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Stigma as a barrier to recognizing personal mental illness and seeking help: a prospective study among untreated persons with mental illness

Schomerus, Georg, Stolzenburg, Susanne, Freitag, Simone, Speerforck, Sven, Janowitz, Deborah, Evans-Lacko, Sara ORCID: 0000-0003-4691-2630, Muehlan, Holger and Schmidt, Silke (2018) Stigma as a barrier to recognizing personal mental illness and seeking help: a prospective study among untreated persons with mental illness. European Archives of Psychiatry and Clinical Neuroscience. ISSN 0940-1334

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Identification Number: 10.1007/s00406-018-0896-0


Background: It is unclear to what extent failure to recognize symptoms as potential sign of a mental illness is impeding service use, and how stigmatizing attitudes interfere with this process. Methods: In a prospective study, we followed a community sample of 188 currently untreated persons with mental illness (predominantly depression) over 6 months. We examined how lack of knowledge, prejudice and discrimination impacted on self-identification as having a mental illness, perceived need, intention to seek help, and help-seeking, both with respect to primary care (visiting a general practitioner, GP) and specialist care (seeing a mental health professional, MHP). Results: 67% sought professional help within 6 months. Fully saturated path models accounting for baseline depressive symptoms, previous treatment experience, age and gender showed that self-identification predicted need (beta 0.32, p<0.001), and need predicted intention (GP: beta 0.45, p<0.001; MHP: beta 0.38, p<0.001). Intention predicted service use with a MHP after 6 months (beta 0.31, p<0.01; GP: beta 0.17, p=0.093). More knowledge was associated with more self-identification (beta 0.21, p<0.01), while support for discrimination was associated with lower self-identification (beta -0.14, p<0.05). Blaming persons with mental illness for their problem was associated with lower perceived need (beta -0.16, p<0.05). Our models explained 37% of the variance of seeking help with a MHP, and 33% of help-seeking with a GP. Conclusions: Recognizing one’s own mental illness and perceiving a need for help are impaired by lack of knowledge, prejudice, and discrimination. Self-identification is a relevant first step when seeking help for mental disorders.

Item Type: Article
Official URL:
Additional Information: © 2018 Springer-Verlag GmbH Germany, part of Springer Nature
Divisions: Personal Social Services Research Unit
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Date Deposited: 24 Apr 2018 13:57
Last Modified: 20 Oct 2021 00:38
Projects: SCHO 1337/4-1, SCHM 2683/4-1
Funders: Deutsche Forschungsgemeinschaft

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