Stigma and Health, Vol 10(1), Feb 2025, 21-32; doi:10.1037/sah0000444
Older adults are unlikely to seek mental health services, and stigma may be a key reason why due to its established link with help-seeking. However, little research has investigated which older adults are particularly likely to have stigma influence mental health service use. To address this research gap, our objective was to test whether experiential avoidance (EA) moderates an internalized stigma model in which the public stigma is internalized as a self-stigma of seeking help, which then negatively affects help-seeking attitudes and intentions. We utilized a moderated mediation analysis of cross-sectional, secondary data from 350 psychologically distressed Canadian adults aged 65 years and older who completed an online survey. This survey included measures of public stigma, self-stigma, help-seeking attitudes, help-seeking intentions, distress, and EA. Results supported the serial mediation model in which public stigma resulted in self-stigma, which led to less positive help-seeking attitudes which subsequently reduced help-seeking intentions. Results also supported EA as a moderator of this mediation model. Those higher in EA were more likely to have internalized stigma negatively affect help-seeking attitudes and intentions, and less likely to have positive attitudes toward help-seeking positively affect intentions to seek help. These results contribute to an understanding of which older adults are especially unlikely to seek mental health services when they are in distress. In addition, identifying EA as a moderator of the negative effects of self-stigma on attitudes and intentions suggests that interventions that enhance acceptance and reduce avoidance should improve help-seeking behaviors for those who need them in later life. (PsycInfo Database Record (c) 2025 APA, all rights reserved)