Do depression literacy, mental illness beliefs and stigma influence mental health help-seeking attitude? A cross-sectional study of secondary school and university students from B40 households in Malaysia

Abstract

Background Mental illness rates among young people is high, yet the frequency of help-seeking is low, especially among those from lower socioeconomic backgrounds. Understanding factors influencing help-seeking, such as mental illness beliefs, stigma and literacy among B40 individuals is important, but past studies are sparse. Hence, we aimed to examine the factors associated with mental help-seeking attitude among students from the B40 income bracket. Differences in beliefs toward mental illness, stigma and help-seeking attitudes among university and secondary school students were also investigated. Methods University and secondary school students from low-income households ( N = 202) were involved in this cross-sectional study. Participants completed the Depression Literacy Questionnaire (D-Lit), General Help Seeking Questionnaire (GHSQ), Mental Help Seeking Attitudes Scale (MHSAS), Self-Stigma of Seeking Help Scale (SSOSH), and Beliefs toward Mental Illness (BMI). Results Mental help-seeking attitude had a significant relationship with self-stigma on seeking help (r = −.258, p < .001), general help-seeking attitude (r = .156, p = .027), and age (r = .187, p < .001). However, the strongest predictor for mental help-seeking attitude was self-stigma on seeking help (F (2,199) = 8.207, p < .001 with R 2 of .076). University students had better depression literacy and lower levels of self-stigma and negative beliefs toward mental illness compared to secondary school students. Conclusion Higher self-stigma and younger age were associated with negative mental help-seeking attitudes among students from low-income households. As self-stigma may be a barrier to actual mental help-seeking, efforts to reduce self-stigma in this population need to be intensified.

Stigma and utilization of treatment for adolescent perinatal depression in Ibadan Nigeria

“…Adolescent mothers in LMICs have reported a high degree of stigmatizing attitudes regarding adolescent sexual activity from healthcare providers, which reflects broader social and cultural forces to healthcare participation [3,14,20,29]. Self-stigma and younger age have been associated with mental help-seeking among young people [12], and perinatal adolescents with depression, have reported additional experiences of social stigma from family members, partners, and people in their social environments, as barriers to health care utilization [13]. Stigma is a fundamental cause of health inequities [10] and stigmatizing attitudes from clinic staff may lead to dissatisfaction with the health system, reduce the likelihood of help-seeking, and eventually compromise maternal and infant health outcomes [11,18,30].…”

Predictors of Psychological Distress and Mental Health Resource Utilization among Employees in Malaysia

“…Awareness of cognitive behavior therapy or other types of psychological therapy was associated with at least five times higher psychological distress, although the latter is likely due to the fact that employees who were aware of cognitive behavior therapy were plausibly more likely to have undergone it than not. Underutilization of services is not uncommon and has been documented both in Malaysia [ 14 ] and elsewhere [ 33 ]. Current findings also showed that a majority of the employees were not aware of resources available to them, which likely affected the utilization rate of such resources.…”

“…Current findings also showed that a majority of the employees were not aware of resources available to them, which likely affected the utilization rate of such resources. It is also possible, given the cultural context of this study, that employees may be reluctant to take up psychological therapy due to the stigma still associated with mental illness and/or usage of services targeted at alleviating it [ 14 , 16 ].…”

“…Much of the published literature in this area has focused on high-resource countries [ 9 , 10 , 11 ]. Thus, there are major gaps in what is known about this situation in low- to middle-resource nations, where mental health literacy and acceptance of mental health are much lower [ 12 , 13 , 14 , 15 ].…”

Stigma and utilization of treatment for adolescent perinatal depression in Ibadan Nigeria

“…Adolescent mothers in LMICs have reported a high degree of stigmatizing attitudes regarding adolescent sexual activity from healthcare providers, which reflects broader social and cultural forces to healthcare participation (Baryamutuma, 2011;Mbeba et al, 2012;Kennedy et al, 2013;WHO, 2017). Self-stigma and younger age have been associated with mental help-seeking among young people (Ibrahim et al 2019), and perinatal adolescents with depression, have reported additional experiences of social stigma from family members, partners, and people in their social environments, as barriers to health care utilization (Kaye, 2008). Stigma is a fundamental cause of health inequities (Hatzenbuehler, Phalen, and Link, 2013) and stigmatizing attitudes from clinic staff may lead to dissatisfaction with the health system, reduce the likelihood of help-seeking, and eventually compromise maternal and infant health outcomes (White Ribbon Alliance, 2011; Holmes 2012; Mannava et al 2015).…”