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3 - Disentangling Mental Illness and Help-Seeking Stigmas

from Part I - Understanding Stigma and Mental Health

Published online by Cambridge University Press:  28 July 2022

By
Rachel E. Brenner ,
Madison R. Egli  and
Joseph H. Hammer
Edited by
David L. Vogel  and
Nathaniel G. Wade
David L. Vogel
Affiliation:
Iowa State University
Nathaniel G. Wade
Affiliation:
Iowa State University
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Summary

This chapter provides an overview and delineation of the four major stigmas related to mental illness and seeking psychological help: public stigma of mental illness, public stigma of seeking help, self-stigma of mental illness, and self-stigma of seeking help. It begins with discussion of a theoretical model that distinguishes these four stigmas, outlines how they relate to each other, and asserts how they relate to mental health and help-seeking outcomes. We then discuss the evidence for the assertions of the model and the theoretical distinction of these forms of stigma. The chapter concludes with discussion of a possible new type of stigma, future directions, and cultural considerations.

Keywords

help seekingmental illnesspublic stigmaself-stigmacounseling
Type
Chapter
Information
The Cambridge Handbook of Stigma and Mental Health , pp. 31 - 51
Publisher: Cambridge University Press
Print publication year: 2022

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References

Al-Krenawi, A., Graham, J. R., Dean, Y. Z., & Eltaiba, N. (2004). Cross-national study of attitudes towards seeking professional help: Jordan, United Arab Emirates (UAE) and Arabs in Israel. International Journal of Social Psychiatry, 50(2), 102–114.Google Scholar
Ben-Porath, D. (2002). Stigmatization of individuals who receive psychotherapy: An interaction between help-seeking behavior and the presence of depression. Journal of Social and Clinical Psychology, 21, 400–413. https://doi.org/10.1521/jscp.21.4.400.22594Google Scholar
Blaine, B. E. (2000). The Psychology of Diversity: Perceiving and Experiencing Social Difference. McGraw-Hill Humanities, Social Sciences & World Languages.Google Scholar
Borgogna, N. C., McDermott, R. C., Aita, S. L., & Kridel, M. M. (2019). Anxiety and depression across gender and sexual minorities: Implications for transgender, gender nonconforming, pansexual, demisexual, asexual, queer, and questioning individuals. Psychology of Sexual Orientation and Gender Diversity, 6(1), 54.Google Scholar
Brenner, R. E., Cornish, M. A., Heath, P. J., Lannin, D. G., & Losby, M. (2020). Seeking help despite the stigma: Experiential avoidance as a moderated mediator. Journal of Counseling Psychology, 67(1), 132–140. https://doi.org/10.1037/cou0000365Google Scholar
Brenner, R. E., Hammer, J. H., Vogel, D. L., et al. (2019, August). Extending the theoretical understanding of mental illness and help-seeking self-stigmas [Poster presentation]. The 127th Annual Convention of the American Psychological Association, Chicago, IL, United States.Google Scholar
Brown, C., Conner, K. O., Copeland, V. C., et al. (2010). Depression stigma, race, and treatment seeking behavior and attitudes. Journal of Community Psychology, 38, 350–368.Google Scholar
Conner, K. O., Copeland, V. C., Grote, N. K., et al. (2010). Mental health treatment seeking among older adults with depression: The impact of stigma and race. American Journal of Geriatric Psychiatry, 18, 531–543.CrossRefGoogle ScholarPubMed
Cook, T. M., & Wang, J. (2010). Descriptive epidemiology of stigma against depression in a general population sample in Alberta. BMC Psychiatry, 10(1), 1–11.CrossRefGoogle Scholar
Corbiere, M., Zaniboni, S., Lecomte, T., et al. (2011). Job acquisition for people with severe mental illness enrolled in supported employment programs: A theoretically grounded empirical study. Journal of Occupational Rehabilitation, 21(3), 342–354.Google Scholar
Cornish, M. A., Brenner, R. E., Vogel, D. L., & Wade, N. G. (2019). Evaluation of an online help seeking stigma-reduction intervention for military personnel. Stigma and Health, 4(4), 480–486. https://doi.org/10.1037/sah0000167CrossRefGoogle Scholar
Corrigan, P. W. (2004). How stigma interferes with mental health care. American Psychologist, 59, 614–625. https://doi.org/10.1037/0003-066X.59.7.614CrossRefGoogle ScholarPubMed
Corrigan, P. W., Kerr, A., & Knudsen, L. (2005). On the stigma of mental illness: Explanatory models and methods for change. Applied and Preventive Psychology, 11, 179–190.Google Scholar
Corrigan, P. W., Michaels, P. J., Vega, E., et al. (2012). Self-Stigma of Mental Illness Scale-Short Form: Reliability and validity. Psychiatr Res, 199, 65–69.Google Scholar
Corrigan, P. W., Rafacz, J., & Rusch, N. (2011). Examining a progressive model of self-stigma and its impact on people with serious mental illness. Psychiatry Research, 189, 339–343.Google Scholar
Corrigan, P. W., & Watson, A. C. (2002). Understanding the impact of stigma on people with mental illness. World Journal of Psychiatry, 1, 16–19.Google Scholar
Corrigan, P. W., Watson, A. C., & Barr, L. (2006). The self-stigma of mental illness: Implications for self-esteem and self-efficacy. Journal of Social and Clinical Psychology, 25, 875–884. https://doi.org/10.1521/jscp.2006.25.8.875Google Scholar
Cross, S. E., Gore, J. S., & Morris, M. L. (2003). The relational- interdependent self-construal, self-concept consistency, and well-being. Journal of Personality and Social Psychology, 85, 933–944. https://doi.org/10.1037/0022-3514.85.5.933Google Scholar
Druss, B. G., Rask, K., & Katon, W. J. (2008). Major depression, depression treatment and quality of primary medical care. General Hospital Psychiatry, 30(1), 20–25.Google Scholar
Evans-Lacko, S., Brohan, E., Mojtabai, R., & Thornicroft, G. (2012). Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries. Psychological Medicine, 42(8), 1741–1752.Google Scholar
Farina, A., Gliha, D., Bourdreau, L. A., Ale, J. G., & Sherman, M. (1971). Mental illness and the impact of believing others know about it. Journal of Abnormal Psychology, 77(1), 1.Google Scholar
Fox, A. B., Smith, B. N., & Vogt, D. (2018). How and when does mental illness stigma impact treatment seeking? Longitudinal examination of relationships between anticipated and internalized stigma, symptom severity, and mental health service use. Psychiatry Research, 268, 15–20.Google Scholar
Freeman, H. E. (1961). Attitudes toward mental illness among relatives of former patients. American Sociological Review, 26, 59–66. https://doi.org/10.2307/2090513Google Scholar
Fung, K., & Tsang, H. (2010). Self-stigma, stages of change and psychosocial treatment adherence among Chinese people with schizophrenia: A path analysis. Social Psychiatric Epidemiology, 45, 561–568. https://doi.org/10.1007/s00127-009-0098-1Google Scholar
Gonçalves, M., Cook, B., Mulvaney-Day, M., Kynrys, G., & Alegria, M. (2013). Adequacy of care in a Portuguese culturally and linguistically targeted mental health care setting. Transcultural Psychiatry, 50, 92–107.Google Scholar
Güneri, O., & Skovholt, T. (1999). Comparative study of counseling needs of American and Turkish students. Unpublished manuscript. Middle East Technical University, Ankara, Turkey.Google Scholar
Heath, P. J., Brenner, R. E., Lannin, D. G., & Vogel, D. L. (2018). Self-compassion moderates the relationship of public and self-stigma of seeking help. Stigma and Health, 3, 65–68. https://doi.org/10.1037/sah0000072Google Scholar
Heath, P. J., Brenner, R. E., Vogel, D. L., Lannin, D. G., & Strass, H. A. (2017). Masculinity and barriers to seeking counseling: The buffering role of self-compassion. Journal of Counseling Psychology, 64, 94–103. https://doi.org/10.1037/cou0000185CrossRefGoogle ScholarPubMed
Heath, P. J., Vogel, D. L., & Al-Darmaki, F. R. (2016). Help-seeking attitudes of United Arab Emirates students: Examining loss of face, stigma, and self-disclosure. The Counseling Psychologist, 44(3), 331–352.Google Scholar
Hilliard, R. C., Redmond, L. A., & Watson, J. C. (2019). The relationships among self-compassion, stigma, and attitudes toward counseling in student-athletes. Journal of Clinical Sport Psychology, 13(3), 374–389.CrossRefGoogle Scholar
Hughes, C., Fujita, K., & Krendl, A. C. (2020). Psychological distance reduces the effect of internalized stigma on mental health treatment decisions. Journal of Applied Social Psychology, 50(8), 489–498.Google Scholar
İmamoğlu, E. O. (2003). Individuation and relatedness: Not opposing but distinct and complementary. Genetic, Social, and General Psychology Monographs, 129, 367–402.Google Scholar
Jorm, A. F., & Wright, A. (2008). Influences on young people’s stigmatising attitudes towards peers with mental disorders: National survey of young Australians and their parents. The British Journal of Psychiatry, 192(2), 144–149.CrossRefGoogle Scholar
Kağıtçıbaşı, Ç. (2012). Sociocultural change and integrative syntheses in human development: Autonomous-related self and social-cognitive competence. Child Development Perspectives, 6, 5–11. https://doi.org/10.1111/j.1750-8606.2011.00173.xGoogle Scholar
Kessler, R. C., Andrews, G., Colpe, L. J., et al. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32, 959–976. https://doi.org/10.1017/s0033291702006074Google Scholar
King, P., Newton, F., Osterlund, B., & Baber, B. (1973). A counseling center studies itself. Journal of College Student Personnel, 14, 338–344.Google Scholar
Komiya, N., Good, G., & Sherod, N. (2000). Emotional openness as a predictor of college students’ attitudes toward seeking psychological help. Journal of Counseling Psychology, 47, 138–143. https://doi.org/10.1037/0022-0167.47.1.138CrossRefGoogle Scholar
Lam, L. C. W., Wong, C. S. M., Wang, M. J., et al. (2015). Prevalence, psychosocial correlates and service utilization of depressive and anxiety disorders in Hong Kong: The Hong Kong Mental Morbidity Survey (HKMMS). Social Psychiatry and Psychiatric Epidemiology, 50(9), 1379–1388.Google Scholar
Lannin, D. G., Guyll, M., Vogel, D. L., & Madon, S. (2013). Reducing the stigma associated with seeking psychotherapy through self-affirmation. Journal of Counseling Psychology, 60(4), 508–519. https://doi.org/10.1037/a0033789Google Scholar
Lannin, D. G., Vogel, D. L., Brenner, R. E., Abraham, W. T., & Heath, P. J. (2016). Does self-stigma reduce the probability of seeking mental health information? Journal of Counseling Psychology, 63, 351–358.CrossRefGoogle ScholarPubMed
Lannin, D. G., Vogel, D. L., Brenner, R. E., & Tucker, J. R. (2015). Predicting self-esteem and intentions to seek counseling: The internalized stigma model. The Counseling Psychologist, 43, 64–93. http://dx.doi.org/10.1177/0011000014541550Google Scholar
Lee, S., Lee, M. T., Chiu, M. Y., & Kleinman, A. (2005). Experience of social stigma by people with schizophrenia in Hong Kong. The British Journal of Psychiatry, 186(2), 153–157.Google Scholar
Link, B. (1987). Understanding labelling effects in the area of mental disorders: An assessment of the effects of expectations of rejection. American Sociological Review, 52, 96–112.Google Scholar
Link, B. G., Cullen, F. T., Struening, E., Shrout, P. E., & Dohrenwend, B. P. (1989). A modified labelling theory approach to mental disorders: An empirical assessment. American Sociological Review, 54, 400–423.Google Scholar
Ludwikowski, W., Vogel, D. L., & Armstrong, P. I. (2009). Attitudes towards career counseling: The role of public and self-stigma. Journal of Counseling Psychology, 56, 408–416.CrossRefGoogle Scholar
Link, B. G., & Phelan, J. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363–385. www.jstor.org/stable/2678626CrossRefGoogle Scholar
Mackenzie, C. S., Visperas, A., Ogrodniczuk, J. S., Oliffe, J. L., & Nurmi, M. A. (2019). Age and sex differences in self-stigma and public stigma concerning depression and suicide in men. Stigma and Health, 4(2), 233–241. https://doi.org/10.1037/sah0000138Google Scholar
Mak, W. W., & Cheung, R. Y. (2010). Self-stigma among concealable minorities in Hong Kong: Conceptualization and unified measurement. American Journal of Orthopsychiatry, 80(2), 267.Google Scholar
Markus, H. R., & Kitayama, S. (1991). Culture and the self: Implications for cognition, emotion, and motivation. Psychological Review, 98, 224–253. https://doi.org/10.1037/0033-295X.98.2.224Google Scholar
Mathison, L. A., Seidman, A. J., Brenner, R. E., Wade, N. G., Heath, P. J., & Vogel, D. L. (2021). A heavier burden of stigma? Comparing outpatient and inpatient help-seeking stigma. Stigma and Health. Advance online publication. https://doi.org/10.1037/sah0000330Google Scholar
Maura, J., & de Mamani, A. W. (2017). Mental health disparities, treatment engagement, and attrition among racial/ethnic minorities with severe mental illness: A review. Journal of Clinical Psychology in Medical Settings, 24(3), 187–210.CrossRefGoogle ScholarPubMed
Mellor, D., Carne, L., Shen, Y. C., McCabe, M., & Wang, L. (2013). Stigma toward mental illness: A cross-cultural comparison of Taiwanese, Chinese immigrants to Australia and Anglo-Australians. Journal of Cross-Cultural Psychology, 44(3), 352–364.Google Scholar
Mocan-Aydin, G. (2000). Western models of counseling and psychotherapy within Turkey: Crossing cultural boundaries. The Counseling Psychologist, 28, 281–298. https://doi.org/10.1177/0011000000282007CrossRefGoogle Scholar
Parcesepe, A. M., & Cabassa, L. J. (2013). Public stigma of mental illness in the United States: A systematic literature review. Administration and Policy in Mental Health and Mental Health Services Research, 40(5), 384–399.Google Scholar
Reise, S. P., Moore, T. N., & Haviland, M. G. (2010). Bifactor models and rotations: Exploring the extent to which multidimensional data yield univocal scale scores. Journal of Personality Assessment, 92, 544–559.Google Scholar
Ritsher, J. B., Otilingam, P. G., & Grajales, M. (2003). Internalized stigma of mental illness: Psychometric properties of a new measure. Psychiatry Research, 121, 31–49.Google Scholar
Sartorius, N., & Schulze, H. (2005). Reducing the Stigma of Mental Illness: A Report from a Global Association. Cambridge University Press.Google Scholar
Seidman, A. J., Lannin, D. G., Heath, P. J., & Vogel, D. L. (2019). Setting the stage: The effect of affirming personal values before psychotherapy intake screenings on perceptions of self-stigma and self-disclosure. Stigma and Health, 4(3), 256–259.Google Scholar
Seidman, A. J., Wade, N. G., Lannin, D. G., et al. (2018). Self-affirming values to increase student veterans’ intentions to seek counseling. Journal of Counseling Psychology, 65, 653–660. https://doi.org/10.1037/cou0000289Google Scholar
Seidman, A. J., Wade, N. G., Vogel, D. L., & Armistead-Jehle, P. (2019). The impact of stigma on behavioral health care utilization among active duty service members, Military Psychology, 31(1), 11–17, https://doi.org/10.1080/08995605.2018.1522927Google Scholar
Shechtman, Z., Alim, E., Brenner, R. E., & Vogel, D. L. (2018). Public stigma, self-stigma, and intentions to seek group therapy help among clinical and non-clinical Arab adults in Israel. International Journal of Culture and Mental Health, 11, 595–604. https://doi.org/10.1080/17542863.2018.1461913Google Scholar
Sibicky, M., & Dovidio, J. (1986). Stigma of psychological therapy: Stereotypes, interpersonal reactions, and the self-fulfilling prophecy. Journal of Counseling Psychology, 33, 148–154. https://doi.org/10.1037/0022-0167.33.2.148Google Scholar
Topkaya, N. (2011). Psikolojik yardım alma nedeniyle kendini damgalama ölçeğinin geçerlik ve güvenirlik çalışması. XI. Psikolojik Danışma ve Rehberlik Kongresi, Ekim.Google Scholar
Topkaya, N., Vogel, D. L., & Brenner, R. E. (2017). Cross-cultural decisions to seek therapy: Examination of the stigmas toward seeking mental health services among Turkish college students. Journal of Counseling & Development, 95, 213–225. https://doi.org/10.1002/jcad.12133Google Scholar
Towle, C. B., & Arslanoglu, T. (1998). Turkish-Americans. Transcultural Health Care: A Culturally Competent Approach, 1–40.Google Scholar
Tucker, J. R., Hammer, J. H., Vogel, D. L., et al. J. (2013). Disentangling self-stigma: Are mental illness and help-seeking self-stigmas different? Journal of Counseling Psychology, 60, 520–531. https://doi.org/10.1037/a0033555Google Scholar
Vogel, D. L., Armstrong, P. I., Tsai, P. C., et al. (2013). Cross-cultural validity of the Self-Stigma of Seeking Help (SSOSH) scale: Examination across six nations. Journal of Counseling Psychology, 60(2), 303.Google Scholar
Vogel, D. L., Bitman, R. L., Hammer, J. H., & Wade, N. G. (2013). Is stigma internalized? The longitudinal impact of public stigma on self-stigma. Journal of Counseling Psychology, 60, 311.Google Scholar
Vogel, D. L., Heath, P. J., Engel, K. E., et al. (2019). Cross-cultural validation of the perceptions of stigmatization by others for seeking help (PSOSH) scale. Stigma and Health, 4(1) 82–85. https://doi.org/10.1037/sah0000119Google Scholar
Vogel, D. L., Strass, H. A., Heath, P. J., et al. (2017). Stigma of seeking psychological services: Examining college students across ten countries/regions. The Counseling Psychologist, 45, 170–192. https://doi.org/10.1002/jcad.12133Google Scholar
Vogel, D. L., Wade, N. G., & Ascheman, . (2009). Measuring perceptions of stigmatization by others for seeking psychological help: Reliability and validity of a new stigma scale with college students. Journal of Counseling Psychology, 56, 301–308. https://doi.org/10.1037/a0014903Google Scholar
Vogel, D. L., Wade, N. G., & Haake, S. (2006). Measuring the self-stigma associated with seeking psychological help. Journal of Counseling Psychology, 53, 325–337.Google Scholar
Vogel, D. L., Wade, N. G., & Hackler, A. H. (2007). Perceived public stigma and the willingness to seek counseling: The mediating roles of self-stigma and attitudes toward counseling. Journal of Counseling Psychology, 54, 40–50.Google Scholar
Vogt, D., Di Leone, B. A. L., Wang, J. M., et al. (2014). Endorsed and Anticipated Stigma Inventory (EASI): A tool for assessing beliefs about mental illness and mental health treatment among military personnel and veterans. Psychological Services, 11(1), 105–113. https://doi.org/10.1037/a0032780Google Scholar
Wade, N. G., Vogel, D. L., Armistead-Jehle, P., et al. (2015). Modeling stigma, help-seeking attitudes, and intentions to seek behavioral healthcare in a clinical military sample. Psychiatric Rehabilitation Journal, 38(2), 135–141. https://doi.org/10.1037/prj0000131Google Scholar
Watson, A. C., Corrigan, P., Larson, J. E., & Sells, M. (2007). Self-stigma in people with mental illness. Schizophrenia Bulletin, 33(6), 1312–1318. https://doi.org/10.1093/schbul/sbl076Google Scholar
Yeh, C. J. (2002). Taiwanese students’ gender, age, interdependent and independent self-construal, and collective self-esteem as predictors of professional psychological help-seeking attitudes. Cultural Diversity and Ethnic Minority Psychology, 8, 19–29.CrossRefGoogle ScholarPubMed

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