The Association of Self-Stigma with Mental Health Help-Seeking Beliefs, Hope, and Social Support Among an Undergraduate Sample: A Cross-Sectional Study

Background and purpose: College students’ attitudes towards help-seeking are important to consider due to the onset of many serious mental illnesses in early adulthood, poorer psychosocial outcomes associated with untreated mental health conditions, and the environmental stressors postsecondary students may experience at university (Eisenberg et al., 2009). Inadequate social support is associated with greater risk of mental distress. However, self-stigma is a significant barrier to seeking treatment for mental distress. Informed by Snyder’s (1996) model of hope, greater self-stigma towards seeking help may be associated with low perceived agency and lack of pathways to goal attainment. The research explores the relationship of social support, hope, openness towards and perceived utility of help-seeking to self-stigma among an undergraduate sample.

Methods: We used a mixed mode design consisting of both online sampling via Qualtrics recruited from psychology subject pool and paper surveys distributed directly to undergraduates (N = 223) from various departments in a private, Midwestern university. Participants were primarily young adults (M = 19.9, SD = 2.3), female identifying (84.3%, n = 188), and white (76.6%, n = 170). All class levels were represented: freshman (37.84%, n = 84); sophomores (17.12%, n = 38); juniors (20.72%, n = 46); seniors (24.32%, n = 54). Bivariate relationships among self-stigma and study variables were explored prior to using multiple OLS regression to test the relationship of the self-stigma to two components of help seeking behaviors (openness towards and perceived utility help-seeking), hope (agency and pathways), and social support when adjusting for demographic variables.

Findings: Correlation analyses showed self-stigma was inversely associated with social support (r = -.18, p = .005), agency (r = -.21, p = .002), pathways (r = - .32, p < .001), openness toward help-seeking (r = -.49, p < .001) and valuing the utility of help-seeking (r = -.48, p < .001). The regression results accounted for 35.7% of the variance in self-stigma scores (F_{(10, 208)} = 11.57, p < .001, R²_adj = .327). Greater openness to help-seeking (β = -.31, p < .001) and the perceived utility of help-seeking (β = -.29, p < .001) were inversely associated with self-stigma. Hope, operationalized as agency and pathways, accounted for 4.3% of the variance in self-stigma scores (p = .001), but only hope-pathways was significantly associated with lower self-stigma (β = -.23, p = .002). Class level, gender, race, and social support did not significantly contribute to the model (p > .05).

Conclusions and Implications: Self-stigma of seeking help for mental distress was associated with less openness and lower perceived utility for seeking help, as well as less belief in having pathways to attain goals. Gender and racial differences in self-stigma were unobserved possibly due to low representation of males and racial/ethnic minorities in the sample. Researchers may build from current findings to inform experimental studies aimed at identifying intra- and interpersonal factors contributing to self-stigma. Researchers and mental health professionals serving in undergraduate settings may consider how motivational interviewing approaches may enhance help-seeking for mental distress.