From attitude to intent to action: Predictors of psychological help-seeking behavior among clinically distressed adults

Although many people suffer from mental health concerns, a large proportion of these people do not seek psychological help (Alonso et al., 2009; Clement et al., 2015; Kessler et al., 2003; Thornicroft, 2007; Vogel, Wester & Larson, 2006). Research indicates that public and self-stigma, attitudes toward counseling, and intentions to seek counseling are all important factors in the help-seeking process (Bayer & Peay, 1997; Cooper et al., 2003; Corrigan, 2004; Komiya et al., 2000; Link et al., 2014; Mojtabai, Olfson, & Mechanic, 2002; Sirey et al., 2001; Vogel et al., 2005; Vogel, Wade, & Haake, 2006; Vogel, Wade, & Hackler, 2007). However, one glaring omission exists in the vast majority of this research: very few studies measure actual help-seeking behavior. In addition, most of this research has been conducted with college students, most of whom did not have a current mental health concern. In the present study, I explored psychological help-seeking behavior in a clinically distressed sample of adults. In particular, I explored whether public stigma of help-seeking, self-stigma of help-seeking, and attitudes towards receiving professional psychological help predicted intentions to seek help in a sample of clinically distressed adults. Additionally, I examined these relationships with actual help-seeking behavior. For this study a total of N =125 clinically distressed adults completed two surveys two weeks apart. Results of the hierarchical regression predicting attitudes suggested that self-stigma predicted attitudes above and beyond the other variables entered into the model. Results of the hierarchical regression predicting hypothetical intentions revealed that encouragement and pressure to seek help by friends and family and attitudes toward counseling are more predictive than self-stigma when all variables were entered into the model. Results of a third hierarchical regression predicting actual intentions revealed similar patterns; self-stigma was related to actual intentions but not in the final model, in which ethnicity, social encouragement, and attitudes predicted actual intentions above and beyond the other variables entered into the model. Results of a logistic regression predicting actual behavior (i.e., scheduling or attending an appointment with a mental health professional) suggest that minority ethnicity, greater public stigma, and greater hypothetical intentions predicts actual help-seeking behavior. Results are discussed based on previous research, Theory of Planned Behavior (TPB), and Theory of Reasoned Action (TRA). Limitations, implications, and future recommendations are discussed