Perceived mental illness stigma among family and friends of young people with depression and its role in help-seeking: a qualitative inquiry

Abstract

Background Depressive disorders are a serious public health concern. Left untreated, further clinical distress and impairment in important life domains may arise. Yet, the treatment gap remains large. Prior research has shown that individuals with depressive disorders prefer seeking help from informal sources such as family and friends ahead of formal sources. However, this preference has its disadvantages such as experiencing actual, perceived and internalized stigmatizing responses from them which may delay or deter help-seeking. This paper aimed to determine the role of perceived stigma among family and friends in an individual’s help-seeking behavior. Methods Data were collected using semi-structured interviews with patients with depressive disorders from a tertiary psychiatric hospital in Singapore to capture individuals’ self-reported experience with depression and stigmatization among family and friends. Interviews were audio recorded and transcribed verbatim. Data of 33 young adults (mean age = 26 years, SD =4.6; 18 female, 15 male) were analyzed using thematic analysis. Results In all, four broad themes were developed: (1) absence of support, (2) provision of unhelpful support, (3) preference for non-disclosure, and (4) opposition towards formal help-seeking. Lack of awareness of depression and perpetuation of stigma manifests as barriers towards help-seeking in the form of absence of support and provision of unhelpful support which subsequently leads to a preference for non-disclosure, as well as opposition by family and friends towards formal help-seeking. Conclusions Data from this study can contribute to the development of public health programs aimed at improving awareness and support from family and friends and facilitating earlier help-seeking among young people with depressive disorders.

Perceived social support and family members of patients with mental disorders: A mixed method study

“…The needs for social relationships and social acceptance were the subcategories of social support concern, which is consistent with quantitative results. Studies have shown that one of the most common and most challenging social pressures on these families is stigma ( 32 , 39 , 40 ). The stigmatizations are mostly due to the general perspective of the community about the lack of competence of the family to look after the patient has led to the initiation or intensification of the disease ( 32 ).…”

“…The stigmatizations are mostly due to the general perspective of the community about the lack of competence of the family to look after the patient has led to the initiation or intensification of the disease ( 32 ). The blame is usually followed by a sense of shame in the family, and to adapt to it, the family tries to avoid social situations and keep the patient hidden from society ( 40 ). Karanci et al argued that improper intervention of the patient and family, deserting, and belittling might create negative perceptions in family members and even eliminate their ability to care for the patient ( 11 ).…”

Experiences with Family Planning amongst Persons with Mental Health Problems: A Nationwide Patient Survey

“…Furthermore, (former) patients felt supported in their mental health problems to a lesser extent than close ones indicated. Feeling an absence of support can negatively impact mental health, as unsupportive responses to mental health problems make it less likely that patients would seek help, as illustrated in another sample of patients with mental health problems and their close ones [ 24 ]. In addition, fear of being stigmatized added to the reluctance of patients to express their worries and needs to close ones and mental health professionals [ 24 , 25 ].…”

Gender Differences in Alcohol Use: a Nationwide Study in a Multiethnic Population

“…A strong family unit and collectivist culture could be a possible explanation for an earlier age of recovery for females in Singapore. However, shame and stigma are also associated and deeply rooted in Singapore culture, especially when it comes to help-seeking, which should not be overshadowed by females earlier age of recovery (Samari et al, 2022). Further study to examine the underlying motivations to achieve earlier recovery among females in Singapore could help inform future interventions.…”