Mental health stigma is a major factor preventing people from accessing the care they need, according to new research from King’s College London.

The new study, published in Psychological Medicine, brings together data from 144 studies, including over 90,000 participants worldwide.

Approximately 1 in 4 people have a mental health problem, yet in Europe and the US, up to 75 percent of people with mental health disorders do not receive treatment. For many disorders such as psychosis, bipolar disorder, major depression and anxiety disorders, delaying or avoiding care is associated with worse outcomes.

Professor Graham Thornicroft, from the Institute of Psychiatry (IoP) at King’s College London and senior author of the paper, says: “We now have clear evidence that stigma has a toxic effect by preventing people seeking help for mental health problems. The profound reluctance to be “a mental health patient” means people will put off seeing a doctor for months, years, or even at all, which in turn delays their recovery.”

The study, which was funded by the National Institute for Health Research (NIHR) as a part of the SAPPHIRE Programme, looked at the effect of stigma on how individuals with mental health problems accessed and engaged with formal services, including GPs, specialist mental health services and talking therapies.

The main types of stigma preventing people from accessing care were ‘treatment stigma’ (the stigma associated with using mental health services or receiving mental health treatment) and ‘internalised stigma’ (shame, embarrassment). Other important barriers preventing people seeking help were fear of disclosing a mental health condition; concerns about confidentiality; wanting to handle the problem on one’s own; and not believing they needed help.

The study also identified certain groups for whom stigma had an even stronger effect on preventing people seeking help. These included young people, men, people from minority ethnic groups, those in the military and health professions.

Dr Sarah Clement, from the IoP at King’s and lead author of the paper, says: “Our study clearly demonstrates that mental health stigma plays an important role in preventing people from accessing treatment. We found that the fear of disclosing a mental health condition was a particularly common barrier. Supporting people to talk about their mental health problems, for example through anti-stigma campaigns, may mean they are more likely to seek help.”

 

The full paper, “What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies”, can be read free of charge for a limited time here.

 

Comments

  1. I can’t say that I’m up-to-date with the happenings you’ve mentioned, but it never ceases to amazing me how ignorant people can be especially when it comes to the topic of mental health. I pride myself in being knowledgeable in that area not only because it’s the field I’m in, but also it because it’s always been something that has been part of my life. My mother has worked in a mental health institute for over 30 years, which I think is what helped open my eyes to what really happens.I may not have a mental illness, but I know plenty of people who do and it can be difficult to reach out and connect. It’s a shame that when people try to reach out via blog, they’re met with such horrible response.

  2. Thanks to blogger Charlotte Porter and kudos to Prof. Sarah Clement of King’s College London and her nine co-authors for highlighting for so many readers a matter so important to not only the mental health of society around the globe but also to the productivity and creativity of innovation and invention in its increasingly knowledge-driven yet distributed economic centers of the workplace. However, while I surmise most of the people represented in this study do work, it was somewhat surprising that employment, employers, and places of employment were not mentioned in the abstract. (I was unable to access the full text of this paper.) There, too, external stigma lurks with its ugly Hydra heads, among co-workers as well as bosses and department heads. Thus a primary reason why a worker might internalize this external stigma and thus to not disclose one’s mental disability to potential health care providers is a fear of losing one’s job — and then of becoming unemployable as one finds out that such stigma keeps one from landing another job. The possibility of such a scenario arising in actuality is not remote when a worker in many countries must take short- or even long-term disability insurance income leave from work with the concurrence of one’s employer authorizing leaves of absence from the workplace in order to receive over the long cumulative time period resulting the decisive help that he or she needs. Thus it is my hope that academia and publishers will branch out, so to speak, and couple the two problems as a mutually interacting system in future studies and platforms when self-disclosures of major mental disabilities are made not only in the process of accessing effective health care and interventions but also in the process of sustaining one’s employment including a continuous presence in the workplace over a career of several decades. If this seems like too daunting a task for study, then perhaps just bite off just a piece of this composite problem and take an ‘out of the box’ look at STEM workers in some particular country or cluster of nations, where STEM = Science, Technology, Engineering and Mathematics.

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