title: Influence of health beliefs and stigma on choosing internet support groups over formal mental health services.
abstract: OBJECTIVE
  As the Internet has become a ubiquitous tool for health information, the use of Internet support groups for mental health concerns has grown. Despite the widespread use of these groups, little research has examined the efficacy and effectiveness of online communities for ameliorating mental health symptoms or factors that prompt people to seek online support rather than formal treatment. Our study addresses this gap in the literature by investigating Internet support group use as an alternative to formal mental health services.
  
  
  METHODS
  Logistic regression was conducted with data from the 2008 National Survey on Drug Use and Health (NSDUH) to examine relationships among treatment beliefs, practical variables such as time and affordability, stigma, and use of Internet support groups among 2,532 survey participants who reported a need for mental health treatment but were not receiving formal services.
  
  
  RESULTS
  Four significant predictors of Internet support group use emerged: fear of being hospitalized or taking medication (adjusted odds ratio [AOR]=8.81, 95% confidence interval [CI]=4.25-18.27), inadequate insurance coverage (AOR=3.22, CI=1.44-7.20), age 26-34 years (AOR=.22, CI=.07-.69), and age 35 or older (AOR=.21, CI=.08-.56).
  
  
  CONCLUSIONS
  Fear of coercion and the costs of traditional mental health services were important predictors of Internet support group use. The finding that inadequate insurance coverage prompted people to seek Internet support aligns with a substantial literature regarding lack of financial resources and reduced access to treatment. Individuals' fears of hospitalization and of taking medication suggested that they may view formal treatment as potentially coercive. Further work is needed to decrease public stigma regarding mental health services and the conditions under which involuntary treatment occurs.
authors.affiliation: School of Social Work, Rutgers University, 536 George St, Suite 103, New Brunswick, NJ 08901, USA. ltownsend@ssw.rutgers.edu
authors.forename: Lisa
authors.initials: L
authors.lastname: Townsend
authors.forename: Robin Edward
authors.initials: RE
authors.lastname: Gearing
authors.forename: Olga
authors.initials: O
authors.lastname: Polyanskaya
mesh_terms: D000293:Adolescent; D000328:Adult; D003068:Coercion; D005239:Fear; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D019458:Insurance Coverage; D020407:Internet / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data*; D057240:Patient Preference / Q000523:psychology; D011619:Psychotropic Drugs; D012657:Self-Help Groups / Q000706:statistics & numerical data*; D057545:Social Stigma; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs