Contextualizing public stigma: Endorsed mental health treatment stigma on college and university campuses
Contextualizing public stigma: Endorsed mental health treatment stigma on college and university campuses
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DOI：
10.1016/j.socscimed.2017.11.029
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发表时间：
2018-01-01
影响因子：
5.4
通讯作者：
Hernandez, Erik L.
中科院分区：
文献类型：
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作者：
Gaddis, S. Michael;Ramirez, Daniel;Hernandez, Erik L.
学者们认为，公共心理健康污名在中观层面上起作用，与症状的严重程度、披露、自尊和寻求治疗的行为有关。然而，公众污名化的操作几乎总是来自于个人层面对他人信仰的概括。我们使用2009年至2015年美国75所大学和大学校园中超过60，000名学生的数据，通过创建学生个人认可的心理健康治疗耻辱的学校级措施，将公众耻辱化。我们提出了21个不同的因变量的多层次logistic回归模型。我们发现，即使在控制了个人层面的耻辱得分后，学校层面的耻辱与自杀意念和自伤的自我报告呈负相关，尽管与抑郁或焦虑的筛查无关。此外，学校一级的耻辱是负相关的药物使用，咨询和治疗访问，并在较小程度上，非正式的支持。我们建议，未来的研究应继续研究的上下文环境的公共耻辱，而政策制定者可能能够实施的变化，以显着减少耻辱在这一水平。
Scholars suggest that public mental health stigma operates at a meso-level and is associated with severity of symptoms, disclosure, self-esteem, and treatment-seeking behavior. However, the operationalization of public stigma nearly always comes from an individual-level generalization of what others believe. Using data from over 60,000 students on 75 U.S. college and university campuses between 2009 and 2015, we contextualize public stigma by creating a school-level measure of students' individual-level endorsed mental health treatment stigma. We present multilevel logistic regression models for 21 different dependent variables. We fmd that even after controlling for individual-level stigma scores, school-level stigma is negatively associated with self-reports of suicidal ideation and self-injury, although not associated with screens for depression or anxiety. Moreover, school-level stigma is negatively associated with medication use, counseling and therapy visits, and to a lesser degree, informal support. We suggest that future research should continue to examine the contextual environment of public stigma, while policymakers may be able to implement changes to significantly reduce stigma at this level.