Personal mental health treatment stigma, perceived caregiver and peer treatment stigma, and help-seeking behaviors among adolescents

Most adolescents with mental health symptoms do not receive formal mental health care, and minoritized adolescents are disproportionately likely to report unmet treatment needs. Social Learning Theory and the Theory of Planned Behavior suggest that interpersonal processes may shape adolescents’ perceptions of others’ and their own mental health treatment stigma, which has been emphasized as one key barrier to accessing care. This study examines associations from peer and caregiver mental health treatment stigma to adolescents’ personal mental health treatment stigma and formal psychological support-seeking. Self-report survey data were collected from a community sample of 3248 6th through 12th graders enrolled in six public schools in Fall 2020. In this sample, 36.4% of White youth reported seeking formal psychological support, the highest rate in the sample. Asian American youth reported the highest level of personal treatment stigma (F = 4.02, p < 0.01), and Asian American and Latin(x) youth reported highest levels of caregiver-held stigma (F = 14.09, p < 001). Trans, nonbinary, and gender expansive youth reported the highest rates of personal, peer, and caregiver stigma (Fs > 4.95; ps < 0.01), and the highest rate of seeking formal psychological care (48.3%). Personal treatment stigma partially mediated associations from caregiver and peer treatment stigma to formal psychological help seeking, with diverging associations from peer and caregiver perceived stigma to reported help-seeking. This work emphasizes the need for identity-responsive care and interventions that consider the social and familial context in stigma reduction efforts.