Stigma Toward Mental Health Treatment: Do Predisposing Factors Predict Stigma Avoidance?

Purpose:

A considerable number of studies have pointed out disparities in mental health service utilization related to predisposing factors such as race/ethnicity, gender, and age. Most ethnic minority groups, men, and young adults are less likely to seek help from mental health professionals. Prior studies suggested high unmet needs among these groups are associated with and their concerns about stigma and limited accessibility to care. However, a limited number of empirical studies examined whether these groups’ unmet needs for mental health treatment are related to stigma on mental health help-seeking. This study, using a nationally representative sample, will examine whether unmet needs mental health treatment among men, ethnic monitories, and young adults are associated stigma avoidance after controlling for enabling and need factors.

Methods:

This study analyzed data from the 2012 National Survey on Drug Use and Health (the U.S. Department of Health and Human Services Substance Abuse and Mental Health Service Administration). The sample for the analysis included 2,537 adults who reported unmet needs for mental health treatment. Binomial regression analysis tested whether predisposing factors (ethnicity, age, gender), enabling factors (income, insurance), and a need factor (having any mental illness in the past year) are associated with the likelihood that they did not seek treatment to avoid stigma. The following three reasons for not seeking mental health treatment were considered as stigma avoidance: fear of neighbors’ negative opinions, fear of negative effects on job, and not wanting others to find out about the treatment.

 Results:

The overall model is a fit to the data than the null model (X²=40.56; p<.001). Analysis of parameter estimates showed that gender and age are predisposing factors that are associated with stigma avoidance in mental health service utilization. Men had higher probability of reporting stigma as a reason for not seeking mental health treatment (OR=1.29). Similarly, young adults aged between 18 and 25 were more liked to report stigma avoidance as a reason for not seeking treatment (OR= 2.03), compared to adults older than 50. Race/ethnicity, however, was not a significant predictor for stigma avoidance. Having insurance (OR=.1.42) and having any mental illness in the past year (OR=1.28) were associated with the increased odds of reporting sigma avoidance as a reason for unmet needs for mental health treatment. 

Discussion:

The results showed that men and young adults, but not ethnic minorities, were significantly more likely to report stigma avoidance as a reason for not receiving mental health treatment after they recognized a need for help. The results from the current study imply that social workers who work with men and younger adults should address stigma on mental health help-seeking to increase their mental health service utilization. Social workers who work with ethnic minority clients who have potential mental health needs should broadly explore barriers to mental health care such as health belief, subjective definitions of mental disorders, and a limited accessibility to care.