Many people who would benefit from mental health services opt not to pursue them or fail to fully participate once they have begun. One of the reasons for this disconnect is stigma; namely, to avoid the label of mental illness and the harm it brings, people decide not to seek or fully participate in care. Stigma yields 2 kinds of harm that may impede treatment participation: It diminishes self-esteem and robs people of social opportunities. Given the existing literature in this area, recommendations are reviewed for ongoing research that will more comprehensively expand understanding of the stigma–care seeking link. Implications for the development of antistigma programs that might promote care seeking and participation are also reviewed.

Although the quality and effectiveness of mental health treatments and services have improved greatly over the past 50 years, many people who might benefit from these services choose not to obtain them or do not fully adhere to treatment regimens once they are begun. Stigma is one of several reasons why people make such choices; namely, social–cognitive processes motivate people to avoid the label of mental illness that results when people are associated with mental health care. A brief definition of stigma is provided, followed by a more complete description of two specific manifestations that dissuade people from treatment: the threats of diminished self-esteem and of public identification when labeled “mentally ill.” The article ends by briefly reviewing implications of these two factors for research and antistigma programs that seek to increase consumer use of mental health services.

An important question throughout this article is whether the problem of stigma and adherence applies to the generic concept of mental illness or differs by diagnosis and/or level of disability. Research evidence on this issue is mixed. On one hand, research suggests there is a nonspecific label effect, implying that...