Skip to main content
Top
Published in: BMC Psychiatry 1/2020

Open Access 01-12-2020 | Research article

The potential impact of an anti-stigma intervention on mental health help-seeking attitudes among university students

Authors: Shazana Shahwan, Jue Hua Lau, Chong Min Janrius Goh, Wei Jie Ong, Gregory Tee Hng Tan, Kian Woon Kwok, Ellaisha Samari, Ying Ying Lee, Wen Lin Teh, Vanessa Seet, Sherilyn Chang, Siow Ann Chong, Mythily Subramaniam

Published in: BMC Psychiatry | Issue 1/2020

Login to get access

Abstract

Background

The reluctance of young adults to seek mental health treatment has been attributed to poor mental health literacy, stigma, preference for self-reliance and concerns about confidentiality. The purpose of this study was to examine the potential impact of an anti-stigma intervention that includes education about depression, information about help-seeking as well as contact with a person with lived experience, on help seeking attitudes.

Methods

A pre-post study design was employed. Changes in help-seeking attitudes were measured using the Inventory of Attitudes towards Seeking Mental Health Services (IASMHS) immediately post-intervention and after 3 months. Sociodemographic data, information on past experiences in the mental health field and contact with people with mental illness were collated. Three hundred ninety university students enrolled in the study. Linear mixed models were used to examine the effects of the intervention.

Results

Scores on all subscales of the IASMHS, Psychological Openness (PO), Help-seeking Propensity (HP) and Indifference to Stigma improved significantly post-intervention and at 3-month follow-up compared to pre-intervention, with HP demonstrating the highest effect size. However, a significant decline was observed on all three scales at 3-month follow-up compared to post-intervention. Gender, having friends/family with mental illness, and previous experience in the mental health field moderated the intervention effects for the PO and HP subscales.

Conclusion

The study showed that the brief anti-stigma intervention was associated with improvements in help-seeking attitudes among university students with differential effects among certain sub-groups. As the beneficial outcomes appeared to decrease over time, booster sessions or opportunities to participate in mental health-related activities post-intervention may be required to maintain the desired changes in help-seeking attitudes.
Literature
2.
go back to reference Rickwood DJ, Deane FP, Wilson CJ. When and how do young people seek professional help for mental health problems?. The Medical journal of Australia; 2007;187(S7):S35-9. Rickwood DJ, Deane FP, Wilson CJ. When and how do young people seek professional help for mental health problems?. The Medical journal of Australia; 2007;187(S7):S35-9.
3.
go back to reference Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211.CrossRef Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211.CrossRef
5.
go back to reference Gulliver A, Griffiths KM, Christensen H. Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry. 2010;10(1):1–9.CrossRef Gulliver A, Griffiths KM, Christensen H. Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry. 2010;10(1):1–9.CrossRef
6.
go back to reference Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, Morgan C, Rüsch N, Brown JS, Thornicroft G. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological medicine. 2015;45(1):11-27. Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, Morgan C, Rüsch N, Brown JS, Thornicroft G. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological medicine. 2015;45(1):11-27.
7.
go back to reference Rüsch N, Müller M, Ajdacic-Gross V, Rodgers S, Corrigan PW, Rössler W. Shame, perceived knowledge and satisfaction associated with mental health as predictors of attitude patterns towards help-seeking. Epidemiol Psychiatr Sci. 2014;23(2):177–87.PubMedCrossRef Rüsch N, Müller M, Ajdacic-Gross V, Rodgers S, Corrigan PW, Rössler W. Shame, perceived knowledge and satisfaction associated with mental health as predictors of attitude patterns towards help-seeking. Epidemiol Psychiatr Sci. 2014;23(2):177–87.PubMedCrossRef
9.
go back to reference Jorm AF, Medway J, Christensen H, Korten AE, Jacomb PA, Rodgers B. Public Beliefs About the Helpfulness of Interventions for Depression: Effects on Actions Taken When Experiencing Anxiety and Depression Symptoms. Aust New Zeal J Psychiatry. 2000;34(4):619–26 [cited 2020 Feb 25]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/10954393.CrossRef Jorm AF, Medway J, Christensen H, Korten AE, Jacomb PA, Rodgers B. Public Beliefs About the Helpfulness of Interventions for Depression: Effects on Actions Taken When Experiencing Anxiety and Depression Symptoms. Aust New Zeal J Psychiatry. 2000;34(4):619–26 [cited 2020 Feb 25]. Available from: http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​10954393.CrossRef
10.
go back to reference Mojtabai R, Olfson M, Sampson NA, Jin R, Druss B, Wang PS, et al. Barriers to mental health treatment: results from the National Comorbidity Survey Replication. Psychol Med. 2011;41(8):1751–61.PubMedCrossRef Mojtabai R, Olfson M, Sampson NA, Jin R, Druss B, Wang PS, et al. Barriers to mental health treatment: results from the National Comorbidity Survey Replication. Psychol Med. 2011;41(8):1751–61.PubMedCrossRef
12.
go back to reference Rickwood DJ, Braithwaite VA. Social-psychological factors affecting help-seeking for emotional problems. Soc Sci Med. 1994;39(4):563–72.PubMedCrossRef Rickwood DJ, Braithwaite VA. Social-psychological factors affecting help-seeking for emotional problems. Soc Sci Med. 1994;39(4):563–72.PubMedCrossRef
13.
go back to reference Gulliver A, Griffiths KM, Christensen H, Brewer JL. A systematic review of help-seeking interventions for depression, anxiety and general psychological distress. BMC Psychiatry. 2012;12(1):1–12.CrossRef Gulliver A, Griffiths KM, Christensen H, Brewer JL. A systematic review of help-seeking interventions for depression, anxiety and general psychological distress. BMC Psychiatry. 2012;12(1):1–12.CrossRef
14.
go back to reference Xu Z, Huang F, Kösters M, Staiger T, Becker T, Thornicroft G, et al. Effectiveness of interventions to promote help-seeking for mental health problems: Systematic review and meta-analysis [Internet], vol. 48: Psychological Medicine. Cambridge University Press; 2018. p. 2658–67. [cited 2020 Nov 3]. Available from: https://pubmed.ncbi.nlm.nih.gov/29852885/. Xu Z, Huang F, Kösters M, Staiger T, Becker T, Thornicroft G, et al. Effectiveness of interventions to promote help-seeking for mental health problems: Systematic review and meta-analysis [Internet], vol. 48: Psychological Medicine. Cambridge University Press; 2018. p. 2658–67. [cited 2020 Nov 3]. Available from: https://​pubmed.​ncbi.​nlm.​nih.​gov/​29852885/​.
15.
go back to reference Mehta N, Clement S, Marcus E, Stona AC, Bezborodovs N, Evans-Lacko S, Palacios J, Docherty M, Barley E, Rose D, Koschorke M. Evidence for effective interventions to reduce mental health-related stigma and discrimination in the medium and long term: systematic review. The British Journal of Psychiatry. 2015;207(5):377-84. Mehta N, Clement S, Marcus E, Stona AC, Bezborodovs N, Evans-Lacko S, Palacios J, Docherty M, Barley E, Rose D, Koschorke M. Evidence for effective interventions to reduce mental health-related stigma and discrimination in the medium and long term: systematic review. The British Journal of Psychiatry. 2015;207(5):377-84.
16.
go back to reference Janoušková M, Tušková E, Weissová A, Trančík P, Pasz J, Evans-Lacko S, et al. Can video interventions be used to effectively destigmatize mental illness among young people? A systematic review [Internet], vol. 41: European Psychiatry. Elsevier Masson SAS; 2017. p. 1–9. [cited 2020 Nov 3]. Available from: https://pubmed.ncbi.nlm.nih.gov/28049074/. Janoušková M, Tušková E, Weissová A, Trančík P, Pasz J, Evans-Lacko S, et al. Can video interventions be used to effectively destigmatize mental illness among young people? A systematic review [Internet], vol. 41: European Psychiatry. Elsevier Masson SAS; 2017. p. 1–9. [cited 2020 Nov 3]. Available from: https://​pubmed.​ncbi.​nlm.​nih.​gov/​28049074/​.
20.
go back to reference Yamaguchi S, Ojio Y, Ando S, Bernick P, Ohta K, Watanabe KI, et al. Long-term effects of filmed social contact or internet-based self-study on mental health-related stigma: a 2-year follow-up of a randomised controlled trial. Soc Psychiatry Psychiatr Epidemiol. 2019 ;54(1):33–42. [cited 2020 Nov 3]. Available from: https://pubmed.ncbi.nlm.nih.gov/30315333/. Yamaguchi S, Ojio Y, Ando S, Bernick P, Ohta K, Watanabe KI, et al. Long-term effects of filmed social contact or internet-based self-study on mental health-related stigma: a 2-year follow-up of a randomised controlled trial. Soc Psychiatry Psychiatr Epidemiol. 2019 ;54(1):33–42. [cited 2020 Nov 3]. Available from: https://​pubmed.​ncbi.​nlm.​nih.​gov/​30315333/​.
24.
go back to reference Subramaniam M, Abdin E, Vaingankar JA, Shafie S, Chua BY, Sambasivam R, et al. Tracking the mental health of a nation: prevalence and correlates of mental disorders in the second Singapore mental health study. Epidemiol Psychiatr Sci. 2019:1–10 [cited 2019 Aug 20]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30947763. Subramaniam M, Abdin E, Vaingankar JA, Shafie S, Chua BY, Sambasivam R, et al. Tracking the mental health of a nation: prevalence and correlates of mental disorders in the second Singapore mental health study. Epidemiol Psychiatr Sci. 2019:1–10 [cited 2019 Aug 20]. Available from: http://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​30947763.
26.
go back to reference Subramaniam M, Shahwan S, Abdin E, Goh CMJ, Ong WJ, Tan GTH, et al. Advancing research to eliminate mental illness stigma: the design and evaluation of a single-arm intervention Among University students in Singapore. Front Psychol. 2020;11. Subramaniam M, Shahwan S, Abdin E, Goh CMJ, Ong WJ, Tan GTH, et al. Advancing research to eliminate mental illness stigma: the design and evaluation of a single-arm intervention Among University students in Singapore. Front Psychol. 2020;11.
27.
go back to reference Tan GTH, Shahwan S, Goh CMJ, Ong WJ, Samari E, Abdin E, et al. Causal beliefs of mental illness and its impact on help-seeking attitudes: a cross-sectional study among university students in Singapore. BMJ Open. 2020;10(7):e035818 [cited 2020 Oct 19]. Available from: /pmc/articles/PMC7389507/?report=abstract.PubMedPubMedCentralCrossRef Tan GTH, Shahwan S, Goh CMJ, Ong WJ, Samari E, Abdin E, et al. Causal beliefs of mental illness and its impact on help-seeking attitudes: a cross-sectional study among university students in Singapore. BMJ Open. 2020;10(7):e035818 [cited 2020 Oct 19]. Available from: /pmc/articles/PMC7389507/?report=abstract.PubMedPubMedCentralCrossRef
29.
go back to reference Mesidor JK, Sly KF. Mental Health Help-Seeking Intentions Among International and African American College Students: An Application of the Theory of Planned Behavior. J Int Students. 2014;137(2):137–49 [cited 2020 Feb 24]. Available from: http://jistudents.org. Mesidor JK, Sly KF. Mental Health Help-Seeking Intentions Among International and African American College Students: An Application of the Theory of Planned Behavior. J Int Students. 2014;137(2):137–49 [cited 2020 Feb 24]. Available from: http://​jistudents.​org.
30.
go back to reference Hyland P, Boduszek D, Dhingra K, Shevlin M, Maguire R, Morley K. A test of the inventory of attitudes towards seeking mental health services. Br J Guid Couns. 2015;43(4):397–412 [cited 2020 Oct 19]. Available from: /record/2015-36736-002.CrossRef Hyland P, Boduszek D, Dhingra K, Shevlin M, Maguire R, Morley K. A test of the inventory of attitudes towards seeking mental health services. Br J Guid Couns. 2015;43(4):397–412 [cited 2020 Oct 19]. Available from: /record/2015-36736-002.CrossRef
31.
go back to reference Kantor V, Knefel M, Lueger-Schuster B. Investigating institutional abuse survivors’ help-seeking attitudes with the inventory of attitudes towards seeking mental health services. Eur J Psychotraumatol. 2017;8(1):1–11 [cited 2020 Oct 19]. Available from: /record/2017-52447-001.CrossRef Kantor V, Knefel M, Lueger-Schuster B. Investigating institutional abuse survivors’ help-seeking attitudes with the inventory of attitudes towards seeking mental health services. Eur J Psychotraumatol. 2017;8(1):1–11 [cited 2020 Oct 19]. Available from: /record/2017-52447-001.CrossRef
32.
go back to reference Loo JMY, Oei TP, Raylu N. Problem gambling, gambling correlates, and help-seeking attitudes in a Chinese sample: an empirical evaluation. Psychology. 2011;02(04):342–54.CrossRef Loo JMY, Oei TP, Raylu N. Problem gambling, gambling correlates, and help-seeking attitudes in a Chinese sample: an empirical evaluation. Psychology. 2011;02(04):342–54.CrossRef
34.
37.
go back to reference Clement S, Van Nieuwenhuizen A, Kassam A, Flach C, Lazarus A, De Castro M, et al. Filmed v. live social contact interventions to reduce stigma: Randomised controlled trial. Br J Psychiatry. 2012;201(1):57–64 [cited 2020 Nov 4]. Available from: https://www.cambridge.org/core.PubMedCrossRef Clement S, Van Nieuwenhuizen A, Kassam A, Flach C, Lazarus A, De Castro M, et al. Filmed v. live social contact interventions to reduce stigma: Randomised controlled trial. Br J Psychiatry. 2012;201(1):57–64 [cited 2020 Nov 4]. Available from: https://​www.​cambridge.​org/​core.PubMedCrossRef
38.
go back to reference Chia NNBAM, Kannusamy P, Klainin-Yobas P. The effectiveness of mental health-related theoretical education and clinical placement in mental health settings in changing the attitudes of health care students towards mental illness: A systematic review. JBI Database Syst Rev Implement Rep. 2012;10(Supplement):1–19.CrossRef Chia NNBAM, Kannusamy P, Klainin-Yobas P. The effectiveness of mental health-related theoretical education and clinical placement in mental health settings in changing the attitudes of health care students towards mental illness: A systematic review. JBI Database Syst Rev Implement Rep. 2012;10(Supplement):1–19.CrossRef
41.
go back to reference Mackenzie CS, Gekoski WL, Knox VJ. Age, gender, and the underutilization of mental health services: the influence of help-seeking attitudes. Aging Ment Heal. 2006;10(6):574–82.CrossRef Mackenzie CS, Gekoski WL, Knox VJ. Age, gender, and the underutilization of mental health services: the influence of help-seeking attitudes. Aging Ment Heal. 2006;10(6):574–82.CrossRef
42.
go back to reference Nam SK, Chu HJ, Lee MK, Lee JH, Kim N, Lee SM. A meta-analysis of gender differences in attitudes toward seeking professional psychological help. J Am Coll Heal. 2010;59(2):110–6.CrossRef Nam SK, Chu HJ, Lee MK, Lee JH, Kim N, Lee SM. A meta-analysis of gender differences in attitudes toward seeking professional psychological help. J Am Coll Heal. 2010;59(2):110–6.CrossRef
43.
go back to reference Sagar-Ouriaghli I, Godfrey E, Bridge L, Meade L, Brown JS. Improving mental health service utilization among men: A systematic review and synthesis of behavior change techniques within interventions targeting help-seeking. American journal of men's health. 2019;13(3):1557988319857009. Sagar-Ouriaghli I, Godfrey E, Bridge L, Meade L, Brown JS. Improving mental health service utilization among men: A systematic review and synthesis of behavior change techniques within interventions targeting help-seeking. American journal of men's health. 2019;13(3):1557988319857009.
44.
go back to reference Gonzalez JM, Alegría M, Prihoda TJ, Copeland LA, Zeber JE. How the relationship of attitudes toward mental health treatment and service use differs by age, gender, ethnicity/race and education. Soc Psychiatry Psychiatr Epidemiol. 2011;46(1):45–57.PubMedCrossRef Gonzalez JM, Alegría M, Prihoda TJ, Copeland LA, Zeber JE. How the relationship of attitudes toward mental health treatment and service use differs by age, gender, ethnicity/race and education. Soc Psychiatry Psychiatr Epidemiol. 2011;46(1):45–57.PubMedCrossRef
46.
go back to reference Vidourek RA, King KA, Nabors LA, Merianos AL. Students’ benefits and barriers to mental health help-seeking. Heal Psychol Behav Med. 2014;2(1):1009–22.CrossRef Vidourek RA, King KA, Nabors LA, Merianos AL. Students’ benefits and barriers to mental health help-seeking. Heal Psychol Behav Med. 2014;2(1):1009–22.CrossRef
47.
go back to reference Sung HY, Tidwell R. Adult Korean Americans: their attitudes toward seeking professional counseling services. Community Ment Health J. 2005;41(5):571–80.CrossRef Sung HY, Tidwell R. Adult Korean Americans: their attitudes toward seeking professional counseling services. Community Ment Health J. 2005;41(5):571–80.CrossRef
48.
go back to reference Seyfi F, Poudel KC, Yasuoka J, Otsuka K, Jimba M. Intention to seek professional psychological help among college students in Turkey: influence of help-seeking attitudes. BMC research notes. 2013;6(1):519. Seyfi F, Poudel KC, Yasuoka J, Otsuka K, Jimba M. Intention to seek professional psychological help among college students in Turkey: influence of help-seeking attitudes. BMC research notes. 2013;6(1):519.
Metadata
Title
The potential impact of an anti-stigma intervention on mental health help-seeking attitudes among university students
Authors
Shazana Shahwan
Jue Hua Lau
Chong Min Janrius Goh
Wei Jie Ong
Gregory Tee Hng Tan
Kian Woon Kwok
Ellaisha Samari
Ying Ying Lee
Wen Lin Teh
Vanessa Seet
Sherilyn Chang
Siow Ann Chong
Mythily Subramaniam
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2020
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-020-02960-y

Other articles of this Issue 1/2020

BMC Psychiatry 1/2020 Go to the issue