Mental Health Stigma, Informal Help-Seeking, and Professional Care in Ghana: A Mediation Analysis

Background and Purpose: Stigma surrounding mental health conditions often discourages individuals from seeking professional help. In Ghana, many individuals experiencing mental health concerns prefer to seek help from informal sources, such as faith-based healers. Informal help-seeking may partly explain the link between mental health stigma and professional help-seeking. Understanding the role of informal help-seeking is crucial, as it may either facilitate or hinder access to professional mental health services. This study examines whether informal help-seeking mediates the relationship between mental health stigma and professional help-seeking among Ghanaian adults.

Methods: A convenience sample of 462 Ghanaian adults was recruited from Accra, a predominantly Christian urban center in the South, and Tamale, a largely Muslim area in the North. Participants were enrolled in a larger study investigating Ghanaian individuals' perceptions and beliefs about mental health concerns and six domains of mental health-related stigma. Of the sample, a slight majority identified as male (n = 251, 55.2%). Participants' ages ranged from 18 to 70 years (M = 31.78, SD = 10.59). Most participants (n = 246, 53.9%) reported having some college education or higher, and nearly two-thirds of the sample (n = 283, 61.3%) were employed full-time. Most participants (n = 269, 58.5%) identified as Christians. Data were analyzed using the mediation model with stigma domains as predictors, informal help-seeking as the mediator, and professional help-seeking as the outcome in Mplus 8.2.

Results: The results indicated that informal help-seeking partially mediated the relationship between stigma concerning treatability and professional help-seeking. Furthermore, the results show that individuals with lower levels of treatability-related stigma were more likely to recommend seeking help from informal sources and mental health professionals such as psychologists, counselors, and social workers. Disclosure-related stigma was negatively associated with recommending professional help-seeking. Thus, individuals who believe that revealing their mental health status will lead to stigma or discrimination are less likely to seek professional treatment.

Conclusions and Implications: These findings indicate that informal help-seeking may promote professional help-seeking, which has implications for social policy and direct practice. One policy improvement that can be championed is for the Ghanaian government to intensify efforts to promote collaboration between traditional or faith-based healers and mental health professionals. A sustained collaboration indicates that Ghana is developing an effective multi-disciplinary and culturally adaptive mental health treatment paradigm. Informal sources such as family and friends often provide initial support for individuals managing mental health symptoms. Mental health awareness and education campaigns that seek to enhance mental health literacy can encourage more people to engage with professional mental health services when needed.