Self- and perceived-stigmatizing responses to help-seeking for depression are prevalent in the community and are associated with reluctance to seek professional help. Interventions should focus on minimizing expectations of negative responses from others and negative self-responses to help-seeking, and should target younger people.

Self- and perceived-stigmatizing responses to help-seeking for depression are prevalent in the community and are associated with reluctance to seek professional help. Interventions should focus on minimizing expectations of negative responses from others and negative self-responses to help-seeking, and should target younger people.

The term mental health literacy was first introduced in 1997 and defined as 'knowledge and beliefs about mental disorders which aid their recognition, management and prevention' [1]. The aim in coining this term was to draw attention to a neglected area. Whereas the public know a lot about other major health problems such as cancer and heart disease, they lack the same degrees of knowledge about mental disorders [2]. Since then, the term mental health literacy has come into widespread use in Australia and it has appeared as a national goal in a number of policy documents [3,4]. The concept has also spawned quite a bit of research and it is the purpose of the present paper to summarize what we have learned since 1997 and what we still need to know. The summary below draws mainly on Australian research and particularly on the series of papers published in the current issue of the journal. Although a number of researchers in other countries started up similar lines of work at around the same time [5], this is arguably an area in which Australia has had a leading role.

Background: In-depth and structured evaluation of the stigma associated with depression has been lacking. This study aimed to inform the design of interventions to reduce stigma by systematically investigating community perceptions of beliefs about depression according to theorised dimensional components of stigma.

Self-stigma may feature strongly and be detrimental for people with depression, but the understanding of its nature and prevalence is limited by the lack of psychometrically-validated measures. This study aimed to develop and validate a measure of self-stigma about depression. Items assessing self-stigma were developed from focus group discussions, and were tested and refined over three studies using surveys of 408 university students, 330 members of a depression Internet network, and 1312 members of the general Australian public. Evaluation involved item-level and bivariate analyses, and factor analytic procedures. Items performed consistently across the three surveys. The resulting Self-Stigma of Depression Scale (SSDS) comprised 16 items representing subscales of Shame, Self-Blame, Social Inadequacy, and Help-Seeking Inhibition. Construct validity, internal consistency and test-retest reliability were satisfactory. The SSDS distinguishes self-stigma from perceptions of stigma by others, yields in-depth information about self-stigma of depression, and possesses good psychometric properties. It is a promising tool for the measurement of self-stigma and is likely to be useful in further understanding self-stigma and evaluating stigma interventions.