A recently published by the journal Scientific Reports highlighted how mental health shame and help-seeking vary across lifestyles and socio-economic groups. The researchers from the University of Leipzig, Germany, primarily sought to identify and provide support to specific target groups for mental health prevention.
In order to understand how lifestyle dictates mental health stigma, the research utilized data from the Study of Health in Pomerania (SHIP), specifically the third follow-up data collection (SHIP-START-3) conducted between 2014 and 2016, with additional data from SHIP-START-1 collected from 2002 to 2006. All the participants were of legal age and German nationality.
After applying cluster analysis techniques, the final sample comprised 1630 participants grouped into nine different lifestyles based on similarities in educational and professional level, income, smoking status, alcohol drinking behavior, and physical activity.
These lifestyles encompassed various combinations of high, middle to low socioeconomic status, and healthy to unhealthy behaviors. The socioeconomic status index was operationalized using household income, educational level, and professional status to analyze the link between mental health shame and help-seeking behavior.
To analyze the association between mental health stigma and help-seeking related to lifestyle factors, the study utilized two items from the SHIP data collection. The items were rated on a 5-point Likert scale and assessed participants’ willingness to seek professional help for long-term depression or other mental problems as well as their level of shame associated with mental illness.
The calculations were further stratified by median age and sex, as well as the presence or absence of self-reported mental illness symptoms.
The findings revealed a moderate association between help-seeking intentions, lifestyle, and mental health shame in the entire sample—which aligns with previous research. Confirming the hypothesis, the characteristics of clustered lifestyles showed minimal context effects, indicating that the association between shame and the willingness to seek professional help for mental illness varied only slightly across lifestyles.
Notably, there was a significant decrease in intentional help-seeking when shame regarding a diagnosed mental illness was higher among individuals with unhealthy behaviors and both high and low socioeconomic status.
The lifestyle characterized by middle socioeconomic status and moderately healthy behavior showed the weakest association between shame and help-seeking intentions, particularly for men, younger participants, and those reporting a mental illness. In these contexts, people still considered seeking help despite feeling ashamed of their diagnosed mental illness.
The study also reported that certain combinations of socio-demographic characteristics led to higher stigma and varying help-seeking intentions. The gender-specific findings were consistent with past research and can be explained by women being socialized to prioritize their own and others’ well-being, leading to more contact with healthcare professionals and earlier detection of health problems.
It was also revealed that mental health shame across lifestyles in the older population is significantly high. Older people may have lower help-seeking tendencies due to a lack of awareness, knowledge, and communication about symptoms or a failure to attribute them to mental illness.
According to the study’s researchers, conceptualizing social structures through health-related lifestyles proved useful in identifying target groups, particularly men and younger individuals with unhealthy lifestyles and different socioeconomic statuses, who should be the focus of prevention programs.
Lifestyle clusters provide a modern approach for evaluating the associations between stigma and the willingness to seek help, going beyond traditional milieus or classes. As lifestyles reflect individuals’ behaviors, which are more flexible compared to social contexts such as income, they offer a valuable tool for investigating various research questions in public health related to disease management, healthcare utilization, attitudes, openness, health literacy, stereotypes, stigmas, intersectionality, and more.
