Advertisement

Social Psychiatry and Psychiatric Epidemiology

, Volume 49, Issue 2, pp 231–239 | Cite as

Attitudes and stigma in relation to help-seeking intentions for psychological problems in low and high suicide rate regions

  • A. Reynders
  • A. J. F. M. Kerkhof
  • G. Molenberghs
  • C. Van Audenhove
Original Paper

Abstract

Purpose

Accessibility and availability of mental health care services are necessary but not sufficient for people to seek help for psychological problems. Attitudes and stigma related to help seeking also determine help seeking intentions. The aim of this study is to investigate how cross-national differences in attitudes and stigma within the general population are related to professional and informal help seeking intentions in low and high suicide rate regions.

Methods

By means of a postal structured questionnaire, data of 2999 Dutch and Flemish respondents between 18 and 65 years were gathered. Attitudes toward help seeking, perceived stigma, self-stigma, shame and intention to seek help were assessed.

Results

People in the Netherlands, where suicide rates are low, have more positive attitudes toward help seeking and experience less self stigma and shame compared to the people in Flanders, where suicide rates are relatively high. These attitudinal factors predicted professional as well as informal help seeking intentions. Perceived stigma was negatively associated with informal help seeking. Shame was positively associated with higher intention to use psychotropic drugs and perceived stigma was negatively associated with the intention to seek help from a psychotherapist in Flanders but not in the Netherlands.

Conclusion

Help seeking for psychological problems prevent these problems to aggravate and it is assumed to be a protective factor for suicide. Our results stress the importance of the promotion of positive attitudes and the reduction of stigma within the general population to facilitate help seeking from professional providers and informal networks. Focusing on these attitudinal factors is believed to be a key aspect of universal mental health and suicide prevention policies.

Keywords

Attitudes Stigma Help-seeking Suicide Cross-national research 

Notes

Acknowledgments

This study was funded by the Flemish Government, Department of Well-being, Health and Family, LUCAS KU Leuven, the Centre for the Prevention of Suicide (Centrum ter Preventie van Zelfdoding) and Foundation Go for Happiness-Prevention of Depression and suicide (Stichting Ga voor Geluk-Preventie van Depressie en Suicide).

References

  1. 1.
    Alonso J, Angermeyer MC, Bernert S, Bruffaerts R (2004) Use of mental health services in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand 109(Supl 420):47–54Google Scholar
  2. 2.
    Kessler RC, Demyttenaere K, Bruffaerts R, Posada-Villa J (2004) Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA 291:2581–2590PubMedCrossRefGoogle Scholar
  3. 3.
    Deisenhammer EA, Huber M, Kemmler G, Weiss EM, Hinterhuber H (2007) Suicide victims’ contact with physicians during the year before death. Eur Arch Psychiatry Clin Neurosci 257:480–485PubMedCrossRefGoogle Scholar
  4. 4.
    Sareen J, Jagdeo A, Cox BJ, Clara I, ten Have M, Belik SL, de Graaf R (2007) Perceived barriers to mental health service utilization in the United States, Ontario, and the Netherlands. Psychatr Serv 58:357–364CrossRefGoogle Scholar
  5. 5.
    Ajzen I, Fishbein M (2005) The influence of attitudes on behavior. In: Albarracin D, Johnson BT, Zanna MP (eds) The handbook of attitudes. Laurence Erlbaum, New Jersey, pp 173–221Google Scholar
  6. 6.
    Bathje GJ, Pryor JB (2011) The relationship of public and self-stigma to seeking mental health services. J Mental Health Couns 33:161–176Google Scholar
  7. 7.
    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 41:738–745PubMedCrossRefGoogle Scholar
  8. 8.
    Vogel DL, Wade NG, Hackler AH (2007) Perceived public stigma and the willingness to seek counseling: the mediating roles of self-stigma and attitudes toward counseling. J Couns Psychol 54:40–50CrossRefGoogle Scholar
  9. 9.
    ten Have M, de Graaf R, Ormel J, Vilagut G (2012) Are attitudes towards mental health help-seeking associated with service use? Results from the European Study of Epidemiology of Mental Disorders. Soc Psychiatry Psychiatr Epidemiol 45:153–163CrossRefGoogle Scholar
  10. 10.
    Rüsch N, Angermeyer MC, Corrigan P (2005) Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. Eur Psychiatry 20:523–539CrossRefGoogle Scholar
  11. 11.
    Ben-Portath DD (2002) Stigmatization of individuals who receive psychotherapy: an interaction between help-seeking behaviour and the presence of depression. J Soc Clin Psychol 21:400–413CrossRefGoogle Scholar
  12. 12.
    Link BG, Cullen FT, Struening E, Shrout PE, Dohrenwend BP (1989) A modified labeling theory approach to mental disorders: an empirical assessment. Am Sociol Rev 54:400–423CrossRefGoogle Scholar
  13. 13.
    Gulliver A, Griffiths KM, Christensen H (2010) Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry 10:113PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    Golberstein E, Eisenberg D, Gollust SE (2009) Perceived stigma and help-seeking behavior: longitudinal evidence from the Healthy Minds Study. Psychiatr Serv 60:1254–1256PubMedCentralPubMedCrossRefGoogle Scholar
  15. 15.
    Schomerus G, Matschinger H, Angermeyer MC (2009) The stigma of psychiatric treatment and help-seeking intentions for depression. Eur Arch Psychiatry Clin Neurosci 259:298–306PubMedCrossRefGoogle Scholar
  16. 16.
    Griffiths KM, Crisp AH, Barney LJ, Reid R (2011) Seeking help for depression from family and friends: a qualitative analysis of perceived advantages and disadvantages. BMC Psychiatry 11:196PubMedCentralPubMedCrossRefGoogle Scholar
  17. 17.
    Holmes EP, River LP (1998) Individual strategies for coping with stigma of severe mental illness. Cogn Behav Pract 5:231–239CrossRefGoogle Scholar
  18. 18.
    Barney LJ, Griffiths KM, Jorm AF, Christensen H (2006) Stigma about depression and its impact on help-seeking intentions. Aust N Z J Psychiatry 40:51–54PubMedCrossRefGoogle Scholar
  19. 19.
    Pompili M, Mancinelli I, Tatarelli R (2003) Stigma as a cause of suicide. Br J Psychiatry 183:173–174PubMedCrossRefGoogle Scholar
  20. 20.
    Kageyama T (2012) Views on suicide among middle-aged and elderly populations in Japan: their associations with demographic variables and feeling shame in seeking help. Psychiatry Clin Neurosci 66:105–112PubMedCrossRefGoogle Scholar
  21. 21.
    Mojtabai R (2010) Mental illness stigma and willingness to seek mental health care in the European Union. Soc Psychiatry Psychiatr Epidemiol 45:705–712PubMedCrossRefGoogle Scholar
  22. 22.
    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, 1–13. 2012. 16–11–2011Google Scholar
  23. 23.
    Angermeyer MC, Matschinger H, Riedel-Heller SG (1999) Whom to ask for help in case of a mental disorder? Preferences of the lay public. Soc Psychiatry Psychiatr Epidemiol 34:202–210PubMedCrossRefGoogle Scholar
  24. 24.
    WHO World Mental Health Survey Consortium (2004) Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Survey. JAMA 21:2581–2590Google Scholar
  25. 25.
    Dezetter A, Briffault X, Bruffaerts R, De Graaf R, Alonso J, König HH, Haro JM, de Girolamo G, Vilagut G, Kovess-Masféty V (2012) Use of general practitioners versus mental health professionals in six European countries: the decisive role of the organization of mental health-care systems. Soc Psychiatry Psychiatr Epidemiol. doi: 10.1007/s00127-012-0522-9 PubMedGoogle Scholar
  26. 26.
    World Health Organization. (2011) Mental Health Atlas-2011 country profiles. http://www.who.int/mental_health/evidence/atlas/profiles/en/index.html. Accessed 20 may 2013
  27. 27.
    Beldie A, den Boer JA, Brain C et al (2012) Fighting stigma of mental illness in midsize European countries. Soc Psychiatry Psychiatr Epidemiol 47(Suppl 1):1–38PubMedCrossRefGoogle Scholar
  28. 28.
    Flemish Agency for Care and Health. http://www.zorg-en-gezondheid.be/Cijfers/Sterftecijfers/Statistiek-van-de-doodsoorzaken/. Accessed 15 January 2013
  29. 29.
    World Health Organization-European Detailed Mortality Database. http://data.euro.who.int/dmdb/. Accessed 15 January 2013
  30. 30.
    Alonso J, Buron A, Rojas-Farreas S, de Graaf R, Haro JM, De Girolamo G, Bruffaerts R, Kovess V, Matschinger H, Vilagaut G (2009) Perceived stigma among individuals with common mental disorders. J Affect Disord 118:180–186PubMedCrossRefGoogle Scholar
  31. 31.
    Aromaa E, Tolvanen A, Tuulari J, Wahlbeck K (2011) Personal stigma and use of mental health services among people with depression in a general population in Finland. BMC Psychiatry 11:52PubMedCentralPubMedCrossRefGoogle Scholar
  32. 32.
    Frankfort-Nachmias C, Nachmias D (1996) Research methods in the social science. Arnold, LondonGoogle Scholar
  33. 33.
    Ware JE, Kosinski M, Keller (1994) SF. SF-36 Physical and Mental Health Summary Scales: A User’s Manual. MA: The Health Institute, BostonGoogle Scholar
  34. 34.
    Schreurs PJG, van de Willige G (1988) Omgaan met problemen en gebeurtenissen: de Utrechtse coping lijst (UCL). Swets & Zeitlinger, LisseGoogle Scholar
  35. 35.
    Vogel DL, Wade NG, Haake S (2006) Measuring the self-stigma associated with seeking psychological help. J Couns Psychol 53:325–337CrossRefGoogle Scholar
  36. 36.
    Link BG (1987) Understanding labeling effects in the area of mental-disorders-an assessment of the effects of expectations of rejection. Am Sociol Rev 52:96–112CrossRefGoogle Scholar
  37. 37.
    Link BG, Struening E, Neese-Todd S, Asmussen S, Phelan JC (2001) The consequences of stigma for the self-esteem of people with mental illnesses. Psychiatric Serv 52:1621–1626CrossRefGoogle Scholar
  38. 38.
    Fisher EH, Farina A (1995) Attitudes toward seeking professional psychological help: a shortened form and considerations for research. J Coll Stud Dev 36:368–373Google Scholar
  39. 39.
    Elhai JD, Schweinle W, Anderson SM (2008) Reliability and validity of the attitudes toward seeking professional psychological help scale-short formS Psychiatry Res 159:320–329PubMedCrossRefGoogle Scholar
  40. 40.
    Baruch Y (1999) Response rate in academic studies- a comparative analysis. Human relations 52:421–438Google Scholar
  41. 41.
    Ravens-Sieberer U, Erhart M, Wetzel R, Krügel A, Brambosch A (2008) Phone respondents reported less mental health problems whereas mail interviewee gave higher physical health ratings. J Clin Epidemiol 61:1056–1060PubMedCrossRefGoogle Scholar
  42. 42.
    Alonso J, Angermeyer MC, Bernert S, Bruffaerts R (2004) Psychotropic drug utilization in Europe: results from the European Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand 109(Suppl 420):55–64Google Scholar
  43. 43.
    Hegerl U, Wittenburg L, Arensman E, Van Audenhove C, Coyne JC, McDaid D, van der Feltz-Cornelis C, Gusmão R, Kopp M, Maxwell M, Meise U, Roskar S, Sarchiapone M, Schmidtke A, Värnick A, Bramesfeld A (2009) Optimizing suicide prevention programs and their implementation in Europe (OSPI Europe): an evidence-based multi-level approach. BMC Public Health 9:428PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • A. Reynders
    • 1
  • A. J. F. M. Kerkhof
    • 2
  • G. Molenberghs
    • 3
  • C. Van Audenhove
    • 1
  1. 1.LUCAS KU LeuvenLeuvenBelgium
  2. 2.Department of Clinical PsychologyVU University and EMGO+ InstituteAmsterdamThe Netherlands
  3. 3.Interuniversity Institute for Biostatistics and Statistical Bioinformatics (I-BioStat)KU Leuven–UHasseltHasseltBelgium

Personalised recommendations