Cross-sectional population based study ascertaining the characteristics of US rural adults with mental health concerns who perceived a stigma regarding mental health issues

Abstract

Introduction: Mental health is an important component of overall health. Mental illness is a leading cause of morbidity and mortality in the US and is associated with chronic diseases such as heart disease, diabetes, and arthritis. In the US, most people with mental health issues or disorders remain untreated. Epidemiological studies have identified rural residents as being at greater risk for health disparities; as a result, rural residents are a vulnerable population in terms of mental health and mental health care. Research has demonstrated that perceived stigma can be a significant barrier to rural residents seeking mental health care. This study examined the research question: What are the characteristics of US rural adults with mental health concerns who perceived stigma? Methods: 2007 Behavioral Risk Factor Surveillance System (BRFSS) data were analyzed using bivariate and multivariate techniques to answer the research question. 2007 BRFSS data were used because in that year non-institutionalized US adults in 37 states and territories were queried about their attitudes toward mental illness. BRFSS is a random digit telephone survey that uses a complex multi-stage sampling approach and subsequently a weighting factor is calculated for application to the data in order to ensure that they are representative of the US population based on the most recent census data.Only weighted data were analyzed. Results: Logistic regression analysis revealed that rural adults reporting mental health concerns who perceived stigma regarding mental health were more likely to be unemployed seeking work or not working and not seeking work, military veterans, or to have deferred medical care because of cost. They were also more likely to not have a health care provider and to rarely or never feel supported emotionally. Conclusions: Support systems may render people with mental health issues less vulnerable to perceiving stigma, thus assisting with removing stigma as a barrier to care. Pharmacist may play a role as support in communities, especially where access to health care providers may be limited.

The Relationship Between Locale and the Risk of Mental Health Problems for US Teenagers

“…Another area from which stigma may arise is the lack of support systems, emotionally and socially. Individuals without a primary healthcare provider are more vulnerable to perceiving stigma [11]. This further proves the point made in the Literature Review and Background section of this paper: that social and emotional support is a key influence on individuals' emotional and mental well-being.…”

Incarceration and adversity histories: Modeling life course pathways affecting behavioral health.

“…For example, social support is a strong resource mediating the relationship between ACEs and depression in later adulthood, although higher levels of ACEs are associated with reduced social support (Cheong, Sinnott, Dahly, & Kearney, 2017) and exacerbation of risk. Similarly, stigma regarding mental health issues serves as a substantial barrier to mental health care access, whereas more accepting environments reduce this risk (Pederson et al, 2013). Likewise, higher early and later life adversity has been associated with weakened positive health behaviors, including physical activity (Nurius et al, 2019), an established protective factor for depressive symptoms (Du et al, 2015).…”

Rural Emergency Medical Service Providers Perceptions on the Causes of and Solutions to the Opioid Crisis: A Qualitative Assessment

“…These individuals were also more likely to report lacking emotional support and an established health care provider. 55 …”

“…These individuals were also more likely to report lacking emotional support and an established health care provider. 55 Not surprisingly, study participants reported that a lack of education served as a perceived causative factor of the opioid crisis. They cited a major need for increased education for community members and healthcare providers alike.…”

“…51 In rural communities, a shortage of mental health facilities and providers, 52 and increased perceived stigma surrounding mental health 53,54 may compound or potentially cause individual struggles with substance use disorders. A study by Pederson et al 55 revealed that rural adults who reported having a mental health concern and who also had perceived stigma regarding mental health were more likely to be unemployed, seeking work, or not working and not seeking work, military veterans, or to have deferred medical care because of cost. These individuals were also more likely to report lacking emotional support and an established health care provider.…”