How can service use for mental illness be improved? A quasi-experimental online study on the potential for change of personal stigma and intermediary variables in the context of service use

• Applicants: Professorin Dr. Silke Schmidt; Professor Dr. Georg Schomerus
• Subject Area: Personality Psychology, Clinical and Medical Psychology, Methodology ; Public Health, Healthcare Research, Social and Occupational Medicine
• Term: from 2015 to 2023
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 269563855

In our ongoing DFG-funded project, we are conducting a prospective study concerning personal attitudes, impending self-stigma and service use for mental illness in a currently untreated community sample. We were able to reconstruct a process that begins with the perception of symptoms, followed by self-identification as mentally ill, which leads to the need for treatment as well as the intention to seek help, and finally service use. The intention to seek help was the strongest predictor of actual help seeking, while stigmatising attitudes were mainly associated with self-identification as mentally ill. Due to these bilateral associations, self-identification was identified as a sensitive element in the service use process. Other important intermediary variables include mental health literacy, self-efficacy, causal beliefs, and subjective nosological concept as well as prior treatment experience and current symptom severity. In this follow-up project, we aim to expand our original model of stigma as a barrier to service use to incorporate these intermediary process variables and systematically test their effect and interdependence in the service use process. A corresponding theoretical framework is provided by the Common Sense Model of Self-Regulation (CSM) which conceptualises the general coping process with health problems and which is therefore highly applicable to our target group of civilians with currently untreated mental disorders. Methodologically, the intermediary variables, which could adaptively affect self-identification and the service use process, will be manipulated in a multi-factorial randomized quasi-experimental online study. Similar to the current study, there will be two follow-up assessments over a period of 6 months. Potentially, our study offers promising implications for research and practice: Firstly, the empirical examination of the merging of theoretical approaches regarding stigma (including the current project), the conceptualisation of mental illness (in the CSM) and stages of service use, all three processes as well as a potential emergence will be closely examined. Secondly, the results of our online study provide starting points for evidence-based design and evaluation of online interventions for mental illness. Because of the growing body of eclectic, non-scientific and primarily commercial offers, this is of paramount importance.

• DFG Programme: Research Grants
• Co-Investigators: Dr. Holger Muehlan; Professor Dr. Samuel Tomczyk