Understanding barriers to mental healthcare access by integrating stigma theory and the theory of planned behavior

The inability to access needed mental healthcare can be a challenge for individuals situated in various social environments and can be understood and predicted via multiple theoretical perspectives. This paper explores access to mental healthcare through the lenses of stigma theory and the Theory of Planned Behavior (TPB) by presenting central tenants of the theories and a brief review of empirical evidence in support of the individual theories. The combined TPB and stigma theory model merges self-stigma with the TPB construct of attitude and public stigma within the construct of subjective norms. A case example illustrates the application of the combined model in understanding barriers to mental health treatment. Discussion of the case study within the combined theoretical framework also acknowledges how culture within the social environment could have impacted mental health outcomes. Thus, it is necessary to intervene in areas of attitude, subjective norms, perceived behavioral control and stigma to shape the social environment through policy, practice and research and to improve mental health.