Examining the roles of self-stigma and public stigma on the relationship between mental health literacy and help-seeking among athletes: A longitudinal study

Objectives: Despite the prevalence and negative consequences of mental health issues among elite athletes, studies suggest many do not seek professional help. Some barriers exist in the process of help-seeking such as a high level of stigma, lack of mental health knowledge. Therefore, understanding barriers and facilitators to help-seeking is imperative to reduce the burden of mental health symptoms and disorders. Cross-sectional evidence suggests that mental health literacy might correlate to attitudes of help-seeking via self-stigma and public stigma. In the current study, a longitudinal design is conducted to extend knowledge of these hypothesized mediational pathways.
Methods: The data were collected three times with an interval of three months each. A final sample of 82 elite athletes aged 20.6 years (SD = 2.86, ranging from 18 to 31; male = 39) reported their mental health literacy at Time 1, self-stigma and public stigma at Time 2, and help-seeking attitudes at Time 3. Mediation analysis was conducted using the bootstrap approach of the PROCESS macro version 4.3 of SPSS 29.
Results: The results of analysis showed the positive relationship between mental health literacy (Time 1) and help-seeking attitude among elite athlete (Time 3), with the public stigma (Time 2) playing mediating roles in this relationship. However, self-stigma (Time 2) did not show mediate effect in this relationship. The chain mediation effect of public stigma and self-stigma (Time 2) on the relationship between mental health literacy (Time 1) and help-seeking attitude among elite athlete (Time 3) was not significant.
Conclusion: According to the longitudinal evidence for the mediating effects of public stigma, future studies with experimental designs could consider testing the potential changing mechanisms of mental health literacy on improving help-seeking attitudes for elite athletes.