The Relationship between Stigma and Other Treatment Concerns and Subsequent Treatment Engagement among Black Mental Health Clients

Abstract

This study examined stigma (both the perception that mental illness is stigmatized and stigma concerns about entering treatment) and other treatment concerns along with subsequent treatment engagement within three months in a sample of 42 black adults referred to public-sector outpatient treatment. Contrary to expectation, perceived stigma of mental illness was unrelated to treatment engagement; however having stigma or other concerns about treatment was associated with increased odds of engagement. Findings indicate the importance of examining stigma as a multi-dimensional construct and raise questions about the utility of addressing stigma as a way of promoting service use in black adults. More work is clearly needed to understand the complex relationship between stigma and help-seeking in black populations and other underserved groups.

The Measure of Sickle Cell Stigma: Initial findings from the Improving Patient Outcomes through Respect and Trust study

“…Recent reports also support this view (Earnshaw et al, 2012, 2013). These added dimensions permit us to analyze stigma as a multidimensional construct (Alvidrez et al, 2010; Bresnahan and Zhuang, 2011; Sayles et al, 2008) and make our work consistent with the classic conceptualization of stigma as “the co-occurrence” of labeling, stereotyping, separation, status loss, and discrimination (Link and Phelan, 2001). …”

Mental Health–Related Discrimination as a Predictor of Low Engagement With Mental Health Services

“…There were few such studies of other forms of stigma or discrimination and their impact on engagement. One study showed that perceived discrimination and devaluation was related to lower engagement with psychotherapy services (8), and another did not (9). A third found a negative relationship between self-stigma and psychosocial treatment adherence (10).…”

Church-Based Health Programs for Mental Disorders Among African Americans: A Review

“…A recent review concluded that CBPR has “great potential for helping reduce mental health treatment disparities among minorities and other underserved populations” (78). Church-based, collaborative research processes could help build trust and reduce stigma associated with research that is especially strong in the African American community (8, 79-81). …”