Stigma surrounding substance use has been documented as a roadblock to recovery, posing a greater barrier to care for some populations more than others. In particular, pregnant and parenting women are an often overlooked and understudied demographic who could benefit considerably from targeted resources. Though, due to stigma surrounding substance use and motherhood, this demographic is routinely subject to judgement and discrimination resulting in delayed treatment entry. In the midst of the COVID-19 pandemic, issues of access have been compounded by a reduction in services despite heightened mental health struggles caused by prolonged periods of isolation and abrupt changes in lifestyle and environment. The purpose of this study is to understand how stigmatization affects help-seeking behaviour and to explore the impact of COVID-19 on women’s mental health and treatment experiences. Semi-structured telephone interviews were conducted from October 2020-February 2021, with current and past clients of integrated treatment programs in Ontario (n=24). Using an interpretive description approach, data was constructed to identify how stigma is internalized, anticipated, and embodied in the context of help-seeking behaviour, as well as to determine the extent to which the pandemic has interfered with maternal wellbeing. The following themes emerged: (1) stigma and help-seeking (2) COVID-19 and maternal wellness (3) stigma at the structural level: barriers to care and (4) mitigating stigma to enhance help-seeking: facilitating recovery through relationships. This research contributes evidence to a growing body of literature emphasizing the importance of relationships in the recovery process for combatting the effects of stigma and promoting early treatment entry and lends insight into the ways in which pregnant and parenting women with problematic substance use have navigated recovery during COVID-19. / Graduate

Many individuals do not seek help for a mental health problem due to stigma and fear of rejection by peers and family. Researchers have highlighted that the age group least likely to seek help is youth. Stigma acts as an important barrier to help-seeking. Evidence indicating how mental health literacy can reduce stigma and encourage help-seeking remains inconclusive. In this study, the health belief model was used to understand how college students perceived an individual's susceptibility to mental illness and the barriers associated with seeking help. A posttest-only randomized controlled trial evaluated the impact of the Is It Just Me? mental health literacy program among college students and assessed whether the program was effective in generating changes in knowledge, lessening stigma, and encouraging help-seeking intentions should students experience a mental health problem. Gender and age data were collected for background information. The results of 2-tailed t tests showed less stigma p = .047, t = -2.02 in the experimental (M= 18.30, SD (2.21) compared to the control condition (M 17.02, SD (3.78)), with no effect on knowledge. With respect to help-seeking intentions, the control condition scored significantly higher than the experimental condition. In conclusion, college students who participated in this short-term mental health literacy program reported less stigma but also less help-seeking. Thus, the program contributed to a greater understanding and acceptance of people living with mental illness. Breaking down stigma and encouraging early intervention for students to seek help if they experience mental health problems can lead to better recovery outcomes and healthier trajectories.

In combat, anger becomes a new baseline and is promoted by peers as an acceptable means of militaristic motivation and coping with the atrocities of war. Unable to reconcile anger upon returning home, some veterans are forced to seek help via nontraditional paths. This interpretative phenomenological study explored the lived experience of male combat veterans who struggled with anger dysregulation issues and sought help from veteran peers on social media. Research questions were developed using the modal model of emotion as a guide for emotional dysregulation. Interviewed participants were invited to share lived experience of anger dysregulation, what help-seeking meant, and how they experienced using social media for management of anger dysregulation. Ten male combat veterans were recruited through snowballing and social media, they were interviewed via Skype. The results of the analyses revealed 7 major themes: emotional distress, shifting identity, reprisal, resistance to formal treatment, emotional reconciliation, social media use, and combat elitism. Participants shared beliefs that current support systems for anger dysregulation were neither fairly implemented nor effective for anger. Further revealed was that social media afforded veterans the opportunity to take advantage of anonymity, engage on their terms, rapidly target peers with similar combat and subsequent anger dysregulation experience, and learn how to rethink and reappraise to reconcile anger. This study contributes to an enhanced scholarly understanding of veterans'€™ nonconventional help-seeking approaches for anger dysregulation. Recommendations are provided to practitioners to support, promote, and be a voice for the voiceless to effect social change by advocating for and defending those who have defended the nation.

Indiana University-Purdue University Indianapolis (IUPUI) / Atypical symptoms, multiple co-morbidities and a lack of public awareness make it difficult for older adults to know when to seek help for sepsis. Diagnosis delays contribute to older adults’ higher sepsis mortality rates. This research describes patients’ and caregivers’ experiences with the symptom appraisal process, self-management strategies, provider-nurse-patient interactions, and barriers when seeking sepsis care. Convenience and purposive stratified sampling were utilized on two data sources. A nurse-patient and nurse-family caregivers were interviewed. Online stories by older adult patient survivors or family members from the Faces of Sepsis ™ Sepsis Alliance website were analyzed. Emergent themes were identified using qualitative descriptive methods. Listlessness and fatigue were most bothersome symptoms for the nurse-family caregivers. Fever, pain and low blood pressure were most common complaints, followed by breathing difficulty, mental status changes and weakness. Patients expressed “excruciating pain” with abdominal and soft tissue sources of infection, and with post-operative sepsis. Concern was expressed that self-management strategies and medications create barriers by masking typical sepsis signs. Health care providers’ interpersonal interactions, lack of awareness of sepsis symptoms and guidelines, complacency towards older adults, and denial by patients were barriers. Further barriers were staff inexperience, delays, care omissions, and tension between health care providers, patients and caregivers—with emerging advocacy by patients and family. In conclusion, providers should assess previous self-management strategies when evaluating symptoms. At primary care visits or hospital discharge, older patients with risk factors need anticipatory guidance for sepsis symptoms and possible emergent infections--specifically patients with pre-existing risk factors such as urinary tract infections, pneumonia, or operative events. Public and professional education are needed to overcome a lack of urgency and understanding of symptoms for diagnosis, treatment and guideline adherence for inpatients and outpatient clinics. Further research on subjective sepsis symptoms may improve patient-clinician communications when evaluating sepsis in older adults.

The present study was aimed at experimentally investigating effects of causal explanations for depression on treatment-seeking behavior and beliefs. Participants at a large Southern university (N = 139; 78% female; average age 19.77) received bogus screening results indicating high depression risk, then viewed an explanation of depression etiology (fixed biological vs. malleable) before receiving a treatment referral (antidepressant vs. psychotherapy). Participants accepted the cover story at face value, but some expressed doubts about the screening task’s ability to properly assess their individual depression. Within the skeptics, those given a fixed biological explanation for depression were relatively unwilling to accept either treatment, but those given a malleable explanation were much more willing to accept psychotherapy. Importantly, differences in skepticism were not due to levels of actual depressive symptoms. The present findings indicate that information about the malleability of depression may have a protective effect for persons who otherwise would not accept treatment.

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Introduction: People who experience mental illness are unlikely to seek help. Research suggests that mental illness stigma negatively impacts help-seeking, yet there is little information about factors that relate to stigma that are positively associated with help-seeking among those with compromised mental health. Emerging research suggests that aspects of the social identity perspective, namely group social identification and perceptions about the group, may provide insights as to how people who experience mental illness navigate help-seeking. Objective: In two studies we aimed to: (1) identify factors (i.e., social identification and perceptions of the group) that relate to stigma that are also associated with the multi-step process of help-seeking; and (2) explore if these factors and aspects of the help-seeking process that occur prior to service utilization (such as illness and symptom recognition) are positively associated with behavioral service utilization. Method: Study 1 employed Amazon's Mechanical Turk to recruit 90 participants who reported being diagnosed with a mental illness and not actively seeking treatment (i.e., medication or seeing a psychologist or psychiatrist). Study 2 employed Facebook to recruit 131 participants who self-reported a mental illness diagnosis. Results: Controlling for symptom severity, mental illness stigma was positively associated with social identification, which in turn positively impacted help-seeking in Study 1. Further, the relationship between social identification and help-seeking was strongest among those with a negative perception of the mental illness group. In Study 2, results indicated that social identification predicted behavioral service utilization, providing support for Study 1. Conclusion: Taken together, these findings suggest that social identification as a person with a mental illness is positively associated with the multi-step process of help-seeking and may be important for those who experience mental illness stigma to get help that enables and facilitates better functioning.

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