Stigma and mental health help-seeking in adolescents: What aspects of stigma are important?

What is it about?

Research suggests that 75% of mental disorders diagnosed in adults are likely to have their onset in adolescence. Help-seeking can contribute to early detection of mental disorders and to delivery of timely interventions, yet most individuals hesitate to seek help for mental health difficulties, while they tend to seek more easily help for physical problems. Adolescents have been identified as one of the least likely cohort to seek mental health help due to a number of reasons, such as limited access to mental health services and stigma. Stigma has been determined as a major barrier against help-seeking for mental health problems in adolescents, typically aged between 12-18 years. Successful help-seeking can result in early intervention for mental disorders, which in turn has been linked to more positive outcomes. Thus, it is important to understand the ways stigma is related to help-seeking behaviours in youth so that we can improve their access to mental health services. Stigma has three distinct components: i) stereotypes, which are negative beliefs about a social group, ii) discrimination, which refers to negative behavioural responses towards members of the group and iii) prejudice, which involves aggressive feelings against the group. Evidence suggests that stigma can be distinguished to personal and public stigma. Public stigma refers to beliefs about other people’s stigmatizing views towards mental health problems, while personal stigma refers to our own stigma beliefs. Evidence from studies in adults shows that different types of stigma can predict help-seeking intentions and in turn help-seeking behaviours for mental health problems. However, we have very little evidence on the relationship between different aspects of stigma and help-seeking intentions in adolescents. We conducted a study to examine the role of personal and public stigma in adolescents’ intentions to seek-help for two frequently occurred mental health problems in this age group: mood disorders (depression and anxiety) and self-harm. Adolescents (n = 722) were recruited from secondary schools in Ireland aged 12 to 18 years and completed online questionnaires about personal and perceived mental health stigma, help-seeking intentions for depression, anxiety and self-harm.

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Photo by Alexis Brown on Unsplash

Photo by Alexis Brown on Unsplash

Why is it important?

We found that public stigma and personal stigma do not predict in the same way adolescents’ intentions to seek help for mental health problems. Public stigma was a stronger predictor of adolescents’ intentions to seek-help for mental health problems than personal stigma. This means that adolescents who believed that other people hold stigmatizing attitudes against mental disorders were less likely to seek-help for mental health problems. We also found that public stigma was linked to decreased likelihood to seek-help in adolescents regardless of their age and gender. How can these findings be used to inform the design of interventions aiming to tackle stigma against mental health and thus improve help-seeking in youth? Interventions can be delivered across three levels: i) at family level, parents and caregivers can create space for talking about mental health problems, thus helping to reduce personal stigma in young people, ii) at school level, school-based interventions can be designed to address different types of stigma by for example enabling contact with people experiencing a diagnosis of depression or anxiety, iii) at community level by increasing knowledge of mental health problems through targeted actions.