Stigma Resistance: Exploring Psychological Well-being and its Relationship to Perceived Stigma and Help-Seeking Behaviour in the General Canadian Population
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Background: Perceived stigma is a public health concern that causes harm by discouraging help-seeking behaviour and treatment participation amongst individuals with mental illnesses. Some individuals, however, resist stigmatization by either ignoring or confronting public stigma. Psychological well-being, a modifiable personal factor, might empower stigma resistance. This is the first study to examine psychological well-being and its relationship to perceived stigma and help-seeking behaviour. Objectives: The first objective was to examine the association between psychological well-being and perceived stigma due to mental illness amongst Canadians who received treatment for a mental health problem in the year prior to the survey. The second objective was to examine the association between psychological well-being and help-seeking behaviour for mental health care amongst Canadians who experienced at least one select mental or substance use disorder in the year prior to the survey. Methods: Data were derived from the first nationally representative, cross-sectional survey of mental health stigma experiences in Canada (N = 25 113). Stata 14 was used to conduct complex survey data analyses, all of which incorporated the recommended sampling weights and bootstrap variance estimation procedures. Logistic regression and modified Poisson regression were used to examine the associations between psychological well-being scores and the outcomes of interest. Considered covariates included: age, disorder type, sex, education, income, and population density. Results: Higher psychological well-being scores reduced the odds of reporting mental health experiences of stigma (OR = 0.96, 95% CI 0.94 to 0.99). Higher psychological well-being scores decreased the likelihood of help-seeking behaviour amongst respondents who met the criteria for at least one selected mental disorder (RR = 0.98, 95% CI 0.97 to 0.984). The observed associations remained statistically significant after adjusting for the effects of all relevant covariates. Conclusion: Higher levels of psychological well-being might facilitate stigma resistance amongst individuals suffering from mental or substance use disorders. However, longitudinal studies using context-specific measures of stigma experiences and expectations are needed to: (a) untangle the directionality of the observed correlations, (b) determine whether psychological well-being facilitates stigma resistance in the mental health care context, and (c) clarify the association between psychological well-being and help-seeking behaviour.