Mental Health Awareness, Stigma, and Help-Seeking Intention in an Indian Tier-II City: Evidence from a Structural Equation Model

Stigma towards mental illness has been the biggest obstacle to care-seeking in the metropolitan zing Indian cities. The study was a cross-sectional survey conducted on the awareness of mental health, patterns of mental health stigma, and stigma-reduction strategies among Vadodara, Gujarat residents (N = 250). The hypothesized pathways of a structural equation model (SEM) were evaluated between Mental Health Awareness (MHA), Stigma Perception (STIG), Socio-Demographic Factors (SDF) and Program Exposure (PROG) on Help-Seeking Intention (HSI) as the mediator and Mental Health Outcome (MHO) as the distal outcome. The model fit was good (chi-square/df = 1.94; CFI = 0.953; RMSEA = 0.061). Stigmatization was found to have a significant and negative correlation with MHA (β = -0.42, p < .001); stigmatization was found to have a negative relationship with help-seeking intention (β = -0.38, p < .001). Program exposure had a most significant direct influence on HSI (β = 0.51, p < .001), and HSI significantly forecasted MHO (β = 0.63, p < .001). The indirect MHA-to-MHO had a significant positive (β = 0.10, p =.001), which verified partial mediation. Multi-group analysis affirmed gender and educational attainment as important moderator variables. There was no threat of common method variance (Harman single factor = 31.4%). Findings show that culturally sensitive multi-modal interventions that incorporate community champions, task-sharing counselors, and online outreach are necessary to enhance treatment gap in Tier-II Indian cities. These results indicate that awareness campaigns are not enough; well-structured community-based interventions are important in transforming awareness to behavioral help-seeking.