle ScholarPubMed
Wang, PS, Aguilar-Gaxiola, S, Alonso, J, Angermeyer, MC, Borges, G, Bromet, EJ, Bruffaerts, R, de Girolamo, G, de Graaf, R, Gureje, O, Haro, JM, Karam, EG, Kessler, RC, Kovess, V, Lane, MC, Lee, S, Levinson, D, Ono, Y, Petukhova, M, Posada-Villa, J, Seedat, S, Wells, JE (2007). Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveys. Lancet 370, 841850.CrossRefGoogle ScholarPubMed
Yanos, PT, Roe, D, Lysaker, PH (2011). Narrative Enhancement and Cognitive Therapy: a new group-based treatment for internalized stigma among persons with severe mental illness. International Journal of Group Psychotherapy 61, 576595.CrossRefGoogle ScholarPubMed
Yap, MB, Jorm, AF (2012). Parents' beliefs about actions they can take to prevent depressive disorders in young people: results from an Australian national survey. Epidemiology and Psychiatric Sciences 21, 117123.CrossRefGoogle ScholarPubMed
Yap, MB, Reavley, NJ, Jorm, AF (2013). The associations between psychiatric label use and young people's help-seeking preferences: results from an Australian national survey. Epidemiology and Psychiatric Sciences, 19. doi:10.1017/S2045796013000073.Google Scholar
50
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Shame, perceived knowledge and satisfaction associated with mental health as predictors of attitude patterns towards help-seeking
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Shame, perceived knowledge and satisfaction associated with mental health as predictors of attitude patterns towards help-seeking
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Shame, perceived knowledge and satisfaction associated with mental health as predictors of attitude patterns towards help-seeking
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *