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Self-labeling as having a mental or physical illness: the effects of stigma and implications for help-seeking

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Personal and perceived stigma can hinder persons in appraising their symptoms as constituting part of a mental illness (self-labeling), an important early step in the help-seeking process. This study examines the impact of personal and perceived stigma on self-labeling and provides prospective data on the possible connections between self-labeling and help-seeking behavior.

Methods

Personal stigmatizing attitudes, perceived stigma and self-labeling behavior as well as their statistical connections were cross-sectionally investigated in a community sample of 207 participants with a present untreated mental health problem. We further conducted prospective analyses to investigate possible associations between self-labeling and help-seeking behavior at 3 and 6 month follow-ups. Socio-demographics, previous treatment and depression symptoms were also measured as potential confounders.

Results

Personal stigmatizing attitudes were significantly more pronounced in respondents who self-labeled as physically compared to mentally ill, while group differences in levels of perceived stigma were not. Self-labeling as physically or mentally ill increased the likelihood of seeking help from the health service provider deemed most suitable for that label (physical: GP, p <0.05; mental: MHP, p < 0.1) compared to persons who applied no self-label.

Conclusions

The findings suggest that personal stigmatizing attitudes—rather than perceived stigma—impact on self-labeling, and highlight the need for interventions that assist persons with mental illness in overcoming those attitudes. They also underscore the possible impact of self-labeling in the help-seeking process and underline the important role of GPs in mental health care. Further, preferably epidemiological research into the matter would be desirable.

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Acknowledgements

This work was funded by the Deutsche Forschungsgemeinschaft (DFG) (grant IDs SCHO 1337/4-1 and SCHM 2683/4-1). The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ellernholzstraße 1-2, 17485, Greifswald, Germany

    Philip Horsfield, Susanne Stolzenburg & Stefanie Hahm

  2. Department of Health and Prevention, Institute of Psychology, Greifswald University, Robert Blum Straße 13, 17487, Greifswald, Germany

    Samuel Tomczyk, Holger Muehlan & Silke Schmidt

  3. Department of Psychiatry and Psychotherapy, University Medicine Leipzig, Semmelweisstraße 10, House 13, 04103, Leipzig, Germany

    Georg Schomerus

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  1. Philip Horsfield
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  2. Susanne Stolzenburg
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  4. Samuel Tomczyk
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  5. Holger Muehlan
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  7. Georg Schomerus
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Correspondence to Philip Horsfield.

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The study was approved by the local ethics committee of University Medicine Greifswald. The manuscript does not contain clinical studies or patient data.

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Horsfield, P., Stolzenburg, S., Hahm, S. et al. Self-labeling as having a mental or physical illness: the effects of stigma and implications for help-seeking. Soc Psychiatry Psychiatr Epidemiol 55, 907–916 (2020). https://doi.org/10.1007/s00127-019-01787-7

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