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



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.

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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.

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Correspondence to Philip Horsfield.

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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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Horsfield, P., Stolzenburg, S., Hahm, S. et al. Self-labeling as having a mental or physical illness: the effects of stigma and implications for help-seeking. Soc Psychiatry Psychiatr Epidemiol 55, 907–916 (2020).

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