Higher Self-stigma Research Articles

Mental Health Literacy Reduces the Impact of Internalized Stigma on Older Adults' Attitudes and Intentions to Seek Mental Health Services

ABSTRACT Objectives Older adults are the least likely age group to seek mental health services, and internalized stigma is an important reason why. We sought to further our understanding of which older adults are particularly likely to be affected by internalized stigma, and why, by investigating mental health literacy (MHL) as a moderator within the internalized stigma model of help-seeking. Methods We utilized a conditional process analysis of cross-sectional, secondary data from 350 distressed older adults. Participants completed an online survey consisting of measures of distress, perceived control, experiential avoidance, MHL, public and self-stigma of seeking help, help-seeking attitudes, and conditional help-seeking intentions. Results MHL moderated the internalized stigma model; distressed older adults with lower MHL were more likely to have public stigma internalized as self-stigma, which then reduced their intentions to seek help. More specifically, low MHL magnified the negative effect of self-stigma on attitudes and intentions. Conclusions These results increase our understanding of which older adults are less likely to seek mental health services: distressed older adults with poor MHL and high self-stigma. Clinical Implications MHL is a malleable construct that can be targeted by interventions designed to increase help-seeking among distressed older adults in need of professional help.

Alcohol-related stigma within the UK veterinary profession.

Veterinarians have poorer mental health and have higher levels of alcohol consumption compared to the general population. This study aimed to explore perceptions and experiences of problem drinking within the veterinary profession in the UK. Online semi-structured interviews were completed with multidisciplined practising veterinarians in the UK. The data were analysed using reflexive thematic analysis. Seventeen veterinarians were recruited. The participants were predominantly female (n = 15, 88%).Seven participants (41%) reported personal experience of problem drinking. Four main themes were identified: a normalised culture of drinking, the impact of drinking on mental health and suicide risk, perceptions and attitudes towards problem drinking, and impacts of formal intervention. Drinking to cope was normalised and widespread among veterinarians. Problem drinking was reported to negatively impact mental health and provoke high self-stigma. Both alcohol-related stigma and fear of involvement from the Royal College of Veterinary Surgeons (RCVS) were barriers to help-seeking. No other veterinary professionals or participants with lived experience of RCVS investigation for problem drinking were included. Alcohol-related stigma and fear of RCVS involvement reduce veterinary help-seeking for problem drinking, which may have a negative effect on veterinarians' mental health.

Self-stigma, religiosity, and perceived social support in people with recent-onset psychosis in the Islamic Republic of Iran: Associations with symptom severity and psychosocial functioning.

Most evidence on psychosocial factors in recent-onset psychosis comes from high-income countries in Europe, Australia, Canada and the USA, while these factors are likely to differ under varying sociocultural and economic circumstances. In this study, we aimed to investigate associations of self-stigma, religiosity and perceived social support with symptom severity and psychosocial functioning in an Iranian cohort of people with recent-onset psychosis (i.e. illness duration of <2 years). We used baseline data of 361 participants (N = 286 [74%] male, mean age = 34 years [Standard Deviation = 10.0]) from the Iranian Azeri Recent-onset Acute Phase Psychosis Survey (ARAS). We included assessments of self-stigma (Internalized Stigma of Mental Illness, ISMI), religiosity (based on Stark & Glock), perceived social support (Multidimensional Scale of Perceived Social Support, MSPSS), symptom severity (Positive And Negative Syndrome Scale, PANSS) and psychosocial functioning (clinician-rated Global Assessment of Functioning Scale, GAF, and self-reported World Health Organization Disability Assessment Schedule 2.0, WHODAS 2.0). Descriptive analyses were employed to characterize the study sample. Covariate-adjusted ordinal and multivariable linear regression analyses were performed to investigate cross-sectional associations of baseline ISMI, religiosity and MSPSS with concurrent PANSS, GAF and WHODAS 2.0. Higher self-stigma was associated with poorer self-reported functioning (B = 0.375 [95% Confidence Interval (CI): 0.186, 0.564]) and more severe concurrent symptoms (B = 0.436 [95% CI: 0.275, 0.597]). Being more religious was associated with poorer clinician-rated functioning (OR = 0.967 [95% CI: 0.944, 0.991]), but with less severe symptoms (B = -0.258 [95% CI: -0.427, -0.088]). Stronger social support was associated with poorer clinician-rated (OR = 0.956 [95% CI: 0.935, 0.978]) and self-reported functioning (B = 0.337 [95% CI: 0.168, 0.507]). This study shows that self-stigma, religiosity and perceived social support were associated with symptom severity and clinician-rated as well as self-reported psychosocial functioning in an Iranian cohort of people with recent-onset psychosis. The findings extend previous evidence on these psychosocial factors to one of the largest countries in the Middle East, and suggest that it may be worthwhile to develop strategies aimed at tackling stigma around psychosis and integrate the role of religiosity and social support in mental ill-health prevention and therapy.

Compassion focused therapy for self-stigma and shame in autism: a single case pre-experimental study.

Exposure to public stigma can lead to the internalization of autism-related stigma (i.e., self-stigma), associated with negative health, occupational and social outcomes. Importantly, self-stigma is linked to shame and social isolation. Although elevated self-stigma has been reported in autistic adults, to the best of our knowledge, interventions designed to target this issue are lacking. Compassion is an effective way to reduce the emotional correlates of self-stigma (i.e., shame) and their impacts on mental health. However, no study has investigated whether compassion focused therapy (CFT) can effectively reduce self-stigma in autistic adults. The present study aims at investigating whether and how self-compassion improvement following CFT may reduce self-stigma and shame in an autistic individual. A single case pre-experimental design (SCED) was used with weekly repeated measures during four phases: (i) pure baseline without any intervention (A), (ii) case conceptualization (A'), (iii) intervention (B) where CFT was delivered, (iv) follow-up without intervention (FU). The participant is a 46-year-old autistic man with high self-stigma and shame. Self-report measures of self-compassion and self-stigma and a daily idiographic measure of shame were used. There was a large increase in self-compassion between pure baseline (A) and the intervention phase (A'B) (Tau-U = 0.99), maintained at follow-up. Similarly, there was a moderate decrease of self-stigma (Tau-U = 0.32). In contrast, when we compared the whole baseline phase AA' (i.e., considering the conceptualisation phase as baseline) to the intervention (B), there was no change in self-stigma (Tau-U = -0.09). There was no change in self-stigma between the intervention (B) and follow-up (Tau-U = -0.19). There was a moderate decrease in daily shame reports between the baseline (AA') and the intervention (B) (Tau-U = 0.31) and a moderate decrease between the pure baseline (A) and intervention phase (A'B) (Tau-U = 0.51). CFT was feasible for this autistic client and our results show that CFT led to the improvement of self-compassion. Changes on self-stigma measures were moderate. Self-stigma may need more time to change. Because self-stigma is involved in poorer social functioning and mental health in autistic adults, our results are promising and suggesting conducting more large-scale studies on CFT in autistic adults.

Predicting Psychopathology in Jewish Ultra-Orthodox IPV Survivors: A Machine Learning Approach

The nature of the abuse, cultural and religious values, trauma-related cognitions, and recovery actions are considered factors that shape intimate partner violence (IPV) survivors’ recovery and pathology. However, less is known about their specific impact on women’s psychopathology and wellbeing. Concomitantly, there is scant information about IPV survivors from collectivistic societies such as the Israeli Jewish Ultra-orthodox (JUO) community. The present study was designed to identify predictors of post-traumatic stress (PTSD) symptoms and wellbeing in women from the JUO community who have experienced IPV. Women (N = 261) provided information about their demographics, the nature of the violence, attitudes with respect to cultural and religious norms that normalize violence, trauma-related cognitions, the coping constructs of disengagement, faith, and engaging in help-seeking and recovery actions, and the PTSD symptoms that affect their wellbeing. A Random Forest machine learning (ML) algorithm was used to identify the strongest predictors of psychopathology and wellbeing. Regression trees were developed to identify individuals at greater risk of PTSD symptoms but also of greater wellbeing. Higher self-stigma and the perception of an unsafe world were associated with PTSD symptoms, whereas lower self-stigma, greater faith, and engagement in steps toward recovery were associated with greater wellbeing. These findings highlight the importance of treating women’s self-stigma and perceptions of an unsafe world while also encouraging faith and active engagement in recovery to promote survivors’ wellbeing and lessen their PTSD symptoms.

Predictors of Psychological Help Seeking Behaviours towards Mental Illness in University Students in Jordan vs UK

The adverse effect of self-stigma on psychological help seeking behaviours in mental illness is well documented with factors such as gender and socio-economic status often determining whether or not help is sought. While self-stigma is a complex and multifaceted concept, understanding how it is predicted by factors including but not limited to culture, education, socio-economic background, and knowledge, is elemental in raising awareness and reducing its impact. We explored the influence of culture and educational background on knowledge and self-stigma towards mental illness in university students in the UK and in Jordan. Jordanian participants were expected to be less knowledgeable with higher self-stigma towards help seeking behaviours in mental illness than the UK participants. Surprisingly, contrary to the extant literature there were no significant effects for culture or for educational background on self-stigma towards mental illness nor on the amount of knowledge between the two samples. The implications of the pattern of results are promising as debated in the discussion.

Study of self- stigma and self -esteem in patients with anxiety and depression

: Self -stigma occurs when a person accepts the negative attitude towards them, then internalize and apply belief to themselves. Self-esteem is individual’s subjective evaluation of their own worth. Self-stigma and self-esteem affects a person’s perception about themselves and the society surrounding them which plays an important role in treatment. It is most commonly affected in people diagnosed with psychiatric disorders.The aim was to study self-stigma and self-esteem in patients with anxiety and depression.After permission from Institutional ethics committee, semi-structured proforma, Internalized Stigma of Mental Illness Inventory-9 and Rosenberg’s Self Esteem Scale was used to assess 50 consecutive participants diagnosed with anxiety and depression according to DSM-5 criteria. Participants satisfying the inclusion and exclusion criteria were included in the study. The data collected was tabulated and analysed statistically and results and conclusions were drawn by using chi-square test, a p-value of &amp;#60;0.05 was considered significant.Mean age of participants was 38.88 years with 64% females, majority being married, predominantly from urban background having education of at least secondary school certificate.19 participants were diagnosed with anxiety while 31 had depression.56% of the participants had high self-stigma and 54% participants had low self-esteem. There wasn’t any significant difference in percentages of high self-stigma and low self-esteem when compared between anxiety disorders and in depression. There were no significant socio-demographic or clinical correlates relating to self- stigma and self-esteem according to this study. It was observed that both high self-stigma and low self-esteem was significantly high in psychiatric patients. It was seen that low self- esteem was associated with high self-stigma and high self-esteem was associated with low self-stigma. Hence, steps must be taken to psycho-educate the patient and their family members in order to reduce self-stigma and help in increasing their self-esteem.

Exploring barriers and facilitators to women's intention and behavior to seek treatment for distressing sexual problems.

Many women experience distressing problems with sexual functioning, most commonly in the form of low sexual desire or arousal, difficulties reaching orgasm, or genito-pelvic pain with sexual activity. Although effective treatments are available, more than half of the women who experience distressing sexual problems do not seek professional help. Understanding help-seeking patterns, experiences with treatment providers, and barriers to treatment is crucial to address this underutilization. Examining the role of personal characteristics, sexual problem symptoms, and cognitive factors in explaining the intention to seek treatment can help identify individuals who are most reluctant to seek help. Psychological online interventions are a promising resource to increase the availability of effective treatments. Knowledge about the predictors of women's intention to use internet-delivered treatments, as well as information about personal preferences regarding their scope, can help tailor them to women's needs. To address these research questions, cross-sectional data of 800 women (Mage = 30.49, range = 18-73) were analyzed. While many women considered clinical psychologists to be the most qualified treatment providers, gynecologists were cited as the most likely first point of contact. Among women not utilizing any treatments, many reported a preference for dealing with a sexual problem on their own as a reason not to seek help. Higher help-seeking intention was related to living in a larger city, experiencing higher sexual distress, experiencing pain or difficulties with vaginal penetration, higher self-stigma. and lower sexual assertiveness. Women who were convinced of the effectiveness of psychological online interventions and who appreciated the benefits of anonymity indicated that they were more likely to use them. Understanding what factors influence women's decisions about whether or not to seek professional help for distressing sexual problems is key to reducing the underutilization of available resources and developing treatments that meet their needs and preferences.

Validity and Reliability of the Korean Version of the Weight Self-Stigma Questionnaire (WSSQ-K).

Weight self-stigma refers to negative self-prejudice due to the internalization of negative social messages about one's weight. People with high self-stigma may have low self-esteem and decreased social activity. Weight-related self-stigma can create diet-related disorders since it is highly related to the recognition of body types. However, there are no tools available to measure the weight-related stigma of the general public in Korea. This study evaluated the validity and reliability of the Korean version of the Weight Self-Stigma Questionnaire (WSSQ-K). A methodological study was conducted with 150 Korean university students. Construct validity was evaluated using exploratory factor analysis. The WSSQ-K was correlated with body mass index and measures of self-esteem and weight concern to evaluate concurrent validity. Internal consistency reliability was evaluated with Cronbach's alpha. In the exploratory factor analysis, two factors were proposed: "self-devaluation" (Cronbach's α = 79) and "fear of enacted stigma" (Cronbach's α = 82). Factor loadings for the 12 items on two factors ranged from 0.539 to 0.811, which explained 53.3% of the total variance. The WSSQ-K correlated with body mass index, self-esteem, and weight concern. The findings showed that the WSSQ-K was a reliable and valid measure that could be used for evaluating weight self-stigma in normal-weight adults in Korea.

Predictors of Perceived, Personal, and Self- Stigma on Depression and Relevant Interventions

Depression is a severe public health issue that affects millions of individuals throughout the world. However, more than half of patients with depression are reluctant to seek help, and the stigma of depression has been identified as the major barrier to their help-seeking. There are three kinds of stigma: perceived stigma, personal stigma, and self-stigma. However, the existing research lacks distinguishment and comparation among them. This study outlines the respective predictors of the three kinds of stigma, to fill this research gap. The findings of this review show that the three types of stigma have different predictors. People who are female, with greater depression severity, more contact with depression patients, and lower social support, reported higher perceived stigma. Higher personal stigma is predicted by being male, lower depression literacy, and less contact with depression. Moreover, greater depression symptomatology, less knowledge about depression, and less social support are associated with higher self-stigma. The existing studies on anti-stigma interventions suggest that personal stigma can be effectively reduced by the depression awareness campaign. Plus, group psychotherapy works well in decreasing self-stigma. However, existing interventions have a limited effect on reducing perceived stigma. Existing studies on predictors of stigma have some limitations: they are cross-sectional studies and usually focus on only one or two types of stigma. Therefore, future studies should conduct some longitudinal studies and investigate all three kinds of stigma simultaneously to make up for these shortcomings. The main contribution of this paper is distinguishing the predictors of perceived stigma, personal stigma, and self-stigma, providing a framework for future study on antecedents of different stigma and the design of stigma reduction interventions. This review can provide some guidance to the prevention and intervention programs for depression stigma at schools.

The impact of self-stigma in people with diagnosis of severe mental illness: a cross-sectional pilot study from a community psychiatry unit in Porto, Portugal

IntroductionSelf-stigma refers to the process in which a person internalizes negative stereotypes, beliefs, and prejudices about their mental illness, adopting a stigmatized view of themselves. Severe mental illness is one of the most socially exclusive stigmata and is associated with poor clinical and functional outcomes and social withdrawal.ObjectivesIn Portugal, investigation regarding self-stigma is scarce. In this study, we aim to evaluate the impact of self-stigma among people with diagnosis of severe mental illness (SMI). For this goal we assess the prevalence of self-stigma of psychiatric patients with diagnosis SMI; and investigate the correlates of elevated self-stigma levels.MethodsFifty-one outpatients with SMI, were recruited from a community psychiatry unit from Porto, Portugal. After informed consent, evaluations included sociodemographic data, illness characteristics, and self-reported standardized scales. Self-stigma (ISMI), self-esteem (RSES) and quality of life (WHO-QoL) were assessed. Data analyses were performed using the SPSS version 28.0 (IBM Corp., Armonk, NY). p-values&lt;0.05 were considered significant.ResultsFrom the study sample, 66.7% were male, with mean age of 44.8±11.0 and 56.9% were single. 33.3% reported living with their parents while 31.4% were living with a partner/spouse. The majority of participants had a diagnosis of schizophrenia (60.8%). Concerning the level of education, 58.8% completed basic education, but most patients were retired due to illness (62.7%). In this study, moderate to high self-stigma levels was found in 31.4% participants. Proportion of elevated self-stigma was significantly higher in unemployed/retired patients vs. those who were active (39.0% vs. 0%; P=0.021). No significant correlations were found with age, level of education, age at diagnosis, duration of illness, and number of hospitalizations. In the correlations analysis, a negative correlation between self-stigma and self-esteem (rho=-0.745; P&lt;0.001), as well as self-stigma and quality of life (rho=-0.585; P&lt;0.001) was found. A positive relationship between self-esteem and quality of life (rho=0.551; P&lt;0.001) was found.ConclusionsThis study investigates, for the first time, the prevalence of self-stigma among outpatients with SMI in a community psychiatric unit from Porto. Our findings suggest a high prevalence of elevated levels of self-stigma among these patients. A significant association with being unemployed/retired was also found. Our results support previous evidence that internalized stigma is strongly associated with diminished self-esteem and impaired quality of life, in particular those aspects related to physical and psychological complaints. Targeting internalized stigma and self-esteem among patient with SMI will likely improve their quality of life, besides improving their clinical and functional outcomes.Disclosure of InterestNone Declared

Even mild internalized stigma merits attention among adults with serious mental illness.

Internalized or self-stigma can be damaging to psychological and social functioning and recovery, especially for people with serious mental illness. Most studies have focused on the effects of high self-stigma, which has included both moderate and high self-stigma, versus low levels of self-stigma which has included no, minimal, or mild self-stigma. Therefore, little is known about the variation within these categories (e.g., minimal versus mild self-stigma) and its impact on recovery. This article examines differences in the demographic, clinical, and psychosocial variables associated with different levels of self-stigma severity. Baseline data (N = 515) from two concurrent randomized controlled trials of a psychosocial intervention aimed at reducing internalized stigma, and its effects among adults with serious mental illnesses were examined. We found that participants with greater psychological sense of belonging, and greater perceived recovery were significantly less likely to have mild or moderate/high internalized stigma than minimal stigma. Those reporting a greater frequency of stigma experiences, however, were more likely to have mild or moderate/high internalized stigma than minimal stigma. Our findings further underscore the multifaceted nature and impact of self-stigma, particularly in interpersonal relationships and interactions, and demonstrate the importance of attending to even mild levels of self-stigma endorsement. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Self-Stigma as The Trigger of Depression Factor in Multidrug - Resistant Tuberculosis (MDR-TB) Patients at a Public Hospital in Gresik

Introduction: Multidrug-Resistant Tuberculosis (MDR-TB) is a chronic infectious disease that can affect the patient's physical appearance so that it has an impact on the patient's psychosocial condition, including the emergence of anxiety and depression. Anxiety and depression in MDR-TB patients have an impact on the patient's rejection of the diagnosis and they choose to stop the treatment process. The incidence of anxiety and depression in MDR-TB patients is influenced by several factors, one of which is self-stigma. The purpose of this study was to determine the impact of the factor of self-stigma on the incidence of depression in MDR-TB patients.Method: The study design used a cross-sectional approach with a sample of 71 MDR-TB patients undergoing treatment. The study used a questionnaire that was filled out directly by the patient during the treatment process. The sampling technique used purposive sampling by setting inclusion criteria. The bivariate statistical test used in the study was chi-square.Results: The results of the self-stigma study obtained a p-value = 0.000 &lt;0.05 with an OR value of 54.643, meaning that there was a significant relationship between self-stigma and depression in MDR-TB patients.Conclusions: MDR-TB patients with high self-stigma have a higher chance of experiencing depression than patients with low self-stigma. Suggestions in this study are that it is hoped that the family, health workers, community, and government can help reduce the stigma against patients with MDR-TB. Promotive efforts by providing support and education to the community can help to eliminate the stigma so that the incidence of depression in MDR-TB patients can be minimized.

Risk and protective factors for mental ill-health in elite para- and non-para athletes

ObjectiveTo apply a socioecological approach to identify risk and protective factors across levels of the “sports-ecosystem,” which are associated with mental health outcomes among athletes in para-sports and non-para sports. A further aim is to determine whether para athletes have unique risks and protective factor profiles compared to non-para athletes.MethodsA cross-sectional, anonymous online-survey was provided to all categorized (e.g., highest level) athletes aged 16 years and older, registered with the Australian Institute of Sport (AIS). Mental health outcomes included mental health symptoms (GHQ-28), general psychological distress (K-10), risky alcohol consumption (AUDIT-C) and eating disorder risk (BEDA-Q). Risk and protective factors across multiple levels of the socioecological model, including individual, microsystem, exosystem and macrosystem level factors were assessed via self-report.ResultsA total of 427 elite athletes (71 para and 356 non-para athletes) participated in the study. No significant differences in the rates of mental health problems were observed between para and non-para athletes. Both differences and similarities in risk and protective factor profiles were found across the multiple levels of the sports-ecosystem. Weak evidence was also found to support the hypothesis that certain risk factors, including experiencing two or more adverse life events in the past year, sports related concussion, high self-stigma, inadequate social support and low psychological safety conferred a greater risk for poorer mental health outcomes for para athletes in particular.ConclusionRisk factors occurring across various levels of the sports ecosystem, including individual, interpersonal and organizational level risk factors were found to be associated with a range of poorer mental health outcomes. The association between mental ill-health and certain risk factors, particularly those at the individual and microsystem level, appear to be greater for para athletes. These findings have important implications for policy and mental health service provision in elite sports settings, highlighting the need for more nuanced approaches to subpopulations, and the delivery of mental health interventions across all levels of the sports ecosystem.

Magnitude and factors associated with treatment non-adherence among patients with depressive disorders at St. Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2019: A cross sectional study.

BackgroundInadequate adherence to treatment is among the main underlying causes of depression becoming a chronic problem. In developing countries due to limited access to health care, inaccurate diagnoses, and scarcity of medications, poor adherence may become an even larger obstacle in the treatment of depression. The current study aims to assess the magnitude and factors related to treatment non-adherence among patients with depressive disorders.ObjectiveTo assess the magnitude and factors associated with treatment non adherence among patients with depressive disorders at St. Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia, 2019.MethodsA hospital-based cross-sectional study was conducted among 415 respondents using systematic random sampling technique. Medication adherence was assessed by using Medication Adherence Rating Scale. Data was entered to Epi-data version 3.1 and analyzed using SPSS version 20. Binary logistic analysis was done and P-values less than 0.05 were considered statistically significant.ResultsThe prevalence of treatment non-adherence among patients with depressive disorders was 26% (95%CI; 21.2, 32.5). Previous suicide attempt (AOR = 3.05, 95%CI; 1.82, 5.12), medication side effects (AOR = 2.46, 95%CI; 1.47, 4.11), moderate to high self-stigma (AOR = 2.60, 95%CI; 1.45, 4.66), and poor quality of life (AOR = 2.47, 95%CI; 1.42, 4.28) were significantly associated with treatment non-adherence among patients with depressive disorders.Conclusion and recommendationTreatment non-adherence is a common problem among patients being treated for depressive disorders. Previous suicide attempts, medication side effects, moderate to high self-stigma, and poor quality of life were significantly associated with treatment non-adherence. Appropriate interventions should be developed to promote measures to facilitate adherence in this group of patients, and address the associated factors when applicable.

A mixed-methods approach to psychological help-seeking in Muslims: Islamophobia, self-stigma, and therapeutic preferences.

Muslims living in the United States (MLUS) report high mental health stigma. They also underutilize professional psychological help, despite experiencing rising Islamophobia and comparatively poorer mental health. In line with double stigma, we examined whether MLUS who perceived greater Islamophobia also experienced greater self-stigma of seeking help, and whether this was related to negative help-seeking attitudes. We also assessed therapist demographic and treatment modality preferences and explored how they related to risk factors for low help-seeking. Utilizing a representative sample of 350 MLUS (50% women, 33% immigrants) acquired via a Qualtrics panel aggregate, we assessed a path model of help-seeking attitudes to determine the direct and indirect effects of perceived Islamophobia via self-stigma and psychological distress. Therapist and treatment preferences were examined via multiple regression models and analysis of variance (ANOVAs). Open-ended responses were coded through content analysis. Perceived Islamophobia was associated with greater psychological distress and also indirectly related to negative help-seeking attitudes via greater self-stigma. Therapists of a similar background, therapy in a mosque-setting, group therapy, and imam collaboration were more appealing to MLUS who were at risk for low help-seeking. Among MLUS, perceived Islamophobia may present a dual risk-simultaneously increasing psychological distress and indirectly leading to negative attitudes toward help-seeking via higher self-stigma. Conversely, for MLUS at risk for low help-seeking, accessible community-based treatments and treatment with a Muslim or race/ethnicity-matched therapist may facilitate help-seeking behaviors. Future work may determine whether addressing double stigma within Muslim communities (e.g., Islamophobia and self-stigma) may improve psychological help-seeking. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Addressing barriers to mental health services: evaluation of a psychoeducational short film for forcibly displaced people

ABSTRACT Background: Despite the high prevalence of mental illness in forcibly displaced people, their utilization of mental health services is low. Major barriers to seeking mental health services include mental health self-stigma. To address this issue, the psychoeducational short film ‘Coping with Flight and Trauma’ was developed as a brief online intervention. Objective: The present study aims to evaluate the feasibility and acceptance of the newly developed 10 min film, and to assess changes in self-stigma and help seeking. Method: The evaluation of the film was conducted using a mixed-methods design with an online survey including the Self-Stigma of Mental Illness Scale, help seeking, and mental health variables at baseline, postintervention, and 3 month follow-up, in addition to telephone interviews postintervention with a randomly selected volunteer subsample. Results: A total of 134 participants with a forced displacement history within the past 8 years took part in the study, of whom 66% scored as having probable post-traumatic stress disorder (PTSD), depression, and/or anxiety. The results revealed emotional, cognitive, and behavioural changes postintervention. Directly after watching the film, participants reported reduced self-stigma and increased openness towards accessing mental health services. At follow-up, precisely 3.8 months later, these changes were no longer significant, yet 11% of participants reported having started psychotherapy since watching the film. Probable PTSD was associated with higher self-stigma at all three time-points. The majority (90%) would recommend watching the film to other forcibly displaced people. Conclusions: Self-stigma was shown to be a robust and persistent issue, which tends to be underestimated by individuals not affected by mental illness. Low-threshold psychoeducational online interventions may be a promising tool to reduce barriers to accessing mental health services for forcibly displaced people, e.g. by being implemented in stepped-care models. HIGHLIGHTS Mental health self-stigma was shown to be a persistent and underestimated burden in forcibly displaced people. Psychoeducational online interventions are promising for addressing the burden of self-stigma and reducing barriers to seeking mental health services.

Mental Health Service Utilization Among Medical Students with a Perceived Need for Care

The authors investigated levels of perceived need for help, patterns of mental health service utilization, and barriers to care among US medical students with a focus on students who perceived a need for help but did not report service use in the past 12months. The authors administered an online survey to 2,868 medical students at three schools in Ohio between January and February 2020 including validated scales for psychological distress, self-stigma, and an exploration of mental health treatment. The authors used multivariable logistic regression to identify factors associated with treatment and qualitative analysis to identify common barriers to care. Twenty-eight percent (N = 800) of 2,868 students responded to the survey. Fifty-six percent (n = 439) of students reported a perceived need for help, while 34.6% of these respondents (n = 152) did not receive treatment. Among those with perceived need who completed the survey (n = 388), Asian students compared to non-Hispanic white students (adjusted odds ratio [aOR] = 0.45, 95% confidence interval [CI] 0.25-0.82) and those with higher self-stigma (aOR = 0.90, 95% CI 0.87-0.94) had lower odds of service use. Students told by others to seek help (aOR = 2.82, 95% CI 1.71-4.64) were the only group with higher odds of service use. The most common barriers to care were lack of time, difficulty accessing services, and stigma. Despite a perceived need for help, many students do not seek care and experience treatment barriers. Schools can encourage help-seeking by identifying students in need, using targeted messaging, fostering a low-stigma environment, and removing barriers.

Diabetes-Related Stigma and its Influence on Social Networks, Social Support, and HbA1c in Ghana.

We applied a social network approach to examine if three types of diabetes-related stigma (self-stigma, perceived stigma and enacted stigma) moderated associations between social network characteristics (network size, kin composition, household composition, and network density), social support, and blood glucose among Ghanaians with type 2 diabetes mellitus (T2DM). Data were obtained through a cross-sectional survey of 254 adults at a diabetes clinic in Ghana that assessed participants' social networks, social support, and frequency of experiencing three types of diabetes-related stigma. Self-stigma moderated associations between kin composition and social support when controlling for network size β=-.97, P=.004). Among study participants reporting low self-stigma, kin composition was positively associated with social support (β=1.29, P<.0001), but this association was not found among those reporting high self-stigma. Network size was positively associated with social support among participants reporting both low and high self-stigma. None of the types of diabetes-related stigma moderated other associations between social networks, social support, and blood glucose. Individuals with T2DM who report high self-stigma may have lower social support, which can reduce their capacity for disease management. Additionally, larger social networks may be beneficial for individuals with T2DM in countries like Ghana, and interventions that expand network resources may facilitate diabetes control.

Self-stigma in Serious Mental Illness: A Systematic Review of Frequency, Correlates, and Consequences.

Self-stigma is associated with poor clinical and functional outcomes in Serious Mental Illness (SMI). There has been no review of self-stigma frequency and correlates in different cultural and geographic areas and SMI. The objectives of the present study were: (1) to review the frequency, correlates, and consequences of self-stigma in individuals with SMI; (2) to compare self-stigma in different geographical areas and to review its potential association with cultural factors; (3) to evaluate the strengths and limitations of the current body of evidence to guide future research. A systematic electronic database search (PubMed, Web of Science, PsycINFO, Scopus, and Ovid SP Cumulative Index to Nursing and Allied Health Literature [CINAHL]) following PRISMA guidelines, was conducted on the frequency, correlates, and consequences of self-stigma in SMI. Out of 272 articles, 80 (29.4%) reported on the frequency of self-stigma (n = 25 458), 241 (88.6%) on cross-sectional correlates of self-stigma and 41 (15.0%) on the longitudinal correlates and consequences of self-stigma. On average, 31.3% of SMI patients reported high self-stigma. The highest frequency was in South-East Asia (39.7%) and the Middle East (39%). Sociodemographic and illness-related predictors yielded mixed results. Perceived and experienced stigma-including from mental health providers-predicted self-stigma, which supports the need to develop anti-stigma campaigns and recovery-oriented practices. Increased transition to psychosis and poor clinical and functional outcomes are both associated with self-stigma. Psychiatric rehabilitation and recovery-oriented early interventions could reduce self-stigma and should be better integrated into public policy.