Mental health literacy reduces the impact of internalized stigma on willingness to seek mental health services

Abstract

Objectives: Older adults (OA) are the age demographic least likely to seek help, and internalized stigma is an important reason why. We sought to further our understanding of which OA are particularly likely to be negatively impacted by internalized stigma, and why, by investigating mental health literacy (MHL) as a moderator within the internalized stigma model (ISM) of help seeking. Methods: We utilized conditional-process analysis of cross-sectional, secondary data from 350 distressed OA. Participants completed an online survey consisting of measures of distress, MHL, public and self-stigma of seeking help, help-seeking attitudes, and willingness to seek services. Results: MHL moderated the ISM; distressed OA with low MHL were more likely to have public stigma internalized as self-stigma, which in turn reduced their willingness to seek services. The direct negative impact of self-stigma on help-seeking attitudes and willingness to seek services was also stronger among distressed OA with low MHL. Conclusions: These results increase our understanding of which OA are unlikely to seek mental health help, and why. Furthermore, MHL is a malleable construct and can serve as the target of interventions designed to increase the help-seeking propensity among OA in need of help.

Perceived control moderates the internalized stigma model of seeking mental health services in distressed older adults.

“…This adds to the list of variables that are emerging as moderators of the internalized stigma model in older adults. This list includes PC, mental health literacy (Krook et al, 2023), and experiential avoidance (Murphy & Mackenzie, 2023). This work is beginning to provide (a) a nuanced picture of which older adults are least likely to seek help for mental health services despite a potential need and (b) mechanisms of change to target when developing interventions to help those at-risk older adults.…”

“…Despite structural barriers to seeking help that are beyond the purview of individuals to change, this study points to an individual barrier that may be modified. Our work adds PC as moderator, alongside experiential avoidance (Murphy & Mackenzie, 2023) and mental health literacy (Krook et al, 2023), all of which may serve as malleable targets of intervention. Together, the foundations for an intervention rooted in established theory with evidence-backed mechanisms of change are beginning to emerge.…”

“…Psychosocial variables that moderate internalized stigma’s impact on help-seeking attitudes and intentions are important proximal factors in understanding psychological help-seeking among older adults. Recent research has identified such variables in distressed older adults, including experiential avoidance (Murphy & Mackenzie, 2023) and mental health literacy (Krook et al, 2023). This study seeks to extend this research, further exploring psychological factors that contribute to distressed older adults’ reluctance to seek professional help.…”

The impact of the Big Five personality traits on help-seeking stigmas, attitudes, and intentions.

“…First, this work can be extended to clinical samples to understand the influence of personality on the help seeking of more at-risk populations. Second, research has found other established predictors, such as experiential avoidance (Brenner et al, 2020; Murphy & Mackenzie, 2023), perceived control (Murphy et al, 2024), and mental health literacy (Mackenzie et al, 2023) to moderate the internalized stigma model, and research might explore personality as a moderator. Third, research has explored longitudinal changes in personality (e.g., Roberts et al, 2006; Srivastava et al, 2003); similar work that includes mental health service use variables would help clarify the interactions among these variables over time.…”