The interplay of etiological knowledge and mental illness stigma on healthcare utilisation in the community : A structural equation model

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2018
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Michel, Chantal
Panczak, Radoslaw
Ochsenbein, Susann
Schimmelmann, Benno G.
Schultze-Lutter, Frauke
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European Psychiatry. Cambridge University Press (CUP). 2018, 51, pp. 48-56. ISSN 0924-9338. eISSN 1778-3585. Available under: doi: 10.1016/j.eurpsy.2017.12.027
Zusammenfassung

Background:
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 also 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.

Methods:
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.

Results:
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.

Conclusion:
Our results indicate that campaigns promoting early healthcare utilisation should focus on different strategies to promote facilitation and reduce barriers to mental healthcare.

Zusammenfassung in einer weiteren Sprache
Fachgebiet (DDC)
150 Psychologie
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Psychiatry and Mental health, Attitudes, Stigma, Help-seeking, Mental health literacy, Mental problems
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ISO 690SCHNYDER, Nina, Chantal MICHEL, Radoslaw PANCZAK, Susann OCHSENBEIN, Benno G. SCHIMMELMANN, Frauke SCHULTZE-LUTTER, 2018. The interplay of etiological knowledge and mental illness stigma on healthcare utilisation in the community : A structural equation model. In: European Psychiatry. Cambridge University Press (CUP). 2018, 51, pp. 48-56. ISSN 0924-9338. eISSN 1778-3585. Available under: doi: 10.1016/j.eurpsy.2017.12.027
BibTex
@article{Schnyder2018inter-68303,
  year={2018},
  doi={10.1016/j.eurpsy.2017.12.027},
  title={The interplay of etiological knowledge and mental illness stigma on healthcare utilisation in the community : A structural equation model},
  volume={51},
  issn={0924-9338},
  journal={European Psychiatry},
  pages={48--56},
  author={Schnyder, Nina and Michel, Chantal and Panczak, Radoslaw and Ochsenbein, Susann and Schimmelmann, Benno G. and Schultze-Lutter, Frauke}
}
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    <dcterms:abstract>Background:&lt;br /&gt;
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 also 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.&lt;br /&gt;&lt;br /&gt;
Methods:&lt;br /&gt;
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.&lt;br /&gt;&lt;br /&gt;
Results:&lt;br /&gt;
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.&lt;br /&gt;&lt;br /&gt;
Conclusion:&lt;br /&gt;
Our results indicate that campaigns promoting early healthcare utilisation should focus on different strategies to promote facilitation and reduce barriers to mental healthcare.</dcterms:abstract>
    <dc:contributor>Panczak, Radoslaw</dc:contributor>
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