Fear of relational impact mediates differences in treatment-seeking for depression between women in the UK and India

Abstract

Fear of relational impact upon diagnosis of depression refers to an apprehension that an individual may experience regarding how their mental health condition could affect their relationships with others. It holds a significant influence over an individual’s treatment-seeking intentions for mental illness. The current thesis explores the fear of relational impact through the lens of cultural differences among British and Indian women who are diagnosed with depression. The paper explores the impact of stigma linked to depression on societal norms and how these norms influence attitudes toward depression. The mixed-methods research was conducted in two sequential stages, commencing with a qualitative study. In Study 1 (N= 16), self-reported clinically diagnosed women with depression from the UK and India were approached to take part in a semi-structured interview about their experiences. Study 2 (N= 341), which was a quantitative study, was conducted to investigate the differences reported between the two groups. The second study included two questionnaires, the first assessed treatment-seeking behaviour (using the Attitudes Toward Seeking Professional Psychological Help-Short Form) while the second questionnaire was developed by the researchers to assess relational concerns, based on the insights from Study 1 data. The results of these studies collectively suggest that fear of relational impact is negatively associated with treatment-seeking intentions and how this varies across cultural contexts. Participants from India reported more fear of relational impact than the UK participants and hence they reported lower treatment-seeking intentions. Furthermore, fear of relational impact in regard to diagnosis of depression was found to be a significant mediator that facilitates the influence of cultural background and treatment-seeking behaviour. We conclude that treatment-seeking for depression is associated with stigma-related fears of its negative relational impact, with variations across cultural context.