Mental Illness Stereotypes and Clinical Care: Do People Avoid Treatment Because of Stigma?

Abstract Despite evidence that pharmacological and psychosocial treatments yield significant benefits for many psychiatric disorders, many people who might otherwise profit from treatment fail to access care or do not fully adhere to services once they are begun. One interpretation of a health belief model suggests that the stigma of mental illness and corresponding treatments is a significant, perceived cost that undermines participation. Evidence that supports this assumption is reviewed in this paper. We begin with a brief summary of empirical models that describe stigma. We then review research studies that suggest how perceived stigma may undermine treatment participation. Despite the presence of a few studies that support the connection between stigma and treatment avoidance, research in this area is remarkably sparse, especially given assertions about the importance of this point in the Surgeon General's 1999 Report. Possible directions for future research are outlined as a result. Finally, we provide a review of stigma-change strategies and their hypothetical effects on treatment use.