The differential effects of stigma on mental health service use by age groups: A comparison study based on Korean nationwide survey 2011 and 2021

Although the prevalence of mental disorders in Korea is comparable to that in other countries, mental health service use remains markedly low. This study aimed to identify barriers to service use by assessing the effect of stigma across age groups using data from two surveys conducted 10 years apart.

This study used data from the Korean Epidemiologic Catchment Area study 2011 (n = 6022) and the National Mental Health Survey of Korea 2021 (n = 5511). Stigma was assessed using the Perceived Devaluation-Discrimination scale. Participants were categorized into three age groups: 18-39, 40-59, and ≥60 years. Multivariable regression analyses were performed to examine the effects of stigma on service use adjusting for sociodemographic covariates. Interaction terms and stratified analyses were used to evaluate age-specific association across the study years.

Stigma was higher among older individuals, and it increased across all age groups from 2011 to 2021. During this period, mental health service use declined overall, except among younger adults. The effect of stigma differed significantly by age group. Higher stigma was associated with reduced service use among middle-aged and older adults in 2011, whereas this association persisted only among middle-aged adults in 2021. No significant association was observed among younger adults in either survey year.

The adverse effect of stigma was dominant in middle-aged adults, reflecting their active social roles, whereas older adults were more likely to be affected by socioeconomic factors. Age-specific interventions are necessary to promote mental health service use.