The Impact of Mental Health Literacy, Stigma, and Social Support on Attitudes Toward Mental Health Help-Seeking

Background and Purpose: Underutilization of mental health care or delayed help-seeking places a heavy economic and social cost on individuals, families, communities, and the nation. However, people are often reluctant to seek mental health care. Mental health literacy, stigma, and social support are significantly associated with attitudes toward mental health help-seeking. Yet, few studies examine the ways in which these variables collectively influence attitudes toward mental health help-seeking. Guided by the Theory of Reasoned Action, this study built a model to examine the roles of mental health literacy, stigma, and social support on attitudes toward mental health help-seeking. Two types of stigma—personal stigma and self-stigma—were included as mediators. It was hypothesized that mental health literacy and social support would have direct relationships with attitudes toward mental health help-seeking; and both personal and self-stigma would mediate relationships between mental health literacy and attitudes toward mental health help-seeking.

Methods: A sample of 191 survey data was drawn from a cross-sectional survey that examined the mental health literacy of a local public housing staff in Texas. The survey questionnaire included: a 30-item mental health literacy measure; a social distance scale measuring personal stigma; one item measuring self-stigma and social support; three items measuring attitudes toward mental health help-seeking; and demographics. Structural Equation Modeling was used to test proposed hypotheses.

Results: The results from structural equation modeling (χ² (613, N = 191) = 688.72, p = .02; RMSEA = .03 (.01 - .04); CFI = .94; and TLI = .94) suggested that the data fit the hypothesized model well. Mental health literacy (β = .58, p = .009) and social support (β = .27, p = .003) positively predicted attitudes toward mental health help-seeking. Neither personal stigma nor self-stigma mediated the relationship between mental health literacy and attitudes toward mental health help-seeking. Of two stigma measures, only self-stigma was a significant factor related to attitudes (β = .22, p = .001).

Conclusions and Implications: Findings suggest that people who had higher mental health literacy scores, stronger social support for mental health care, and lower self-stigma about receiving professional mental health services were likely to have favorable attitudes toward mental health help-seeking. As supporting others to seek professional mental health care is likely to be related to knowledge and beliefs about mental illness and treatment resources, mental health literacy of, not only people with mental illness, but also those in social support system are critical in facilitating mental health care. Results imply that social workers have a critical role in assessing mental health literacy of clients, as well as of the clients’ support system in order to provide adequate mental health education.