Stigma and behavioral health literacy among individuals with proximity to mental health or substance use conditions

BACKGROUND: Stigma reduction has been identified as a key public health strategy to increase enrollment in behavioral health services. As our understanding about stigma reduction has become more sophisticated, there has been an increased recognition that efforts to reduce stigma must engage the complex relationships between stigma, literacy, and contact with others who have a behavioral health condition. AIMS: The goal of this project was to improve understanding about the relationships between behavioral health literacy, stigma, and contact to inform efforts to increase public behavioral health literacy and decrease stigma. Specifically, this project explored how the structure of these relationships varied for different substance use and mental health conditions. METHOD: Structural equation modeling was used to depict relationships with data from a nationally-representative survey on behavioral health literacy and stigma. RESULTS: The impact of prior contact and literacy on stigma varied by behavioral health condition. CONCLUSIONS: Stigma reduction efforts will be most successful when they match the level of literacy and prior contact with the condition among the target audience for stigma reduction efforts.