It is unclear to what extent failure to recognize symptoms as potential sign of a
mental illness is impeding service use, and how stigmatizing attitudes interfere with
this process. In a prospective study, we followed a community sample of 188 currently
untreated persons with mental illness (predominantly depression) over 6 months. We
examined how lack of knowledge, prejudice and discrimination impacted on self-identification
as having a mental illness, perceived need, intention to seek help, and help-seeking,
both with respect to primary care (visiting a general practitioner, GP) and specialist
care (seeing a mental health professional, MHP). 67% sought professional help within
6 months. Fully saturated path models accounting for baseline depressive symptoms,
previous treatment experience, age and gender showed that self-identification predicted
need (beta 0.32, p < 0.001), and need predicted intention (GP: beta 0.45, p < 0.001;
MHP: beta 0.38, p < 0.001). Intention predicted service use with a MHP after 6 months
(beta 0.31, p < 0.01; GP: beta 0.17, p = 0.093). More knowledge was associated with
more self-identification (beta 0.21, p < 0.01), while support for discrimination was
associated with lower self-identification (beta - 0.14, p < 0.05). Blaming persons
with mental illness for their problem was associated with lower perceived need (beta
- 0.16, p < 0.05). Our models explained 37% of the variance of seeking help with a
MHP, and 33% of help-seeking with a GP. Recognizing one's own mental illness and perceiving
a need for help are impaired by lack of knowledge, prejudice, and discrimination.
Self-identification is a relevant first step when seeking help for mental disorders.