The Interplay of Etiological Knowledge and Mental Illness Stigma on Healthcare Utilisation in the Community: A Structural Equation Model

Poster B3, Tuesday, October 9, 11:30 am - 1:00 pm, Essex Ballroom

Chantal Michel1,2, Nina Schnyder1, Radek Panczak3, Susann Ochsenbein1, Benno G. Schimmelmann1,4, Frauke Schultze-Lutter1,5; 1University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland, 2Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland, 3Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland, 4University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg-Eppendorf, Hamburg, Germany, 5Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany

The stigma of mental illness, especially personal attitudes towards psychiatric patients and mental health help-seeking, is an important barrier in healthcare utilisation. These attitudes are not independent of each other and are influenced by other factors, such as mental health literacy, especially the public’s causal explanations for mental problems. We aimed to disentangle the interrelations between the different aspects of stigma and causal explanations with respect to their association with healthcare utilisation. Stigma and causal explanations were assessed cross-sectional using established German questionnaires with two unlabelled vignettes (schizophrenia and depression) in a random-selection representative community sample (N=1375, aged 16-40 years). They were interviewed through a prior telephone survey for current mental disorder (n=192) and healthcare utilisation (n=377). Structural equation modelling was conducted with healthcare utilisation as outcome and stigma and causal explanations as latent variables. The final model was additionally analysed based on the vignettes. We identified two pathways. One positive associated with healthcare utilisation, with high psychosocial stress and low constitution/personality related causal explanations, via positive perception of help-seeking and more help-seeking intentions. One negative associated with healthcare utilisation, with high biogenetic and constitution/personality, and low psychosocial stress related explanations, via negative perception of psychiatric patients and a strong wish for social distance. Sensitivity analysis generally supported both pathways with some differences in the role of biogenetic causal explanation. Our results indicate that campaigns promoting early healthcare utilisation should focus on different strategies to promote facilitation and reduce barriers to mental healthcare.

Topic Area: Epidemiology

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