The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care

Abstract

Treatments have been developed and tested to successfully reduce the symptoms and disabilities of many mental illnesses. Unfortunately, people distressed by these illnesses often do not seek out services or choose to fully engage in them. One factor that impedes care seeking and undermines the service system is mental illness stigma. In this article, we review the complex elements of stigma in order to understand its impact on participating in care. We then summarize public policy considerations in seeking to tackle stigma in order to improve treatment engagement. Stigma is a complex construct that includes public, self, and structural components. It directly affects people with mental illness, as well as their support system, provider network, and community resources. The effects of stigma are moderated by knowledge of mental illness and cultural relevance. Understanding stigma is central to reducing its negative impact on care seeking and treatment engagement. Separate strategies have evolved for counteracting the effects of public, self, and structural stigma. Programs for mental health providers may be especially fruitful for promoting care engagement. Mental health literacy, cultural competence, and family engagement campaigns also mitigate stigma's adverse impact on care seeking. Policy change is essential to overcome the structural stigma that undermines government agendas meant to promote mental health care. Implications for expanding the research program on the connection between stigma and care seeking are discussed.

Service user and caregiver involvement in mental health system strengthening in low- and middle-income countries: a cross-country qualitative study

“…This study shows that stigma is also the major barrier to service user and caregiver participation. Feelings of disempowerment are commonly reported among service users as a result of stigma (Corrigan et al 2014). This was emphasised by participants from Ethiopia and Nepal who mentioned not having the know-how or feeling empowered enough to participate and interact in health system processes.…”

Contextualizing public stigma: Endorsed mental health treatment stigma on college and university campuses

“…Since Erving Goffman's (1963) seminal work on the topic, the volume of research on stigma has rapidly expanded, spawning multiple major review articles in the past two decades alone (Clement et al 2015;Corrigan, Druss, and Perlick 2014;Gulliver, Griffiths, and Christensen 2010;Link and Phelan 2001;Major and O'Brien 2005;Parcesepe and Cabassa 2013;Pescosolido and Martin 2015). This heightened attention is, in part, due to the important associations between stigma and the severity of mental illness symptoms (Andrade et al 2014;Brown 2017;Drapalski et al 2013), disclosure of conditions to friends, family, and healthcare professionals (Dew et al 2007;Donnelly 2017;Prior et al 2003), self-esteem (Corrigan 2004;Corrigan and Watson 2002;Corrigan, Watson, and Barr 2006), and treatment-seeking behavior (Clement et al 2015;Tsang, Fung, and Chung 2010;Vogel, Wade, and Haake 2006).…”

Investigating the Prevalence and Risk Factors of Depression Symptoms among NCAA Division I Collegiate Athletes

“…Increasing the awareness of mental health issues through education and the promotion of available resources can increase the awareness and recognition of mental illness [38]. Educational and contact interventions have also been successful in reducing the stigma around mental health-notably still present in athletics [11] and a significant barrier to accessing treatment [39]-and have led to improvements in overall attitudes about mental health treatment [40].…”