How are perceived stigma, self-stigma, and self-reliance related to treatment-seeking? A three-path model

Psychiatr Rehabil J. 2015 Jun;38(2):109-116. doi: 10.1037/prj0000138. Epub 2015 Apr 6.


Objective: Many college students may experience mental health problems but do not seek treatment from mental health professionals. The present study examined how perceived stigma and self-stigma toward seeking mental health treatment, as well as perceptions of self-reliance for coping with mental health problems, relate to college student treatment-seeking.

Method: In total, 246 students completed a self-report survey that included measures of perceived stigma and self-stigma for treatment-seeking, self-reliance for addressing mental health concerns, self-reported mental health problems, symptoms of depression and alcohol-related problems, attitudes toward treatment-seeking, and treatment-seeking behavior.

Results: Regression analyses revealed that higher perceived stigma, self-stigma, and self-reliance were all related to a more negative attitude toward treatment-seeking. In a 3-path mediation model, bootstrapping results indicated an indirect effect where perceived stigma was related to attitude toward treatment-seeking and treatment-seeking behaviors through self-stigma and self-reliance. Specifically, higher perceived stigma was related to higher self-stigma, higher self-stigma was related to higher self-reliance, and higher self-reliance was associated with a more negative attitude toward treatment-seeking in the overall sample, and a decreased probability of having sought treatment among those who screened positive for a mental health problem.

Conclusions and implications for practice: Perceived stigma may influence whether or not college students seek treatment for mental health problems by potentially increasing stigmatizing attitudes toward themselves and increasing preferences for handling problems on their own. Researchers and practitioners are recommended to seek a better understanding of the complex treatment barriers to reduce stigma and facilitate treatment-seeking.

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Alcohol-Related Disorders / psychology
  • Depression / psychology
  • Depressive Disorder, Major / psychology
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Help-Seeking Behavior
  • Humans
  • Male
  • Mental Disorders / psychology*
  • Mental Health Services / statistics & numerical data*
  • Patient Acceptance of Health Care / psychology*
  • Regression Analysis
  • Social Stigma*
  • Students / psychology*
  • Universities
  • Young Adult