Attitudes and stigma in relation to help-seeking intentions for psychological problems in low and high suicide rate regions



Accessibility and availability of mental health care services are necessary but not sufficient for people to seek help for psychological problems. Attitudes and stigma related to help seeking also determine help seeking intentions. The aim of this study is to investigate how cross-national differences in attitudes and stigma within the general population are related to professional and informal help seeking intentions in low and high suicide rate regions.


By means of a postal structured questionnaire, data of 2999 Dutch and Flemish respondents between 18 and 65 years were gathered. Attitudes toward help seeking, perceived stigma, self-stigma, shame and intention to seek help were assessed.


People in the Netherlands, where suicide rates are low, have more positive attitudes toward help seeking and experience less self stigma and shame compared to the people in Flanders, where suicide rates are relatively high. These attitudinal factors predicted professional as well as informal help seeking intentions. Perceived stigma was negatively associated with informal help seeking. Shame was positively associated with higher intention to use psychotropic drugs and perceived stigma was negatively associated with the intention to seek help from a psychotherapist in Flanders but not in the Netherlands.


Help seeking for psychological problems prevent these problems to aggravate and it is assumed to be a protective factor for suicide. Our results stress the importance of the promotion of positive attitudes and the reduction of stigma within the general population to facilitate help seeking from professional providers and informal networks. Focusing on these attitudinal factors is believed to be a key aspect of universal mental health and suicide prevention policies.



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This study was funded by the Flemish Government, Department of Well-being, Health and Family, LUCAS KU Leuven, the Centre for the Prevention of Suicide (Centrum ter Preventie van Zelfdoding) and Foundation Go for Happiness-Prevention of Depression and suicide (Stichting Ga voor Geluk-Preventie van Depressie en Suicide).

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Correspondence to A. Reynders.

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Reynders, A., Kerkhof, A.J.F.M., Molenberghs, G. et al. Attitudes and stigma in relation to help-seeking intentions for psychological problems in low and high suicide rate regions. Soc Psychiatry Psychiatr Epidemiol 49, 231–239 (2014).

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  • Attitudes
  • Stigma
  • Help-seeking
  • Suicide
  • Cross-national research