title: Stigma- and non-stigma-related treatment barriers to mental healthcare reported by service users and caregivers.
abstract: Delayed treatment seeking for people experiencing symptoms of mental illness is common despite available mental healthcare. Poor outcomes are associated with untreated mental illness and caregivers may eventually need to seek help on the service user's behalf. More attention has recently focused on the role of stigma in delayed treatment seeking. This study aimed to establish the frequency of stigma- and non-stigma-related treatment barriers reported by 202 service users and 80 caregivers; to compare treatment barriers reported by service users and caregivers; and to investigate demographic predictors of reporting stigma-related treatment barriers. The profile of treatment barriers differed between service users and caregivers. Service users were more likely to report stigma-related treatment barriers than caregivers across all stigma-related items. Service users who were female, had a diagnosis of schizophrenia or with GCSEs (UK qualifications usually obtained at age 16) were significantly more likely to report stigma-related treatment barriers. Caregivers who were female or of Black ethnicities were significantly more likely to report stigma-related treatment barriers. Multifaceted approaches are needed to reduce barriers to treatment seeking for both service users and caregivers, with anti-stigma interventions being of particular importance for the former group.
authors.affiliation: Section of Community Mental Health Box PO29, Health Service and Population Research Department, Institute of Psychiatry, King׳s College London, De Crespigny Park, London SE5 8AF, United Kingdom. Electronic address: lisa.dockery@kcl.ac.uk.
authors.forename: Lisa
authors.initials: L
authors.lastname: Dockery
authors.affiliation: Section of Community Mental Health Box PO29, Health Service and Population Research Department, Institute of Psychiatry, King׳s College London, De Crespigny Park, London SE5 8AF, United Kingdom. Electronic address: debrajeffery@nhs.net.
authors.forename: Debra
authors.initials: D
authors.lastname: Jeffery
authors.affiliation: Section of Community Mental Health Box PO29, Health Service and Population Research Department, Institute of Psychiatry, King׳s College London, De Crespigny Park, London SE5 8AF, United Kingdom. Electronic address: nxjt025@live.rhul.ac.uk.
authors.forename: Oliver
authors.initials: O
authors.lastname: Schauman
authors.affiliation: Section of Community Mental Health Box PO29, Health Service and Population Research Department, Institute of Psychiatry, King׳s College London, De Crespigny Park, London SE5 8AF, United Kingdom. Electronic address: paul.1.williams@kcl.ac.uk.
authors.forename: Paul
authors.initials: P
authors.lastname: Williams
authors.affiliation: Section of Community Mental Health Box PO29, Health Service and Population Research Department, Institute of Psychiatry, King׳s College London, De Crespigny Park, London SE5 8AF, United Kingdom. Electronic address: simone.farrelly@kcl.ac.uk.
authors.forename: Simone
authors.initials: S
authors.lastname: Farrelly
authors.affiliation: Section of Community Mental Health Box PO29, Health Service and Population Research Department, Institute of Psychiatry, King׳s College London, De Crespigny Park, London SE5 8AF, United Kingdom. Electronic address: oliver.bonnington@lshtm.ac.uk.
authors.forename: Oliver
authors.initials: O
authors.lastname: Bonnington
authors.affiliation: Section of Community Mental Health Box PO29, Health Service and Population Research Department, Institute of Psychiatry, King׳s College London, De Crespigny Park, London SE5 8AF, United Kingdom. Electronic address: jheanell.gabbidon@kcl.ac.uk.
authors.forename: Jheanell
authors.initials: J
authors.lastname: Gabbidon
authors.affiliation: Section of Community Mental Health Box PO29, Health Service and Population Research Department, Institute of Psychiatry, King׳s College London, De Crespigny Park, London SE5 8AF, United Kingdom. Electronic address: fran.lassman@googlemail.com.
authors.forename: Francesca
authors.initials: F
authors.lastname: Lassman
authors.affiliation: Section of Community Mental Health Box PO29, Health Service and Population Research Department, Institute of Psychiatry, King׳s College London, De Crespigny Park, London SE5 8AF, United Kingdom. Electronic address: george.szmukler@kcl.ac.uk.
authors.forename: George
authors.initials: G
authors.lastname: Szmukler
authors.affiliation: Section of Community Mental Health Box PO29, Health Service and Population Research Department, Institute of Psychiatry, King׳s College London, De Crespigny Park, London SE5 8AF, United Kingdom. Electronic address: graham.thornicroft@kcl.ac.uk.
authors.forename: Graham
authors.initials: G
authors.lastname: Thornicroft
authors.affiliation: Section of Community Mental Health Box PO29, Health Service and Population Research Department, Institute of Psychiatry, King׳s College London, De Crespigny Park, London SE5 8AF, United Kingdom. Electronic address: sarah.clement@kcl.ac.uk.
authors.forename: Sarah
authors.initials: S
authors.lastname: Clement
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology* / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D003156:Community Mental Health Services; D003866:Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008131:London; D008297:Male; D008605:Mental Health Services; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D057545:Social Stigma
keywords: Barrier; Caregiver; Delay; Help-seeking; Mental health; Stigma; Treatment