Rural‐Urban Differences in Stigma and the Use of Care for Depressive Disorders

Abstract

Stigma may be a particularly important barrier to mental health care in rural communities where lack of anonymity increases the probability that someone who seeks care will be labeled "crazy." This study examined rural-urban differences in the stigma associated with depressive symptoms and the stigma associated with seeking treatment for depressive disorders. In addition, the study compared how the stigma associated with seeking treatment predicted use of care in rural and urban residents with a history of depressive symptoms. Two hundred subjects from metropolitan and adjacent non-metropolitan counties rated one of four randomly selected vignettes using 14-point semantic differential scales. The findings indicated that rural residents with a history of depressive symptoms labeled people who sought professional help for the disorder somewhat more negatively than their urban counterparts. Logistic models controlling for sociodemographic characteristics demonstrated that the more negative the labeling, the less likely depressed rural residents were to have sought professional help. Labeling was not associated with use of care among urban people with depressive symptoms. We concluded that prospective studies are warranted to inform the development of interventions to decrease the stigma associated with seeking treatment for depressive disorders in rural communities.

Cross-sectional population based study ascertaining the characteristics of US rural adults with mental health concerns who perceived a stigma regarding mental health issues

“…This study confirmed the findings previously reported that suggested rural populations perceive greater levels of stigma related to mental health when compared to non-rural US populations [16]. Our study further specified the characteristics of rural adults with mental health concerns that were more likely to perceive stigma related to mental health issues.…”

Food insecurity and maternal depression in rural, low-income families: a longitudinal investigation

“…Research shows that rural residents with a history of depression are less likely to seek professional help (35,36) . Further, stigma (37,38) and lack of anonymity (39) prevent many rural residents from seeking psychological care.…”

Travel Distance and the Use of Inpatient Care among Patients with Schizophrenia

“…Rost et al (1993) found that rural residents with depression were more likely to express more negative views (i.e. stigma) with respect to seeking professional care than urban residents.…”

“…Because stigma can discourage the use of psychiatric care (e.g. Rost et al 1993), rural residency influences the use of health care through its contextual effect on perceived stigma.…”