Mental illness, mental healthcare and the effects of stigma on treatment

Background. Mental illness is a leading cause of disability in the U.S.; however, less than 25% of adults seek care. Stigma is a key reason why people with mental illness are less likely to receive care. The inclusion of mental illness screening tools, such as the Kessler-6, in public health databases means that it is possible to identify the prevalence of mental illness, treatment use and barriers to care in a community dwelling population. There is little quantitative information on how stigma affects mental illness treatment use in population-based samples. Thus, we analyze surveillance data to estimate the prevalence of mental illness and assess treatment and stigma.

Methods. Data from the 2007 BRFSS administered in 37 states were used to identify persons in severe psychological distress (a proxy for severe mental illness), assess their use of mental health care, and quantify the effects of stigma on the decision to obtain treatment.

Results. Some 3.9% of respondents were determined to be in severe psychological distress (SPD). Among those in SPD, 45.3% received mental health treatment. Among those in SPD receiving treatment, 61.5% reported feeling stigmatized, that is, people are uncaring or unsympathetic towards those with mental health issues. In comparison, 45.6% of those in SPD not receiving treatment reported feeling stigmatized (p<0.001).

Conclusions. The findings reveal that feelings of stigma are more pronounced among those who sought treatment than those that did not among a community dwelling population in SPD.