Perceived Cultural Stigma and Professional Help-Seeking Intentions Among Families of Children with Mental Health Difficulties: A Multigroup Mediation Model Across Urban and Rural Communities
Keywords:
cultural stigma, family social support, professional help-seeking intention, child mental health, caregivers, mediation, rural communities, urban communities, CanadaAbstract
Objective: This study aimed to examine the direct and indirect association between perceived cultural stigma and professional help-seeking intention through family social support and determine whether this mediation model differed between urban and rural Canadian communities.
Methods and Materials: This cross-sectional study included 648 parents and primary caregivers of children aged 6–17 years with clinically significant mental health difficulties, comprising 356 urban and 292 rural participants from six Canadian provinces. Participants completed measures of perceived cultural stigma, family social support, professional help-seeking intention, child psychological difficulties, and demographic characteristics. Confirmatory factor analysis and measurement invariance testing preceded multigroup structural equation modeling. Indirect effects were evaluated using 5,000 bias-corrected bootstrap samples, with caregiver, child, clinical, and regional variables controlled.
Findings: Perceived cultural stigma significantly predicted lower family social support (β = −.41, p < .001) and weaker professional help-seeking intention directly (β = −.27, p < .001). Family social support significantly predicted stronger help-seeking intention (β = .39, p < .001). The indirect effect of stigma through family support was significant (β = −.16, 95% CI [−.33, −.19]), indicating partial mediation. The stigma-to-support pathway was significantly stronger among rural than urban caregivers (β = −.52 vs. −.33, p = .009). The indirect effect was also stronger in rural communities (β = −.18 vs. −.15, p = .036), whereas the support-to-help-seeking and direct stigma-to-help-seeking pathways did not differ significantly between groups.
Conclusion: Perceived cultural stigma may discourage caregivers from seeking professional care for their children partly by weakening family support, particularly in rural communities, highlighting the need for culturally responsive and family-centered interventions.
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References
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