Adolescent public stigma and help seeking intention are associated with later service use: A five-year follow-up study using annual self-report surveys and medical records

Purpose Various barriers including public stigma and lack of mental health literacy have been identified to adolescent help-seeking intention for their mental health problems. However, few prospective studies have investigated whether adolescent public stigma and help-seeking intentions are associated with actual service use in a long-term prospective design including medical records. Methods This prospective study over a five-year period used questionnaire responses from 1919 students on admission (608 females [19.7%], mean age: 18.92 [SD 0.68] years), and follow-up information from annual health checkups and medical records from 1437 participants (74.9%). The baseline stigma questionnaire included practically useful knowledge of mental health problems, past experiences and behavioral intentions with people with mental health problems, and help-seeking intentions and disclosing comfortability questions about their own mental health problems. Logistic regression analyses were performed, including any psychiatric and psychological service use during the follow-up period as the dependent variable, baseline stigma measures as independent variables, and demographic and psychosocial factors as covariates. Results After mutually adjusted for independent and confounding variables, behavioral intention ( OR = 1.060 [ 95%CI 1.003―1.120], p = 0.037) and help-seeking intention (1.234 [1.029―1.479], p = 0.023) were significantly associated with any psychiatric and psychological service use. Conclusion Our five-year prospective study showed that behavioral intention with people with mental health problems and help-seeking intention about their own mental health problems were associated with later service use in adolescents. The results suggest the importance of anti-stigma campaigns and mental health literacy programs for earlier service use in adolescents.