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European Archives of Psychiatry and Clinical Neuroscience
Published in: European Archives of Psychiatry and Clinical Neuroscience 5/2009

01-08-2009 | ORIGINAL PAPER

The stigma of psychiatric treatment and help-seeking intentions for depression

Authors: Dr. Georg Schomerus, Herbert Matschinger, Matthias C. Angermeyer

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 5/2009

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Abstract

Aims

The stigma of mental illness has often been considered a potential cause for reluctant willingness to seek help for mental problems, but there is little evidence on this issue. We examine two aspects of stigma related to seeing a psychiatrist and their association with help-seeking intentions for depression: anticipated discrimination by others when seeking help and desire for social distance from those seeking help.

Methods

Representative population survey in Germany 2007 (n = 2,303), containing a depression vignette with a question on readiness to seek psychiatric care for this problem, a focus group developed scale anticipated discrimination when seeing a psychiatrist (ADSP), and a scale on desire for social distance from someone seeing a psychiatrist (SDSP). We further elicited previous contact to psychiatric treatment, depressive symptoms, and socio-demographic data.

Results

Both scales had good internal consistency (Cronbach’s alpha ADSP 0.87, SDSP 0.81). Exploratory factor analysis of all items revealed a distinct factor representing the social distance scale and three factors “anticipated discrimination”, “anticipated job problems” and “anticipated shame” derived from the ADSP scale. In both the general population and in those with current depressive syndrome, personal desire for social distance significantly decreased willingness to seek psychiatric help, but anticipated discrimination by others did not. Other factors related to likely help-seeking were female gender and previous contact to psychiatric treatment or to psychotherapy.

Conclusion

Contrary to expectations, anticipated discrimination from others was unrelated to help-seeking intentions, while personal discriminatory attitudes seem to hinder help-seeking. Our findings point to self-stigmatization as an important mechanism decreasing the willingness to seek psychiatric help.
Literature
1.
Alonso J, Codony M, Kovess V, Angermeyer MC, Katz SJ, Haro JM et al (2007) Population level of unmet need for mental healthcare in Europe. Br J Psychiatry 190:299–306PubMedCrossRef
2.
Andrews G, Issakidis C, Carter G (2001) Shortfall in mental health service utilisation. Br J Psychiatry 179:417–425PubMedCrossRef
3.
Angermeyer MC, Matschinger H (1997) Social distance towards the mentally ill: results of representative surveys in the Federal Republic of Germany. Psychol Med 27:131–141PubMedCrossRef
4.
Angermeyer MC, Matschinger H (2004) Public attitudes towards psychotropic drugs: have there been any changes in recent years? Pharmacopsychiatry 37:152–156PubMedCrossRef
5.
Angermeyer MC, Matschinger H (2005) The stigma of mental illness in Germany: a trend analysis. Int J Soc Psychiatry 51:276–284PubMedCrossRef
6.
Barney LJ, Griffiths KM, Jorm AF, Christensen H (2006) Stigma about depression and its impact on help-seeking intentions. Aust N Z J Psychiatry 40:51–54PubMedCrossRef
7.
Ben-Porath DD (2002) Stigmatization of individuals who receive psychotherapy: an interaction between help-seeking behavior and the presence of depression. J Soc Clin Psychol 21:400–413CrossRef
8.
Bijl RV, de Graaf R, Hiripi E, Kessler RC, Kohn R, Offord et al (2003) The prevalence of treated and untreated mental disorders in five countries. Health Aff (Millwood) 22:122CrossRef
9.
Bogardus ES (1925) Measuring social distance. J Appl Sociol 1–2:216–226
10.
Britt TW (2000) The stigma of psychological problems in a work environment: evidence from the screening of service members returning from Bosnia. J Appl Soc Psychol 30:1599–1618CrossRef
11.
Burns T, Eichenberger A, Eich D, Ajdacic-Gross V, Angst J, Rössler W (2003) Which individuals with affective symptoms seek help? Results from the Zurich epidemiological study. Acta Psychiatr Scand 108:419–426PubMedCrossRef
12.
Cooper AE, Corrigan PW, Watson AC (2003) Mental illness stigma and care seeking. J Nerv Ment Dis 191:339–341PubMedCrossRef
13.
Corrigan PW, Rüsch N (2003) Mental illness stereotypes and clinical care: do people avoid treatment because of stigma? Psychiatr Rehabil Skills 6:312–334
14.
Deisenhammer EA, Huber M, Kemmler G, Weiss EM, Hinterhuber H (2007) Suicide victims’ contacts with physicians during the year before death. Eur Arch Psychiatry Clin Neurosci 257:480–485PubMedCrossRef
15.
Dew MA, Dunn LO, Bromet EJ, Schulberg HC (1988) Factors affecting help-seeking during depression in a community sample. J Affect Disord 14:223–234PubMedCrossRef
16.
Fischer EH, Turner JLB (1970) Orientations to seeking professional help—development and research utility of an attitude scale. J Consult Clin Psychol 35:79–90PubMedCrossRef
17.
Golberstein E, Eisenberg D, Gollust SE (2008) Perceived stigma and mental health care seeking. Psychiatr Serv 59:392PubMedCrossRef
18.
Griffiths KM, Christensen H, Jorm AF, Evans K, Groves C (2004) Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression—randomised controlled trial. Br J Psychiatry 185:342–349PubMedCrossRef
19.
Günther OH, Friemel S, Bernert S, Matschinger H, Angermeyer MC, König HH (2007) Die Krankheitslast von depressiven Erkrankungen in Deutschland (the burden of depressive disorders in Germany). Psychiatr Prax 34:292–301PubMedCrossRef
20.
Huberman AM, Miles MB (1994) Data management and analysis methods. In: Denzin NK, Lincoln YS (eds) Handbook of qualitative research. Sage Publications, London, pp 428–444
21.
Jacobi F, Wittchen HU, Hilting C, Hifler M, Pfister H, Müller N et al (2004) Prevalence, co-morbidity and correlates of mental disorders in the general population: results from the German Health Interview and Examination Survey (GHS). Psychol Med 34:597–611PubMedCrossRef
22.
Jorm AF, Christensen H, Griffiths KM (2006) The public’s ability to recognize mental disorders and their beliefs about treatment: changes in Australia over 8 years. Aust N Z J Psychiatry 40:36–41PubMedCrossRef
23.
Jorm AF, Medway J, Christensen H, Korten AE, Jacomb PA, Rodgers B (2000) Attitudes towards people with depression: effects on the public’s help-seeking and outcome when experiencing common psychiatric symptoms. Aust N Z J Psychiatry 34:612–618PubMedCrossRef
24.
Komiti A, Judd F, Jackson H (2006) The influence of stigma and attitudes on seeking help from a GP for mental health problems. Soc Psychiatry Psychiatr Epidemiol 41:738–745PubMedCrossRef
25.
Kovess-Masfety V, Alonso J, Brugha TS, Angermeyer MC, Haro JM, Sevilla-Dedieu C (2007) Differences in lifetime use of services for mental health problems in six European countries. Psychiatr Serv 58:213PubMedCrossRef
26.
Leaf PJ, Livingston MM, Tischler GL, Weissman MM, Holzer CE, Myers JK (1985) Contact with health-professionals for the treatment of psychiatric and emotional problems. Med Care 23:1322–1337PubMedCrossRef
27.
Link BG, Cullen FT, Frank J, Wozniak JF (1987) The social rejection of former mental patients—understanding why labels matter. Am J Sociol 92:1461–1500CrossRef
28.
Link BG, Phelan JC (2001) Conceptualizing stigma. Annu Rev Sociol 27:363–385CrossRef
29.
Martin A, Rief W, Klaiberg A, Braehler E (2006) Validity of the Brief patient health questionnaire mood scale (PHQ-9) in the general population. Gen Hosp Psychiatry 28:71–77PubMedCrossRef
30.
Rickwood D, Cavanagh S, Curtis L, Sakrouge R (2004) Educating young people about mental health and mental illness: evaluating a school-based programme. Int J Ment Health Promot 6:23–32
31.
Rüsch N, Angermeyer MC, Corrigan PW (2005) Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. Eur Psychiatry 20:529–539PubMedCrossRef
32.
Rüsch N, Hölzer A, Hermann C, Schramm E, Jacob GA, Bohus M et al (2006) Self-stigma in women with borderline personality disorder and women with social phobia. J Nerv Ment Dis 194:766–773PubMedCrossRef
33.
Salize HJ, Rössler W, Becker T (2007) Mental health care in Germany. Eur Arch Psychiatry Clin Neurosci 257:92–103PubMedCrossRef
34.
35.
Schomerus G, Angermeyer MC (2008) Stigma and its impact on help-seeking for mental disorders—what do we know? Epidemiol Psichiatr Soc 17:31–37PubMed
36.
Schulze B, Richter-Werling M, Matschinger H, Angermeyer MC (2003) Crazy? So what! Effects of a school project on students’ attitudes towards people with schizophrenia. Acta Psychiatr Scand 107:142–150PubMedCrossRef
37.
Sirey JA, Bruce ML, Alexopoulos GS, Perlick DA, Raue P, Friedmann SJ et al (2001) Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression. Am J Psychiatry 158:479–481PubMedCrossRef
38.
Spießl H, Hübner-Liebermann B, Hajak G (2007) Depression—und viele schauen (noch) weg! [Depression—but many are (still) looking away!]. Psychiatr Prax 34:53–54PubMedCrossRef
39.
Spitzer RL, Kroenke K, Williams JBW (1999) Validation and utility of a self-report version of PRIME-MD—the PHQ primary care study. JAMA 282:1737–1744PubMedCrossRef
40.
Stengler-Wenzke K, Angermeyer MC, Matschinger H (2000) Depression und stigma [depression and stigma]. Psychiatr Prax 27:330–335PubMed
41.
Vogel DL, Wade NG, Haake S (2006) Measuring the self-stigma associated with seeking psychological help. J Couns Psychol 53:325–337CrossRef
42.
Wang PS, Angermeyer M, Borges G, Bruffaerts R, Chiu WT, de Girolamo G et al (2007) Delay and failure in treatment seeking after first onset of mental disorders in the World Health Organization’s World Mental Health Survey Initiative. World Psychiatry 6:177PubMed
43.
Wright A, Harris MG, Wiggers JH, Jorm AF, Cotton SM, Harrigan SM et al (2005) Recognition of depression and psychosis by young Australians and their beliefs about treatment. Med J Aust 183:18–23PubMed
44.
Wrigley S, Jackson H, Judd F, Komiti A (2005) Role of stigma and attitudes toward help-seeking from a general practitioner for mental health problems in a rural town. Aust N Z J Psychiatry 39:514–521PubMedCrossRef
Metadata
Title
The stigma of psychiatric treatment and help-seeking intentions for depression
Authors
Dr. Georg Schomerus
Herbert Matschinger
Matthias C. Angermeyer
Publication date
01-08-2009
Publisher
Steinkopff-Verlag
Published in
European Archives of Psychiatry and Clinical Neuroscience / Issue 5/2009
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI
https://doi.org/10.1007/s00406-009-0870-y

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