Mental health treatment seeking among older adults with depression: The impact of stigma and race.

Stigma associated with mental illness continues to be a significant barrier to help seeking, leading to negative attitudes about mental health treatment and deterring individuals who need mental health services from seeking care. Individuals suffering from mental health symptoms who can benefit from mental health treatment choose not to pursue services, or begin treatment but drop out prematurely, to avoid the label of 'mentally ill,' as well as the stereotypes, prejudice and discrimination associated with bearing such a label. Empirical investigation suggests that the stigma of having a mental illness may exert an adverse influence on attitudes toward mental health treatment and service utilization patterns by individuals with a mental health diagnosis. There is, however, a dearth of research that examines the way in which stigma influences attitudes toward seeking mental health services among aging populations and racial/ethnic minorities. This mixed methods study examined the impact of stigma on racial differences in treatment seeking attitudes and behaviors among older adults1 with depression. Results indicate that older adults with depression have high levels of public stigma and do not intend to seek, nor are they currently engaged in mental health treatment. Results also suggest that African American older adults endorse higher internalized stigma and less positive attitudes toward seeking mental health treatment than their white counterparts. In addition, high level of internalized stigma was related and attitudes toward seeking mental health treatment. Older African Americans in the current to more negative attitudes towards treatment and partially mediated the relationship between race study identified a number of experiences living in the black community that impacted their treatment seeking attitudes and behaviors, which led to their identification and utilization of more culturally endorsed coping strategies to deal with their depression. Findings from this study provide a greater understanding of the stigma associated with having a mental illness and its influence on attitudes and intentions toward seeking mental health services among older adults, particularly African American elders. Additionally, findings from this study provide impetus for a number of practice implications and suggestions for future research. 1The term older adults will be used throughout this paper to represent individuals aged 60 and older.