Toward understanding mental illness stigma and help-seeking: A social identity perspective [2019]

• The Social Identity Perspective (SIP) provides new insights.

• The SIP improves understanding about mental illness stigma and help-seeking.

• More stigma was associated with more identification with the mental illness group.

• Identification and group perceptions influenced help-seeking (the self-relevant step).

• Identification and self-relevant step of help-seeking influenced service use.

People who experience mental illness are unlikely to seek help. Research suggests that mental illness stigma negatively impacts help-seeking, yet there is little information about factors that relate to stigma that are positively associated with help-seeking among those with compromised mental health. Emerging research suggests that aspects of the social identity perspective, namely group social identification and perceptions about the group, may provide insights as to how people who experience mental illness navigate help-seeking.

In two studies we aimed to: (1) identify factors (i.e., social identification and perceptions of the group) that relate to stigma that are also associated with the multi-step process of help-seeking; and (2) explore if these factors and aspects of the help-seeking process that occur prior to service utilization (such as illness and symptom recognition) are positively associated with behavioral service utilization.

Study 1 employed Amazon’s Mechanical Turk to recruit 90 participants who reported being diagnosed with a mental illness and not actively seeking treatment (i.e., medication or seeing a psychologist or psychiatrist). Study 2 employed Facebook to recruit 131 participants who self-reported a mental illness diagnosis.

Controlling for symptom severity, mental illness stigma was positively associated with social identification, which in turn positively impacted help-seeking in Study 1. Further, the relationship between social identification and help-seeking was strongest among those with a negative perception of the mental illness group. In Study 2, results indicated that social identification predicted behavioral service utilization, providing support for Study 1.

Taken together, these findings suggest that social identification as a person with a mental illness is positively associated with the multi-step process of help-seeking and may be important for those who experience mental illness stigma to get help that enables and facilitates better functioning.

Kathleen A. Klik, Stacey L. Williams, Katherine J. Reynolds
Social Science & Medicine, Volume 222, February 2019