Influences of face, stigma, and psychological symptoms on help‐seeking attitudes in Macao

Abstract

The purpose of this study was to examine the relationships between concerns about loss of face, stigma, psychological symptoms, and attitudes toward seeking mental health services such as counseling in Macao. Participants included 391 students attending the largest public university in Macao: 277 were from Macao and 114 were from Mainland China. Participants completed questionnaires measuring attitudes toward seeking professional psychological help, concerns about loss of face, self-stigma, public-stigma, and psychological symptoms. Results showed that positive attitudes toward help-seeking were significantly negatively correlated with self-stigma, public-stigma, and concerns about loss of face but there was no significant correlation with psychological symptoms. Psychological symptoms were positively correlated with face concerns, self-stigma, and public-stigma. Stigma (self and public) was found to be significantly positively associated with face concerns, but the correlations were weak. Findings also showed that Macao students had higher levels of distress, and endorsed greater self- and public-stigma than Mainland Chinese students; however, the groups did not differ in face concerns or attitudes toward help-seeking. Regression analysis indicated that group membership was not a significant predictor of help-seeking. Self-stigma was the strongest predictor of professional help-seeking. Age and sex were also found to be significant predictors. Results suggested that younger students were more likely to seek help and that female students reported greater levels of distress and tended to have more positive attitudes toward seeking psychological services than male students.

Is It Cultural Context or Cultural Value? Unpackaging Cultural Influences on Stigma Toward Mental Illness and Barrier to Help-Seeking

“…Concern for face loss and fear of moral contamination may lead to perceptions of threating the extension of one’s family lineage, with severe social consequences (Yang & Kleinman, 2008; Yang et al, 2013). Indeed, both face and stigma were found to be related to psychological symptoms and negative attitudes toward seeking mental health services among Macau and Mainland Chinese students (Cheang & Davis, 2014). We propose that concern for loss of face is the mechanism underlying stigma toward mental illness that may bar individuals from seeking help from mental health professionals to prevent shaming one’s family, as mental illness is severely stigmatized in Chinese communities.…”

Determining the effectiveness of a video-based contact intervention in improving attitudes of Penang primary care nurses towards people with mental illness

“…Mental illness-related stigma was defined by Goffman (1963) as a ‘discrediting trait’ which results in negative attitudes towards people with mental illness [ 1 , 2 ]. Attitudes towards people with mental illness are influenced by many factors, including culture, level of education, knowledge, and contact with people with mental illness [ 3 – 20 ]. Culture shapes family beliefs, media portrayals of people with mental illness and local health care provisions for mental health [ 4 , 6 ].…”

Help-seeking preferences among Chinese college students exposed to a natural disaster: a person-centered approach

“…This suggests that age and cohort effects may potentially influence the association of losing face concern with helpseeking preferences. Furthermore, two previous studies among Chinese students supported this result that the loss of face concern was not a significant predictor of mental health help-seeking (Cheang & Davis, 2014;Kung, 2004). The influence of losing face concern on help-seeking preferences needs to be further explored among Chinese populations.…”

“…Another notable finding was that students from mainland China were more likely to seek help than students from Macao. One previous study among 391 college students studying in Macao provided supportive evidence for these results, showing that compared with Macao students, those from Mainland China could be more likely to seek mental health help (Cheang & Davis, 2014). Macao is a small, conservative, and densely populated city so local students may have greater concern and barriers (e.g.…”

“…Chinese college students with higher self-stigma were less likely to prefer to seek help from mental health professionals or loved ones after experiencing the natural disaster, which was consistent with some previous studies. Cheang and Davis ( 2014 ) conducted a survey among 413 Chinese college students in Macao and reported that self-stigma had a significant and negative impact on professional help-seeking. Another study with a representative sample of 1,312 Australian adults showed that participants with a higher level of self-stigma were more reluctant to seek professional help (Barney, Griffiths, Jorm, & Christensen, 2006 ).…”