(PS7-A2) Stress Moderates the Association Between Stigma and Treatment Seeking Preferences in a Hispanic Sample

Introduction: Mental health stigma is one of the significant barriers hindering Hispanics from seeking treatment (e.g. Eghaneyan and Murphy,  2020) Unknown is whether existing psychological conditions, such as stress, might impact the relationship between stigma and treatment seeking. The present study investigated the moderating role of an individual’s levels of stress in the association between mental illness stigma and treatment seeking in Hispanic young adults. We hypothesized the association between stigma and treatment seeking would be stronger in individuals with low levels of stress and weaker in those with high levels of stress

Method: The study was conducted in a border city in Texas where Hispanics are heavily populated. 353 university students (76.4% women; 99% Hispanic; mean age = 22.2), completed the Beliefs towards Mental Illness Scale (Hirai et al., 2018), Depression, Anxiety, and Stress Scale – Stress subscale (Lovibond et al., 1995), and a questionnaire about treatment seeking preferences online. Treatment seeking options include folk medicine, psychological, family, and religious treatments, and participants reported their treatment preferences for each option based on a 6-point Likert scale. A moderation analysis was conducted using Hayes’ PROCESS Macro V4.0 using 5,000 bootstrapped samples

Results: On average stigma was significantly correlated only with folk medicine (r = .12, p < .05) and religious treatments (r = .18, p < .01). Stress did not moderate these associations (b = .0008, p = ns, CI[-.0009, .0026]) and (b = .0002, p = ns, CI[-.0017, .0020]). Stress significantly moderated the relationship between stigma and care from their family (b = -.0015, p < .05, CI[-.0030, .0000]). Stigma was significantly related to seeking family care only at the low level of stress (1SD below: b = .182, p < .01, CI[.0033, .0228]. Stress did not moderate the association between stigma and psychological treatment seeking.

Discussion: Our findings indicate that highly stigmatized Hispanics prefer seeking folk medicine or religious treatments, regardless of their stress levels. These options may be seen as acceptable, less stigma-evoking, or steadily preferred treatment options for Hispanics. This suggests the possibility of psychologists working with folk medicine practitioners and religious healers to promote the mental health of Hispanics or an integration between evidence based psychological treatments, folk medicine, and religious treatment options to develop interventions that may be less stigma-provoking. The moderation results suggest that Hispanics with high stigma and low stress are those who would not seek any form of professional help outside the family. This suggests the importance of continuing mental health outreach programs to identify these individuals and offer diverse treatment options. Unlike the previous findings, the current study did not show the association between stigma and psychological treatment seeking on average and stress levels did not change the non-significant association. There may be an indirect or mediated relationship between mental illness stigma and treatment seeking (Sickel et al., 2015). Future research should examine stigma and treatment seeking in Hispanics in the community.