This study examines how religious affiliation, atheism versus Christianity, impacted mental-health help-seeking intentions amid persistent service underutilization. A sample of 136 adults, self-identifying as atheist or Christian, completed an online survey assessing differing patterns of how attitudes, public, and self-stigma impact intention to seek help between Christians and atheists. Multivariate analysis of variance revealed that religious affiliation significantly influenced intentions to seek mental health services, with atheists reporting greater intention to seek help in comparison to Christians. Both attitude and self-stigma were significant predictors of intention to seek help. Interestingly, the relationship between self-stigma and intention to seek help was significantly negatively associated among atheists, and significantly positive among Christians. These findings highlight the role of religious affiliation in shaping help-seeking intention and underscore the importance of culturally sensitive approaches to intervention. The results contribute to the broader discourse on belief systems, stigma, and access to care in diverse populations.
References
[1]
National Alliance on Mental Illness (2023) Mental Health by the Numbers. https://www.nami.org/mhstats
[2]
Fleetwood, K.J., Guthrie, B., Jackson, C.A., Kelly, P.A.T., Mercer, S.W., Morales, D.R., et al. (2025) Depression and Physical Multimorbidity: A Cohort Study of Physical Health Condition Accrual in UK Biobank. PLOSMedicine, 22, e1004532. https://doi.org/10.1371/journal.pmed.1004532
[3]
World Health Organization (2022) World Mental Health Report. World Health Organization.
[4]
Aigner, C.J. (2025) The Role of Self-Stigma and Depressive Symptomology in Mental Health Help-Seeking. JournalofCollegeStudentMentalHealth, 39, 130-141. https://doi.org/10.1080/28367138.2024.2329599
[5]
Pescosolido, B.A., Halpern-Manners, A., Luo, L. and Perry, B. (2021) Trends in Public Stigma of Mental Illness in the US, 1996-2018. JAMANetworkOpen, 4, e2140202. https://doi.org/10.1001/jamanetworkopen.2021.40202
[6]
Mitchell, T. (2019) In U.S., Decline of Christianity Continues at Rapid Pace. Pew Research Center.
[7]
Lloyd, C.E.M. and Waller, R.M. (2020) Demon? Disorder? Or None of the Above? A Survey of the Attitudes and Experiences of Evangelical Christians with Mental Distress. MentalHealth, Religion&Culture, 23, 679-690. https://doi.org/10.1080/13674676.2019.1675148
[8]
Vaingankar, J.A., Choudhary, N., Chong, S.A., Kumar, F.D.S., Abdin, E., Shafie, S., et al. (2021) Religious Affiliation in Relation to Positive Mental Health and Mental Disorders in a Multi-Ethnic Asian Population. InternationalJournalofEnvironmentalResearchandPublicHealth, 18, Article 3368. https://doi.org/10.3390/ijerph18073368
[9]
Koenig, H.G. (2012) Religion, Spirituality, and Health: The Research and Clinical Implications. ISRNPsychiatry, 2012, Article ID: 278730. https://doi.org/10.5402/2012/278730
[10]
Seitz, R.J. and Angel, H. (2015) Psychology of Religion and Spirituality: Meaning-Making and Processes of Believing. Religion, Brain&Behavior, 5, 139-147. https://doi.org/10.1080/2153599x.2014.891249
[11]
Liddle, S.K., Vella, S.A. and Deane, F.P. (2021) Attitudes about Mental Illness and Help Seeking among Adolescent Males. PsychiatryResearch, 301, Article ID: 113965. https://doi.org/10.1016/j.psychres.2021.113965
[12]
Murphy, D.J. and Mackenzie, C.S. (2024) The Impact of the Big Five Personality Traits on Help-Seeking Stigmas, Attitudes, and Intentions. StigmaandHealth. https://doi.org/10.1037/sah0000547
[13]
Ajzen, I. (1991) The Theory of Planned Behavior. OrganizationalBehaviorandHumanDecisionProcesses, 50, 179-211. https://doi.org/10.1016/0749-5978(91)90020-t
[14]
Ansell, M.E., Finlay-Jones, A.L., Bayliss, D.M. and Ohan, J.L. (2024) “It Just Makes You Feel Horrible”: A Thematic Analysis of the Stigma Experiences of Youth with Anxiety and Depression. JournalofChildandFamilyStudies, 33, 2121-2133. https://doi.org/10.1007/s10826-024-02877-0
[15]
Peters, H.J., Schwenk, H.N., Ahlstrom, Z.R. and McIalwain, L.N. (2017) Microaggressions: The Experience of Individuals with Mental Illness. CounsellingPsychologyQuarterly, 30, 86-112. https://doi.org/10.1080/09515070.2016.1164666
[16]
Johnson-Kwochka, A.V., Stull, L.G. and Salyers, M.P. (2022) The Impact of Diagnosis and Religious Orientation on Mental Illness Stigma. PsychologyofReligionandSpirituality, 14, 462-472. https://doi.org/10.1037/rel0000384
[17]
Conceição, V., Rothes, I. and Gusmão, R. (2022) The Association between Stigmatizing Attitudes Towards Depression and Help Seeking Attitudes in College Students. PLOSONE, 17, e0263622. https://doi.org/10.1371/journal.pone.0263622
[18]
Ajzen, I. (2020) The Theory of Planned Behavior: Frequently Asked Questions. HumanBehaviorandEmergingTechnologies, 2, 314-324. https://doi.org/10.1002/hbe2.195
[19]
Pasmatzi, E., Koulierakis, G. and Giaglis, G. (2016) Self-Stigma, Self-Esteem and Self-Efficacy of Mentally Ill. Psychiatriki, 27, 243-252. https://doi.org/10.22365/jpsych.2016.274.243
[20]
Murphy, D.J., Mackenzie, C.S., Dryden, R.P. and Hamm, J.M. (2024) Perceived Control Moderates the Internalized Stigma Model of Seeking Mental Health Services in Distressed Older Adults. JournalofCounselingPsychology, 71, 473-486. https://doi.org/10.1037/cou0000733
[21]
Evans, L., Chang, A., Dehon, J., Streb, M., Bruce, M., Clark, E., et al. (2024) The Relationships between Perceived Mental Illness Prevalence, Mental Illness Stigma, and Attitudes toward Help-Seeking. CurrentPsychology, 43, 1806-1815. https://doi.org/10.1007/s12144-023-04329-2
[22]
Bazargan, M., Cobb, S. and Assari, S. (2021) Discrimination and Medical Mistrust in a Racially and Ethnically Diverse Sample of California Adults. The Annals of Family Medicine, 19, 4-15. https://doi.org/10.1370/afm.2632
[23]
Williamson, L.D. and Bigman, C.A. (2018) A Systematic Review of Medical Mistrust Measures. PatientEducationandCounseling, 101, 1786-1794. https://doi.org/10.1016/j.pec.2018.05.007
[24]
Kuang, K. and Wang, N. (2024) Predictors and Outcomes of Help-Seeking Behaviors: A Longitudinal Investigation in Mental Illness. HealthCommunication, 39, 1906-1917. https://doi.org/10.1080/10410236.2023.2247157
[25]
Xu, Z., Huang, F., Kösters, M., Staiger, T., Becker, T., Thornicroft, G., et al. (2018) Effectiveness of Interventions to Promote Help-Seeking for Mental Health Problems: Systematic Review and Meta-analysis. PsychologicalMedicine, 48, 2658-2667. https://doi.org/10.1017/s0033291718001265
[26]
Faries, M.D. (2016) Why We Don’t “just Do It”: Understanding the Intention-Behavior Gap in Lifestyle Medicine. AmericanJournalofLifestyleMedicine, 10, 322-329. https://doi.org/10.1177/1559827616638017
[27]
Nadeem, R. (2022) Modeling the Future of Religion in America. Pew Research Center.
Lefevor, G.T., Paiz, J.Y., Milburn, H.E., Sheffield, P.E. and Tamez Guerrero, N.A. (2022) Religiousness and Help Seeking: Individual, Congregational, and Clergy Factors. CounsellingPsychologyQuarterly, 35, 89-109. https://doi.org/10.1080/09515070.2021.1874297
[30]
Brewster, M.E., Robinson, M.A., Sandil, R., Esposito, J. and Geiger, E. (2014) Arrantly Absent: Atheism in Psychological Science from 2001 to 2012. TheCounselingPsychologist, 42, 628-663. https://doi.org/10.1177/0011000014528051
[31]
Cash, T.F., Begley, P.J., McCown, D.A. and Weise, B.C. (1975) When Counselors Are Heard but Not Seen: Initial Impact of Physical Attractiveness. Journal of Counseling Psychology, 22, 273-279.
[32]
Vogel, D.L., Wade, N.G. and Haake, S. (2006) Measuring the Self-Stigma Associated with Seeking Psychological Help. JournalofCounselingPsychology, 53, 325-337. https://doi.org/10.1037/0022-0167.53.3.325
[33]
Komiya, N., Good, G.E. and Sherrod, N.B. (2000) Stigma Scale for Receiving Psychological Help (SSRPH) [Database Record]. APA PsycTests. https://doi.org/10.1037/t23348-000
[34]
Fischer, E.H. and Farina, A. (1995) Attitudes toward Seeking Professional Psychological Help: A Shortened Form and Considerations for Research. Journal of College Student Development, 36, 368-373.
[35]
Jaccard, J., Turrisi, R. and Wan, C.K. (1990) Interaction Effects in Multiple Regression. Sage Publications.
[36]
Bischof, G., Bischof, A. and Rumpf, H. (2021) Motivational Interviewing: An Evidence-Based Approach for Use in Medical Practice. DeutschesÄrzteblattinternational, 118, 109-115. https://doi.org/10.3238/arztebl.m2021.0014
[37]
Khanolkar, K. (2024) Impact of Atheist Identity Disclosure on Experience of Microaggressions in therapy. Master’s Thesis, Minnesota State University. https://www.proquest.com/docview/3089005285
[38]
Bishop, B. (2018) Advocating for Atheist Clients in the Counseling Profession. CounselingandValues, 63, 17-30. https://doi.org/10.1002/cvj.12070
[39]
Abbott, D.M. and Anaya, E.J. (2022) “Breaking Free”: A Grounded Theory Study of Atheist Women in the United States. PsychologyofWomenQuarterly, 46, 501-517. https://doi.org/10.1177/03616843221115338
[40]
Yu, B.C.L., Chio, F.H.N., Chan, K.K.Y., Mak, W.W.S., Zhang, G., Vogel, D., et al. (2023) Associations between Public and Self-Stigma of Help-Seeking with Help-Seeking Attitudes and Intention: A Meta-Analytic Structural Equation Modeling Approach. JournalofCounselingPsychology, 70, 90-102. https://doi.org/10.1037/cou0000637
[41]
Link, B.G., Cullen, F.T., Struening, E., Shrout, P.E. and Dohrenwend, B.P. (1989) A Modified Labeling Theory Approach to Mental Disorders: An Empirical Assessment. AmericanSociologicalReview, 54, 400-423. https://doi.org/10.2307/2095613
[42]
Chisholm, K., Patterson, P., Torgerson, C., Turner, E., Jenkinson, D. and Birchwood, M. (2016) Impact of Contact on Adolescents’ Mental Health Literacy and Stigma: The Schoolspace Cluster Randomised Controlled Trial. BMJOpen, 6, e009435. https://doi.org/10.1136/bmjopen-2015-009435
[43]
Lucksted, A., Drapalski, A., Calmes, C., Forbes, C., DeForge, B. and Boyd, J. (2011) Ending Self-Stigma: Pilot Evaluation of a New Intervention to Reduce Internalized Stigma among People with Mental Illnesses. PsychiatricRehabilitationJournal, 35, 51-54. https://doi.org/10.2975/35.1.2011.51.54
[44]
Riebel, M., Rohmer, O., Charles, E., Lefebvre, F., Weibel, S. and Weiner, L. (2023) Compassion-focused Therapy (CFT) for the Reduction of the Self-Stigma of Mental Disorders: The Compassion for Psychiatric Disorders, Autism and Self-Stigma (COMPASS) Study Protocol for a Randomized Controlled Study. Trials, 24, Article No. 393. https://doi.org/10.1186/s13063-023-07393-y
[45]
Allport, G.W. and Ross, J.M. (1967) Personal Religious Orientation and Prejudice. JournalofPersonalityandSocialPsychology, 5, 432-443. https://doi.org/10.1037/h0021212
[46]
Abdel-Khalek, A.M. (2017) The Construction and Validation of the Arabic Scale of Intrinsic Religiosity (ASIR). PsychologyandBehavioralScienceInternationalJournal, 4, Article ID: 555644. https://doi.org/10.19080/pbsij.2017.04.555644
[47]
Eskelinen, V., Pauha, T., Kunst, J., Räsänen, A. and Jasinskaja-Lahti, I. (2021) Exploring Religiosity and Attitudes Towards Christians and Non-Believers among Recent Muslim Refugees to Finland. InternationalJournalofInterculturalRelations, 80, 206-216. https://doi.org/10.1016/j.ijintrel.2020.10.007
[48]
Vitell, S.J., Bing, M.N., Davison, H.K., Ammeter, A.P., Garner, B.L. and Novicevic, M.M. (2009) Religiosity and Moral Identity: The Mediating Role of Self-Control. JournalofBusinessEthics, 88, 601-613. https://doi.org/10.1007/s10551-008-9980-0