Stigma and poor mental health literacy as barriers to service use among unemployed people with mental illness – a qualitative study

Abstract

Introduction/objectivesMental health problems were shown by different studies to be both: results of and risk factors for unemployment. However, unemployed people with mental health problems often have difficulties in finding and using mental health services and therefore do not benefit from therapies. Because unemployed individuals outside the healthcare system are a hard-to-reach group, barriers to but also facilities for mental health services are poorly understood.AimsThe aim of the study is to identify barriers and facilitators of help seeking and service use, based on experiences of unemployed people with mental health strains.MethodsWe conducted 15 qualitative semi-structured interviews with unemployed individuals, facing self-reported mental health problems or mental illness. Topics included individual experiences with help-seeking and mental health service use, with a focus on barriers and facilitators. Interviews were audiotaped and transcribed verbatim. Transcripts were analyzed using qualitative content analysis and major themes were identified.ResultsPatients fear adverse reactions of psychiatric medication. They report to be treated as “different” by their social environment and health professionals, which leads to a lack of self-esteem and inhibits them in their help seeking efforts. Social support and desire for change on the other hand can be strong motivational factors in searching for help.ConclusionPerception of GPs towards mental health issues of their patients, and especially unemployed patients, has to be raised. Stigmatization of mental illnesses and help seeking should be reduced in practical context.Disclosure of interestThe authors have not supplied their declaration of competing interest.