Understanding Beliefs about Mental Illness and Intentions to Seek Mental Health Treatment: A Terror Management Paradigm
Research on Terror Management Theory has suggested that individuals manage anxiety associated with nonconscious thoughts of death by reminding themselves that they are valuable members of a meaningful world. These defensive responses to threats of death may be manifested by engaging in self-esteem enhancing behaviors or acting in ways that align with one’s cultural worldview. Studies have examined Terror Management Theory in the context of physical health in order to understand factors contributing to health-promoting and health-defeating behaviors. The current study was an extension of such research, where self-reported mental health and intentions to seek help for mental health problems were assessed in relation to contingencies of self-esteem and cultural/societal worldview. It was hypothesized that individuals whose self-esteem was contingent upon being mentally healthy and who had negative attitudes about or perceived stigma associated with mental illness or help-seeking would be more likely to report fewer mental health problems and less likely to report intentions to seek help if experiencing mental health problems after being reminded of their mortality (experimental group), as opposed to thoughts of dental pain (control group). The main hypotheses were not substantiated. Future research addressing limitations in the design and administration of the study, and use of more reliable measures may provide more information about the role of mortality salience in adaptive or maladaptive mental health care engagement. Within-gender trends suggest preliminary evidence of the influence of gender in mental health perceptions and decision-making that may be worth examining more closely in future research. Females who reported greater dispositional self-esteem and had less stigmatized attitudes associated with mental illness were more likely to report better mental health when reminded of their mortality. For females, low perceptions of stigma were also associated with better self-reported mental health and intentions to seek help. After a mortality salience induction, when males anticipated worse self-esteem due to mental health problems or perceived greater stigma associated with seeking help, they were more likely to report better mental health. If future research reveals stronger evidence for these within-gender trends in self-reported mental health and intentions to seek help, it could be attributed to socialized and stereotyped attitudes about mental health and help-seeking, which may be more influential when mortality is salient. By expanding previous research on physical health to the domain of mental health, this study demonstrates how researchers can creatively build upon TMT research. For example, this type of research may explain biased perceptions of mental health stability and reluctance to seek treatment for individuals whose mortality is particularly salient such as military service members. Future research that contributes to TMT literature may lead to greater specificity in conceptualization of the theory and better predictions within hypotheses.