Contextualizing public stigma: Endorsed mental health treatment stigma on college and university campuses

Abstract

Scholars suggest that public mental health stigma operates at a meso-level and is associated with severity of symptoms, disclosure, self-esteem, and treatment-seeking behavior. However, the operationalization of public stigma nearly always comes from an individual-level generalization of what others believe. Using data from over 60,000 students on 75 U.S. college and university campuses between 2009-2015, we contextualize public stigma by creating a school-level measure of students' individual-level endorsed mental health treatment stigma. We present multilevel logistic regression models for 21 different dependent variables. We find that even after controlling for individual-level stigma scores, school-level stigma is negatively associated with self-reports of suicidal ideation and self-injury, although not associated with screens for depression or anxiety. Moreover, school-level stigma is negatively associated with medication use, counseling and therapy visits, and to a lesser degree, informal support. We suggest that future research should continue to examine the contextual environment of public stigma, while policymakers may be able to implement changes to significantly reduce stigma at this level.

Dominant Cultural and Personal Stigma Beliefs and the Utilization of Mental Health Services: A Cross-National Comparison

“…The cross-national, multi-level design of our study allows us to draw a distinction between the prevailing stigma beliefs within a country and the beliefs of individuals by aggregating individuals' beliefs at the country level. Other scholars have used similar strategies, including aggregation at the level of countries (Mojtabai, 2010;Evans-Lacko et al, 2012;Pachankis et al, 2014) or schools (Gaddis et al, 2018), or within categories of stigmatized identities (Quinn and Chaudoir, 2009). Based on this reasoning, we predict that citizens of countries with a strongly stigmatizing culture are less likely to utilize professional mental health care services, regardless of their personal stigma beliefs (H2).…”

Experience of stigma and discrimination in families of persons with schizophrenia in the Czech Republic

“…The process of transferring stigma from people with mental illness to their companions and relatives and discrediting them is described in the literature as "courtesy stigma" Goffman, 1969), "associative stigma" (Mehta & Farina, 1988), "stigma by association" (Goldstein & Johnson, 1997;Neuberg et al, 1994;Ostman, 2002) or "family stigma" Phelan et al, 1998). Stigma is widespread (Koschorke et al, 2014;Nadia Kadri, Fatiha Manoudi, & Soumia Berrada, 2004;Shibre et al, 2001), exists in different domains of life (Buizza et al, 2007;Gaddis et al, 2018), and associated with both subjective and objective burden on family members (González-Torres et al, 2007;Kjellin & Margareta, 2002;Larson & Corrigan, 2008;Lefley, 1989;Muhlbauer, 2002;Phelan et al, 1998;Shibre et al, 2001;Struening et al, 2001;Zou et al, 2014).…”

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“…PAL sessions being timetabled centrally are therefore one of the various interventions that address students' affective issues and help lower their negative emotions. The direct involvement of HE administrators at meso-level is also encouraged by Gaddis, Ramirez & Hernandez (2018) to influence local environments.…”

“…The aim of this paper is to explore affect in first-year students in HE, with a particular focus on anxiety and related emotions, and evaluate a peer-assisted learning (PAL) scheme as an effective strategy in alleviating levels of stress and anxiety. In recent years, students' mental health and well-being have been the object of several studies that have highlighted the alarmingly increasing rates of depression, stress and anxiety amongst university students all over the world (Gaddis, Ramirez & Hernandez, 2018;Lee et al, 2018;Viskovich & Pakenham, 2018;Moore, Pollio, Hong, Valencia, Sorrell, & North, 2018;Carter, 2016;Adewuya, Ola, Olutayo, Mapayi, & Oginni, 2006;Nerdrum, Rustøen, & Rønnestad, 2006;Aktekin, Karaman, Senol, Erdem, Erengin, & Akaydin, 2001;Stewart-Brown, Evans, Patterson, Petersen, Doll, Balding, & Regis, 2000).…”