Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2017 Reducing Stigma and Encouraging Help Seeking Intentions Through a Mental Health Literacy Program Nicole Loreto Walden University Follow this and additional works at: https://scholarworks.waldenu.edu/dissertations Part of the Psychiatric and Mental Health Commons This Dissertation is brought to you for free and open access by the Walden Dissertations and Doctoral Studies Collection at ScholarWorks. It has been accepted for inclusion in Walden Dissertations and Doctoral Studies by an authorized administrator of ScholarWorks. For more information, please contact [email protected]. Walden University College of Social and Behavioral Sciences This is to certify that the doctoral dissertation by Nicole Loreto has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Maria van Tilburg, Committee Chairperson, Psychology Faculty Dr. Peggy Gallaher, Committee Member, Psychology Faculty Dr. Rachel Piferi, University Reviewer, Psychology Faculty Chief Academic Officer Eric Riedel, Ph.D. Walden University 2017 Abstract Reducing Stigma and Fostering Help-seeking Intentions Through a Mental Health Literacy Program by Nicole Loreto MSc, Syracuse University, 2001 BS, Laurentian University, 1986 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Psychology Walden University October 2017 Abstract Many individuals do not seek help for a mental health problem due to stigma and fear of rejection by peers and family. Researchers have highlighted that the age group least likely to seek help is youth. Stigma acts as an important barrier to help-seeking. Evidence indicating how mental health literacy can reduce stigma and encourage help-seeking remains inconclusive. In this study, the health belief model was used to understand how college students perceived an individual’s susceptibility to mental illness and the barriers associated with seeking help. A posttest-only randomized controlled trial evaluated the impact of the Is It Just Me? mental health literacy program among college students and assessed whether the program was effective in generating changes in knowledge, lessening stigma, and encouraging help-seeking intentions should students experience a mental health problem. Gender and age data were collected for background information. The results of 2-tailed t tests showed less stigma p = .047, t = -2.02 in the experimental (M= 18.30, SD (2.21) compared to the control condition (M 17.02, SD (3.78)), with no effect on knowledge. With respect to help-seeking intentions, the control condition scored significantly higher than the experimental condition. In conclusion, college students who participated in this short-term mental health literacy program reported less stigma but also less help-seeking. Thus, the program contributed to a greater understanding and acceptance of people living with mental illness. Breaking down stigma and encouraging early intervention for students to seek help if they experience mental health problems can lead to better recovery outcomes and healthier trajectories. Reducing Stigma and Fostering Help-seeking Intentions Through a Mental Health Literacy Program by Nicole Loreto MSc, Syracuse University, 2001 BS, Laurentian University, 1986 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Psychology Walden University October 2017 Dedication This dissertation is dedicated to my fiancé and children, who have been so supportive in this major milestone for me. Table of Contents List of Tables ...................................................................................................................... v Chapter 1: Introduction to the Study ................................................................................... 1 Problem Statement ........................................................................................................ 4 Purpose of the Study ..................................................................................................... 5 Research Questions ....................................................................................................... 6 Theoretical Framework ................................................................................................. 7 Nature of the Study ..................................................................................................... 10 Definitions of Key Terms ........................................................................................... 10 Mental Illness ........................................................................................................ 11 Mental Health ........................................................................................................ 11 Mental Health Literacy ......................................................................................... 11 Stigma ................................................................................................................... 11 Help-seeking ......................................................................................................... 12 Assumptions ................................................................................................................ 12 Delimitations ............................................................................................................... 12 Limitations .................................................................................................................. 14 Significance ................................................................................................................. 15 Summary ..................................................................................................................... 16 Chapter 2: Literature Review ............................................................................................ 17 Mental Illness and Adolescence: A Critical Development Phase ............................... 19 Seeking Help for a Mental Illness ............................................................................... 21 i Why Do Many Affected by Mental Illness Not Seek Help? ...................................... 22 Stigma and Mental Illness ........................................................................................... 28 Health Belief Model, Mental Illness, and Help-Seeking Behavior ............................ 34 Stigma Reduction Approaches .................................................................................... 37 Mental Health Literacy ............................................................................................... 40 Summary ..................................................................................................................... 47 Chapter 3: Research Method ............................................................................................. 49 Introduction ................................................................................................................. 49 Nature of Study ........................................................................................................... 51 About the Program Is It Just Me? ............................................................................... 52 Research Design and Approach .................................................................................. 52 Sampling Strategy ....................................................................................................... 53 Recruitment Procedures .............................................................................................. 53 Sample Size ................................................................................................................. 54 Data Collection Instruments ....................................................................................... 54 Data Analysis .............................................................................................................. 59 Protection of Participants’ Rights ............................................................................... 60 Ethical Considerations ................................................................................................ 60 Threats to Study Validity ............................................................................................ 61 Delimitations ............................................................................................................... 62 Limitations .................................................................................................................. 63 Summary ..................................................................................................................... 64 ii Chapter 4: Results ............................................................................................................. 66 Data Cleaning .............................................................................................................. 66 Results ......................................................................................................................... 67 Research Question 1: Mental Health Knowledge ....................................................... 69 Research Question 2: Mental Health Stigma