Date of Award

2026

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

First Advisor

Ki Eun (Kay) Shin, PH.D.

Second Advisor

Hilary Vidair, PH.D.

Third Advisor

Lauren Lipner, PH.D.

Abstract

Despite the disproportionate increase in their suicide risk in recent years, ethnoracially minoritized individuals utilize mental health treatment less frequently than their non-Hispanic, White counterparts. Understanding the underlying mechanisms is crucial to identify strategies to mitigate such disparities. While mental health-related stigma has received attention as a potential mechanism, select types of stigma have been examined in isolation, leaving it unclear which forms of stigma are most relevant to the observed ethnoracial disparities in treatment-seeking among suicidal individuals. The current study assessed and examined a range of stigma constructs as potential mediators of ethnoracial differences in treatment-seeking outcomes among suicidal adults. 488 adults with lifetime suicidal ideation completed an online survey assessing demographics, four types of stigma (anticipated identity-based discrimination, self-stigma of seeking help, self-stigma of suicide, and cultural sanction of suicide), and treatment-seeking attitudes, intentions, and behaviors. Contrary to hypotheses, ethnoracially minoritized participants did not report higher levels of stigma than non-Hispanic, White participants, except higher cultural sanction of suicide in Hispanic/Latino participants relative to non-Hispanic participants. Racially minoritized participants also reported less favorable treatment-seeking attitudes and lower odds of prior treatment utilization than White participants. With the exception of cultural sanction of suicide significantly mediating ethnic differences in treatment-seeking outcomes, no mediations via stigma constructs were significant. Findings suggest the multidimensional nature of stigma and highlight the importance of considering broader structural and cultural factors when addressing ethnoracial disparities in mental health service utilization.

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