Beware of the Mad Hatter

Mental disorders cause high individual and societal costs and burden. Although they are
treatable and potentially preventable, healthcare utilisation is often delayed or completely
absent. Important barriers of healthcare utilisation are mental illness related stigmatising
attitudes. Stigma is not a unitary concept but covers several aspects whose single
contributions to delay or absence of healthcare utilisation are so far unclear. The first aim
of this PhD thesis was to examine associations between different aspects of stigma and
healthcare utilisation in a meta-analysis, providing more robust and aggregated evidence to
the growing body of literature in this field. Stigmatising attitudes are not independent of
each other and are influence by other factors, an important one being knowledge about
signs and treatment of mental disorders, i.e. mental health literacy (MHL). In particular
persons’ causal or etiological explanations for a mental illness were associated with
stigmatising attitudes before. The second aim of this PhD thesis was to examine
associations between persons’ causal explanations for mental disorders and stigma, and
between stigma and healthcare utilisation in the general population. Using structural
equation modelling and a comprehensive set of variables in order to elucidate complex
relations between the latent constructs, makes this work stand out from majority of
previous research. The main findings of this PhD will be discussed in the light of earlier
studies and social psychological research and theories. Furthermore, suggestions for future
studies and for campaigns promoting healthcare utilisation via improving MHL and
stigmatising attitudes will be derived.

2017

dissertation

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