Understanding help-seeking in rural counties: A serial mediation analysis

Area of Science:

• Psychology
• Rural Health
• Sociology

Background:

• Cultural values in rural Southern US areas can impede mental health service utilization.
• Self-reliance is a prominent cultural value that may influence help-seeking behaviors.

Purpose of the Study:

• To examine the serial mediation pathway linking general self-reliance to attitudes toward seeking psychological help.
• Investigate the roles of public stigma, self-stigma, and mental health self-reliance in this process.

Main Methods:

• Online survey administered to 783 community members in rural Southern US counties.
• Measurement of general self-reliance, public stigma, self-stigma, mental health self-reliance, and attitudes toward help-seeking.

Main Results:

• A direct association was found between general self-reliance and negative attitudes toward seeking psychological help.
• This association was serially mediated by increased public stigma, followed by increased self-stigma, and subsequently, increased mental health self-reliance.

Conclusions:

• Findings suggest a pathway where self-reliance contributes to stigma and self-reliance in managing mental health, which discourages professional help-seeking.
• Clinical implications include the need for policy changes, enhanced provider visibility, and addressing specific barriers to therapy in rural settings.