Labelling of mental disorders and help-seeking in young people

Abstract

BACKGROUND: Mental disorders are the most common health problem affecting young people, yet their rates of help-seeking are amongst the lowest. Improving help-seeking rates amongst young people is vital. The labels used to describe emerging physical health problems have been found to influence the effectiveness of help-seeking choices. In regard to mental health, accurate psychiatric labelling of mental disorders is promoted in community awareness campaigns designed to increase help-seeking rates. However, research examining the association between labelling of mental disorders and help-seeking is scarce, particularly with young people. Indeed, it has been contended that the use of psychiatric labels to describe mental disorders may be coupled with stigmatizing beliefs and thus inhibit help-seeking, in which case lay mental health or non-specific labels may be less harmful. Motivated by these factors, the aim of this thesis was to examine the range of labels young people use to describe mental disorders, the association between label use and help-seeking intentions and beliefs, and the association between label use and stigmatising beliefs.

METHOD: A national telephone survey was conducted with 2802 Australian young people aged 12-25 years and 1528 co-resident parents from June to August 2006. Respondents were randomly assigned a vignette describing a young person experiencing symptoms of depression, psychosis or social phobia. This was followed by a series of questions relating to the vignette that examined the label used to describe the problem, help-seeking intentions and beliefs, and stigmatizing beliefs. The range of labels used was examined using percent frequencies. Factors associated with label use and the association between label use and help-seeking choices and label use and stigma were examined using binary logistic regression analyses.

RESULTS: Depression was accurately labelled twice as frequently as was psychosis, whereas social phobia was rarely accurately labelled and was most commonly labelled using lay terms. Use of accurate labels increased with age and females were more likely to use them. For all vignettes, likelihood of using an accurate label was associated with exposure to mental health community awareness campaigns and accuracy of label used by a parent. Accurate labelling was associated with a preference for professionally recommended sources of help with greater consistency than any other labels commonly used. Stigma was not commonly associated with label use. Most mental health labels were associated with seeing the person as “sick” rather than “weak”, and accurate psychiatric labels had the strongest effect sizes. However, for the psychosis vignette, the “dangerous/unpredictable” component of stigma was associated with mental health labels, and the accurate psychiatric label showed the strongest association.

DISCUSSION: It can be broadly concluded that accurate psychiatric labels are linked to mental health specific sources of help while generic lay labels are linked to more general sources of help. Using an accurate label may act as a schematic hub for conceptualizing an emerging mental disorder that enables effective selection of recommended sources of help. Stigma is not commonly associated with use of an accurate label and is therefore unlikely to be a barrier to help-seeking in most instances. These findings can help to inform and improve the effectiveness of community awareness strategies designed to increase help-seeking rates for mental disorders in young people.