Although mental illness is common among college students and students have access to mental health care, most students do not seek treatment (Blanco et al., 2008; Rosenthal & Wilson, 2008). The stigma associated with mental illness poses a major barrier to seeking help (SAMHSA, 2006). Many students with mental illness may anticipate stigma (social devaluing and distancing) from others due to their mental illness. The objective of the current work is to integrate research on stigma with research on interpersonal relationship goals and processes to examine the effects of stigma on psychological distress and help seeking among students with mental illness, specifically students with diagnosed mood and anxiety disorders. Previous research finds that the interpersonal goals of college students can influence supportive relationships and predict change in symptoms of depression and anxiety over the first semester of college (Crocker et al., 2010). Students with compassionate goals create positive relationship spirals by being more supportive and responsive to others and receiving more support in return; whereas students with self-image goals, focused on controlling how others view the self, undermine these positive relationship spirals. We hypothesize that the combination of level of mental illness and anticipated stigma predict decreased compassionate goals and increased self-image goals, which creates a negative support dynamic leading to decreased help seeking, increased distress, and poor academic outcomes for students with mental illness. However, we predict that roommates of students with mental illness can interrupt these negative processes if they have high compassionate goals. We examine these predictions in a longitudinal study. Students with a mental illness history (diagnosed mood or anxiety disorder prior to entering college) and their roommates will be recruited during the first weeks of their first semester in college. Students and their roommates will complete a pre-test session of trait measures of stigma (anticipated, internalized, personal, and perceived), relationship goals, mental health history, symptomatology, mental health treatment, mental health knowledge, and personality variables. Both roommates will then complete daily reports of relationship processes over 21 days, followed by an immediate post-test session, measurement of outcomes again at the end of the first and second semesters, including measures of symptomatology, help-seeking, and academic outcomes. Recruiting pairs allows us to chart relationship dynamics, including feelings of increased trust, responsiveness, and disclosure. This type of predictive, dyadic, longitudinal work is critically needed to make stigma research of clinical use.
The current work seeks to understand how the stigma beliefs of college students with mental illness affect psychological symptomatology, treatment seeking and engagement, and academic outcomes. Furthermore, we examine how interpersonal relationship goals, through increasing supportive and trusting relationships, can buffer the negative effects of stigma and increase positive outcomes, including increased help seeking. Given the long-term negative consequences of untreated mental illness, including decreased academic performance, poorer overall health, and higher likelihood of suicide, the current work is highly relevant to public health.
