Associations Between Public and Self-Stigma of Help-Seeking With Help-Seeking Attitudes and Intention: A Meta-Analytic Structural Equation Modeling Approach

Public Significance Statement The findings suggested that help-seeking self-stigma might be more influential than help-seeking public stigma on individuals' attitudes and intention to seek help. However, given the theoretical assertion that self-stigma is a result of internalizing public stigma, and the strong association between public stigma and self-stigma, help-seeking campaigns should address both types of stigma. Specifically, educating individuals to resist public stigmatizing perceptions concerning help-seeking and empowering individuals to seek help should be both focused to better promote help-seeking attitudes and intention. The present study examined the association between help-seeking public stigma and help-seeking self-stigma (i.e., internalization of stigma) and the relative association of both types of stigma with help-seeking attitude and intention using a full-information meta-analytic structural equation modeling approach. We also investigated the moderating effect of gender, age, collectivism, and social group in the internalization process. Results from 115 independent samples containing data from 54,793 individuals showed that public stigma of help-seeking was strongly and positively associated with self-stigma of help-seeking. Moreover, after controlling for the effect of each other, self-stigma, but not public stigma, remained significantly associated with help-seeking attitude and help-seeking intention. Gender, age, collectivism, and social group did not significantly moderate the association between public and self-stigma. The findings highlight that people who perceive more stigma of help-seeking from others tend to have higher levels of self-stigma. Compared with help-seeking public stigma, help-seeking self-stigma might have a larger impact on one's help-seeking attitude and intention. Help-seeking promotion campaigns should be devised to tackle both types of stigma to foster positive help-seeking attitude and intention.

Automated summary

The study finds that help-seeking self-stigma has a stronger impact on individuals' attitudes and intentions to seek help compared to help-seeking public stigma. Therefore, help-seeking campaigns should address both types of stigma by educating individuals to resist public stigmatizing perceptions and empowering them to seek help. The results also show that people who perceive more help-seeking stigma from others tend to have higher levels of self-stigma. Gender, age, collectivism, and social group do not significantly moderate the association between public and self-stigma.