Individual contributions to stigma and attitudes towards help-seeking among rural emerging adult college students

Abstract

INDIVIDUAL CONTRIBUTIONS TO STIGMA AND ATTITUDES TOWARD HELPSEEKING AMONG RURAL EMERGING ADULT COLLEGE STUDENTS By Margaret Ray Gsell, M.S. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University Virginia Commonwealth University, 2010 Major Director: Wendy L. Kliewer, Ph.D. Professor, Department of Psychology Rural communities are by definition less densely populated and more geographically isolated than non-rural communities, which often translates into higher rates of poverty and poor access to health care, especially mental health care. Previous research has found that persons residing in rural communities endorse higher rates of stigmatized beliefs towards individuals with mental illness and subsequently lower rates of professional help-seeking when compared to persons residing in non-rural communities. This study evaluated whether these attitudes were also present among emerging adults (18-24 years old) who had lived in a rural community for at least 10 years and were currently enrolled in a Virginia university. Further, this study extended prior work relating individual values linked to rural residence, stigma and professional (primary care provider and mental health specialist) help-seeking by also evaluating non-professional (spiritual leaders, family and friends) sources of help, a ix particularly salient source of help in rural communities. Three colleges were sites for recruitment (N=225) and surveys were completed online. Contrary to prediction, no rural cultural variable emerged within the data. Structural equation modeling was used to examine the relation among each of the hypothesized rural cultural variables (religious commitment, internal health locus of control, low emotional openness and family cohesion), stigma towards mental illness and both professional and non-professional help-seeking attitudes and behaviors. Values were entered into models as unique contributors of stigma and helpseeking attitudes. Religious commitment, internal health locus of control and low emotional openness were positively related to stigmatized beliefs towards persons with mental illness. As hypothesized, participants with stigmatized beliefs towards those with mental health concerns also endorsed low levels of professional help-seeking attitudes. However, there were no significant relations for non-professional help-seeking attitudes. Stigma reduced help-seeking behaviors from professional providers and increased help-seeking from religious providers. However, contrary to predictions, persons who endorsed stigma also endorsed prior help-seeking from family members and friends for mental health concerns. Future research can expand these findings by using longitudinal methodology with both rural emerging adults seeking higher education as well as their rural community dwelling counterparts.