Self-Disclosure of Mental Health Identity in the College Classroom: The Role of Stigma and Avoidance

College students have been reporting a high rate of mental health issues. In a national college survey of 67,972 students (American College Health Association, 2019), 56% of students felt hopeless, 66% felt very lonely, and 71% felt very sad in the last year. In another sample, 45% of students reported moderate to severe anxiety and 36% reporting moderate to severe depressive symptoms (Lee et al., 2021). Absent in current research is an understanding of the reasons that students self-disclose these mental health concerns with their classmates. Self-disclosure may have some positive benefits to the individual and may also erode negative societal stereotypes about mental illness in the classroom community (Wood et al., 2014). We tested a model of self-disclosure with predictors of stigma, avoidance, and the interaction term of stigma and avoidance on self-disclosure. We hypothesized stigma would be negatively associated with disclosing mental health identity, only under conditions of lower avoidance motivations.

Students were recruited at a large, public state university where they received a small amount of class credit for participation. A group of 150 students (50.8% of all students) had a mental health identity (endorsed mental health difficulties, medication use, or counseling). These students tended to be female (89.3%), Caucasian (70.7%), and an average of 20 years of age (M = 19.91). When asked about their mental health condition, whereby students could endorse one or more mental health conditions, 82.7% (N = 124) of students endorsed anxiety and 57.3% (N = 86) endorsed depression. Survey questions included the extent of self-disclosure to a classmate, a stigma scale (Link et al., 1991), and an approach/avoidance scale based on the work of Elliott (2006).

A multiple regression model was tested to investigate whether the association between stigma and mental health disclosure depends on avoidance. Variables predicted mental health disclosure to classmates, R2 = .15, F(3, 146) = 8.84, p < .001. The stigma-by-avoidance interaction was significant (B = .30, SE = .10, t = 2.88, p < .01) and significantly impacted the model (ΔR2 = .05, F(1, 146) = 8.28, p < .01). Under medium or high levels of avoidance, stigma did not significantly predict disclosure to classmates, (B = -.02, SE = .08, t = -.22, p = .83) and (B = .18, SE = .12, t = 1.53, p = .13), respectively. However, under low levels of avoidance, stigma negatively predicted disclosure with classmates (B = -.22, SE = .10, t = -2.19, p = .03).

Lower stigma was associated with greater self-disclosure only when students reported low levels of avoidance. This finding connects to prior self-disclosure intervention research with its two-pronged focus on both internalized stigma and an emphasis on how one communicates their mental illness, for example the group intervention of Honest, Open, and Proud (Corrigan et al., 2013). Additional research should attempt to understand the potential benefits of mental health self-disclosure. Just as ableism, sexism, and homophobia can be interrogated in classrooms, students’ self-disclosures may help critique mental health stigma within these educational spaces.