Stigma Starts Early

PURPOSE: To explore gender differences and the role of stigma in teen willingness to use mental health services. METHODS: Self-administered, written questionnaires were conducted with 274 eighth graders in a suburban community in a mid-Atlantic state. Teens reported on social support for emotional concerns, mental health experience and knowledge, and stigma and barriers associated with mental health service use. Data analysis included chi-square statistics and analysis of variance (ANOVA) to examine associations between gender and independent variables of interest. Logistic regression analyses assessed the relationship of gender, stigma, and willingness to use mental health services, adjusting for race and receipt of mental health services. RESULTS: More girls than boys turned to a friend for help for an emotional concern, whereas more boys turned to a family member first. Boys had less mental health knowledge and experience and higher mental health stigma than girls. In adjusted analyses, girls were twice as likely as boys to report willingness to use mental health services (odds ratio [OR] 2.45, 95% confidence interval [CI] 1.20-4.99). Parental disapproval and perceived stigma helped to explain the relationship between gender and willingness to use mental health services (OR 1.65, 95% CI .72-3.77). CONCLUSIONS: Gender differences in negative mental health attitudes and willingness to use mental health services are present early in adolescence. Enhanced mental health education and services in middle school may reduce gender disparities by incorporating stigma reduction efforts that actively involve parents and address differences in knowledge and exposure to mental health issues.