Self-labeling as having a mental or physical illness: the effects of stigma and implications for help-seeking

  • Philip HorsfieldEmail author
  • Susanne Stolzenburg
  • Stefanie Hahm
  • Samuel Tomczyk
  • Holger Muehlan
  • Silke Schmidt
  • Georg Schomerus
Original Paper



Personal and perceived stigma can hinder persons in appraising their symptoms as constituting part of a mental illness (self-labeling), an important early step in the help-seeking process. This study examines the impact of personal and perceived stigma on self-labeling and provides prospective data on the possible connections between self-labeling and help-seeking behavior.


Personal stigmatizing attitudes, perceived stigma and self-labeling behavior as well as their statistical connections were cross-sectionally investigated in a community sample of 207 participants with a present untreated mental health problem. We further conducted prospective analyses to investigate possible associations between self-labeling and help-seeking behavior at 3 and 6 month follow-ups. Socio-demographics, previous treatment and depression symptoms were also measured as potential confounders.


Personal stigmatizing attitudes were significantly more pronounced in respondents who self-labeled as physically compared to mentally ill, while group differences in levels of perceived stigma were not. Self-labeling as physically or mentally ill increased the likelihood of seeking help from the health service provider deemed most suitable for that label (physical: GP, p <0.05; mental: MHP, p < 0.1) compared to persons who applied no self-label.


The findings suggest that personal stigmatizing attitudes—rather than perceived stigma—impact on self-labeling, and highlight the need for interventions that assist persons with mental illness in overcoming those attitudes. They also underscore the possible impact of self-labeling in the help-seeking process and underline the important role of GPs in mental health care. Further, preferably epidemiological research into the matter would be desirable.


Stigma Self-labeling Help-seeking Personal stigmatizing attitudes Mental health 



This work was funded by the Deutsche Forschungsgemeinschaft (DFG) (grant IDs SCHO 1337/4-1 and SCHM 2683/4-1). The authors declare no conflict of interest.

Compliance with ethical standards

Ethical standards

The study was approved by the local ethics committee of University Medicine Greifswald. The manuscript does not contain clinical studies or patient data.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Psychiatry and PsychotherapyUniversity Medicine GreifswaldGreifswaldGermany
  2. 2.Department of Health and Prevention, Institute of PsychologyGreifswald UniversityGreifswaldGermany
  3. 3.Department of Psychiatry and PsychotherapyUniversity Medicine LeipzigLeipzigGermany

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