Lay attitudes are often seen as potential barriers to mental health recovery. But apart from perceiving them as potential barriers, they can also play an important role in stimulating individuals to consult (in)formal help sources, in particular through the process of help referral. Where existing research mainly focusses on actual help seeking behaviour, this study will focus on lay publics’ referral behaviour.
Aims:
This study analyses the relation between causal beliefs and stigmatising attitudes and social distance on the one hand, and (in)formal help seeking recommendations on the other.
Methods:
Data from a survey carried out in 2019, assessing the attitudes of Public Health Insurance Provider (HIP) members towards mental health problems, was used. Part of the survey questions was based on a quantitative quasi-experimental design, using hypothetical written vignettes. The weighted data represent a sample of the adult Flemish population (22–94 years, N = 5675). Multiple linear regression analysis was used to examine the relation between causal beliefs and stigma, while binominal logistic regression analysis was used to investigate the relation between causal beliefs and help seeking recommendations.
Results:
The results reveal that causal beliefs significantly associate with stigma, measured by stigmatising attitudes and social distance: personal- or biogenetic beliefs associate with more stigma, where psychosocial beliefs associate with less stigma. Concerning help seeking recommendations, psychosocial beliefs associate with recommending psychological or psychotherapeutic care, biogenetic beliefs associate with advising help from general practitioners and suggesting psychiatric help, while personal beliefs negatively associate with recommending formal help. Meanwhile, biogenetic beliefs associate with less informal help seeking recommendations (e.g. family, friends and online self-help), where personal beliefs associate with more informal help seeking recommendations and psychosocial beliefs only associate with online help referral.
Conclusion:
This study highlights the importance of causal beliefs in affecting public stigma and help seeking recommendations.
AgaN.RowaertS.WuytsY.VanderplasschenW. (2017). Historiek en organisatie van de geestelijke gezondheidszorg in Vlaanderen. In ClaesC.VanderplasschenW.De PauwS.Van DammeL.VandeveldeS. (Eds.), Orthopedagogische werkvelden in beweging: Recente evoluties en veranderingen in Vlaanderen (pp. 269–330). Maklu.
2.
AjzenI. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211.
3.
AlbeeG. W.JoffeJ. M. (2004). Mental illness is NOT “an illness like any other”. Journal of Primary Prevention, 24(4), 419–436.
4.
AlexanderL.LinkB. (2003). The impact of contact on stigmatizing attitudes toward people with mental illness. Journal of Mental Health, 12(3), 271–289.
5.
AnderssonM. A.HarknessS. K. (2018). When do biological attributions of mental illness reduce stigma? Using qualitative comparative analysis to contextualize attributions. Society and Mental Health, 8(3), 175–194.
6.
AngermeyerM. C.DietrichS. (2006). Public beliefs about and attitudes towards people with mental illness - A review of population studies. Acta Psychiatrica Scandinavica, 113(3), 163–179.
7.
AngermeyerM. C.HolzingerA.CartaM. G.SchomerusG. (2011). Biogenetic explanations and public acceptance of mental illness: Systematic review of population studies. The British Journal of Psychiatry, 199(5), 367–372.
8.
AngermeyerM. C.MatschingerH. (2003). The stigma of mental illness: Effects of labelling on public attitudes towards people with mental disorder. Acta Psychiatrica Scandinavica, 108(4), 304–309.
9.
AngermeyerM. C.MatschingerH.Riedel-HellerS. G. (1999). Whom to ask for help in case of a mental disorder? Preferences of the lay public. Social Psychiatry and Psychiatric Epidemiology, 34(4), 202–210.
10.
AngermeyerM. C.MatschingerH.Riedel-HellerS. (2001). What to do about mental disorder: Help-seeking recommendations of the lay public. Acta Psychiatrica Scandinavica, 103(3), 220–225.
11.
AngermeyerM. C.MatschingerH.SchomerusG. (2013). Attitudes towards psychiatric treatment and people with mental illness: Changes over two decades. The British Journal of Psychiatry, 203(2), 146–151.
12.
AngermeyerM. C.van der AuweraS.CartaM. G.SchomerusG. (2017). Public attitudes towards psychiatry and psychiatric treatment at the beginning of the 21st century: A systematic review and meta-analysis of population surveys. World Psychiatry, 16(1), 50–61.
13.
BoonstraN.KlaassenR.SytemaS.MarshallM.De HaanL.WunderinkL.WiersmaD. (2012). Duration of untreated psychosis and negative symptoms - A systematic review and meta-analysis of individual patient data. Schizophrenia Research, 142(1−3), 12–19.
14.
CarterL.ReadJ.PyleM.LawH.EmsleyR.MorrisonA. (2018). Causal beliefs in people experiencing psychosis: The relationship to treatment accessed and the perceived helpfulness of treatment. Psychology and Psychotherapy: Theory, Research and Practice, 91(3), 332–344.
15.
ColeM. G.YaffeM. J. (1996). Pathway to psychiatric care of the elderly with depression. International Journal of Geriatric Psychiatry, 11(2), 157–161.
16.
ConradP. (1992). Medicalization and social control. Annual Review of Sociology, 18(1), 209–232.
17.
CorriganP.MarkowitzF. E.WatsonA.RowanD.KubiakM. A. (2003). An attribution model of public discrimination towards persons with mental illness. Journal of Health and Social Behavior, 44(2), 162–179.
18.
CorriganP. W.RowanD.GreenA.LundinR.RiverP.Uphoff-WasowskiK.KubiakM. A. (2002). Challenging two mental illness stigmas: Personal responsibility and dangerousness. Schizophrenia Bulletin, 28(2), 293–309.
19.
CorriganP. W.WatsonA. C. (2007). The stigma of psychiatric disorders and the gender, ethnicity, and education of the perceiver. Community Mental Health Journal, 43(5), 439–458.
20.
CorriganP. W.WatsonA. C.BarrL. (2006). The self–stigma of mental illness: Implications for self–esteem and self–efficacy. Journal of Social and Clinical Psychology, 25(8), 875–884.
21.
CraigheadW. E.CraigheadL. W. (2001). The role of psychotherapy in treating psychiatric disorders. Medical Clinics of North America, 85(3), 617–629.
22.
CroweM.PorterR.InderM.LaceyC.CarlyleD.WilsonL. (2014). Australian and New Zealand journal of. Australian & New Zealand Journal of Psychiatry, 48(12), 1083–1095.
23.
DeaconB. J. (2013). The biomedical model of mental disorder: A critical analysis of its validity, utility, and effects on psychotherapy research. Clinical Psychology Review, 33(7), 846–861.
24.
DeaconB. J.McKayD. (2015). The biomedical model of psychological problems: A call for critical dialogue. Lancet, 16, 2–3.
25.
Dell’OssoB.GlickI. D.BaldwinD. S.AltamuraA. C. (2013). Can long-term outcomes be improved by shortening the duration of untreated illness in psychiatric disorders? A conceptual framework. Psychopathology, 46(1), 14–21.
26.
DunlopB. W.KelleyM. E.MletzkoT. C.VelasquezC. M.CraigheadW. E.MaybergH. S. (2012). Depression beliefs, treatment preference, and outcomes in a randomized trial for major depressive disorder. Journal of Psychiatric Research, 46(3), 375–381.
27.
FanW.YanZ. (2010). Factors affecting response rates of the web survey: A systematic review. Computers in Human Behavior, 26(2), 132–139.
28.
GhaemiS. N. (2009). The rise and fall of the biopsychosocial model. The British Journal of Psychiatry, 195(1), 3–4.
29.
GrovesR. M.CialdiniR. B.CouperM. P. (1992). Understanding the decision to participate in a survey. Public Opinion Quarterly, 56(4), 475–495.
30.
HaslamN. (2000). Psychiatric categories as natural kinds: Essentialist thinking about mental disorder. Social Research, 67, 1031–1058.
31.
HaslamN. (2005). Dimensions of folk psychiatry. Review of General Psychology, 9(1), 35–47.
32.
HaunbergerS. (2011). To participate or not to participate: Decision processes related to survey non-response. Bulletin of Sociological Methodology, 109(1), 39–55.
33.
JormA. F.GriffithsK. M.ChristensenH.ParslowR. A.RogersB. (2004). Actions taken to cope with depression at different levels of severity: A community survey. Psychological Medicine, 34(2), 293–299.
34.
KhalsaS. R.McCarthyK. S.SharplessB. A.BarrettM. S.BarberJ. P. (2011). Beliefs about the causes of depression and treatment preferences. Journal of Clinical Psychology, 67(6), 539–549.
35.
KuppinS.CarpianoR. M. (2006). Public conceptions of serious mental illness and substance abuse, their causes and treatments: Findings from the 1996 general social survey. American Journal of Public Health, 96(10), 1766–1771.
36.
KvaaleE. P.GottdienerW. H.HaslamN. (2013). Biogenetic explanations and stigma: A meta-analytic review of associations among laypeople. Social Science & Medicine, 96, 95–103.
37.
LamD. C.SalkovskisP. M.WarwickH. M. (2005). An experimental investigation of the impact of biological versus psychological explanations of the cause of “mental illness”. Journal of Mental Health, 14(5), 453–464.
38.
LauberC.CarlosN.WulfR. (2005). Lay beliefs about treatments for people with mental illness and their implications for antistigma strategies. The Canadian Journal of Psychiatry, 50(12), 745–752.
39.
LauberC.NordtC.FalcatoL.RösslerW. (2001). Lay recommendations on how to treat mental disorders. Social Psychiatry and Psychiatric Epidemiology, 36(11), 553–556.
40.
LinkB. G.PhelanJ. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27(1), 363–385.
41.
ManfredaK. L.BosnjakM.BerzelakJ.HaasI.VehovarV. (2008). Web surveys versus other survey modes: A meta-analysis comparing response rates. International Journal of Market Research, 50(1), 79–104.
42.
MartinJ. K.PescosolidoB. A.TuchS. A. (2000). Of fear and loathing: The role of ‘disturbing behavior,’ labels, and causal attributions in shaping public attitudes toward people with mental illness. Journal of Health and Social Behavior, 41(2), 208–223.
43.
MehtaS.FarinaA. (1997). Is being “sick” really better? Effect of the disease view of mental disorder on stigma. Journal of Social and Clinical Psychology, 16(4), 405–419.
44.
MoroM. F.AngermeyerM. C.MatschingerH.HolzingerA.PirasA. P.CutranoF.CartaM. G. (2015). Whom to ask for professional help in case of major depression? Help-seeking recommendations of the Sardinian public. Administration and Policy in Mental Health and Mental Health Services Research, 42(6), 704–713.
45.
NonnemanW.Van DoorslaerE. (1994). The role of the sickness funds in the Belgian health care market. Social Science & Medicine, 39(10), 1483–1495.
46.
PattynE.VerhaegheM.SercuC.BrackeP. (2013). Medicalizing versus psychologizing mental illness: What are the implications for help seeking and stigma? A general population study. Social Psychiatry and Psychiatric Epidemiology, 48(10), 1637–1645.
47.
PescosolidoB. A. (1992). Beyond rational choice: The social dynamics of how people seek help. American Journal of Sociology, 97(4), 1096–1138.
48.
PescosolidoB. A.MartinJ. K.LongJ. S.MedinaT. R.PhelanJ. C.LinkB. G. (2010). “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. American Journal of Psychiatry, 167(11), 1321–1330.
49.
PescosolidoB. A.MedinaT. R.MartinJ. K.LongJ. S. (2013). The “backbone” of stigma: Identifying the global core of public prejudice associated with mental illness. American Journal of Public Health, 103(5), 853–860.
50.
PhelanJ. C. (2005). Geneticization of deviant behavior and consequences for stigma: The case of mental illness. Journal of Health and Social Behavior, 46(4), 307–322.
51.
PhelanJ. C.YangL. H.Cruz-RojasR. (2006). Effects of attributing serious mental illnesses to genetic causes on orientations to treatment. Psychiatric Services, 57(3), 382–387.
52.
PordeusV. (2015). Mental illness arises epigenetically–Like all other diseases. Journal of Psychology and Psychotherapy Research, 2, 23–24.
53.
RadloffL. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.
54.
ReadJ.HaslamN.SayceL.DaviesE. (2006). Prejudice and schizophrenia: A review of the ‘mental illness is an illness like any other’approach. Acta Psychiatrica Scandinavica, 114(5), 303–318.
55.
Riedel-HellerS. G.MatschingerH.AngermeyerM. C. (2005). Mental disorders - Who and what might help?Social Psychiatry and Psychiatric Epidemiology, 40(2), 167–174.
SchnittkerJ. (2013). Public beliefs about mental illness. In C. S. Aneshensel, J. C. Phelan & A. Bierman (Eds.), Handbook of the sociology of mental health (pp. 75–93). Springer.
58.
SchokkaertE. (2016). De gezondheidszorg in evolutie: uitdagingen en keuzes. KVAB Press.
59.
SchomerusG.AngermeyerM. C. (2008). Stigma and its impact on help-seeking for mental disorders: What do we know?Epidemiology and Psychiatric Sciences, 17(1), 31–37.
60.
ten HaveM.OldehinkelA.VolleberghW.OrmelJ. (2003). Does educational background explain inequalities in care service use for mental health problems in the Dutch general population?Acta Psychiatrica Scandinavica, 107(3), 178–187.
61.
Van de VeldeS.LevecqueK.BrackeP. (2009). Measurement equivalence of the CES-D 8 in the general population in Belgium: A gender perspective. Archives of Public Health, 67(1), 15.
62.
WalkerI.ReadJ. (2002). The differential effectiveness of psychosocial and biogenetic causal explanations in reducing negative attitudes toward “mental illness”. Psychiatry: Interpersonal and Biological Processes, 65(4), 313–325.
63.
WampoldB. E. (2007). Psychotherapy: The humanistic (and effective) treatment. American Psychologist, 62(8), 857.
64.
WeinerB. (1985). An attributional theory of achievement motivation and emotion. Psychological Review, 92(4), 548.
65.
WeinerB. (1995). Judgments of responsibility: A foundation for a theory of social conduct. Guilford Press.
66.
WeinerB.PerryR. P.MagnussonJ. (1988). An attributional analysis of reactions to stigmas. Journal of Personality and Social Psychology, 55(5), 738.
67.
WrigleyS.JacksonH.JuddF.KomitiA. (2005). Role of stigma and attitudes toward help-seeking from a general practitioner for mental health problems in a rural town. Australian & New Zealand Journal of Psychiatry, 39(6), 514–521.
68.
ZillmannD.SchmitzA.SkopekJ.BlossfeldH. -P. (2014). Survey topic and unit nonresponse. Quality & Quantity, 48(4), 2069–2088.
