Racial and Ethnic Minority College Students’ Stigma Associated With
Seeking Psychological Help: Examining Psychocultural Correlates
Hsiu-Lan Cheng
New Mexico State University
Kwong-Liem Karl Kwan
San Francisco State University
Todd Sevig
University of Michigan
Many college students underuse professional psychological help for mental health difficulties. The
stigma associated with seeking such help appears to be one of the reasons for this underuse. Levels of
psychological distress and past use of counseling/psychotherapy have been found to be important
correlates of stigma associated with seeking psychological help (Obasi & Leong, 2009; Vogel, Wade, &
Haake, 2006). For racial and ethnic minorities, the hindering effects of self-stigma and perceived
stigmatization by others on treatment seeking may further be compounded by their relationships with
their own ethnic groups, with other ethnic groups, and with the dominant society. This study used
structural equation modeling (SEM) to test a model that explored the effects of psychological distress and
psychocultural variables (i.e., ethnic identity, other-group orientation, perceived discrimination) on
perceived stigmatization by others and self-stigma for seeking psychological help, controlling for past use
of counseling/psychotherapy. The sample consisted of 260 African American, 166 Asian American, and
183 Latino American students. SEM multigroup analyses indicated measurement invariance, but partial
structural invariance, across racial/ethnic groups. Across all 3 groups, higher levels of psychological
distress and perceived racial/ethnic discrimination, respectively, predicted higher levels of perceived
stigmatization by others for seeking psychological help, which, in turn, predicted greater self-stigma for
seeking psychological help. Higher levels of other-group orientation predicted lower levels of self-stigma
of seeking psychological help across groups. Higher levels of ethnic identity predicted lower levels of
self-stigma of seeking psychological help only for African Americans. Implications for research and
practice are discussed.
Keywords: stigma and psychological help seeking, racial and ethnic minority, perceived discrimination,
ethnic identity, other-group orientation
A growing body of research has indicated that although the
frequency and severity of mental health problems on college
campuses have increased, many students do not seek psycho-
logical help (Benton, Robertson, Tseng, Newton, & Benton,
2003; Blanco et al., 2008; Zivin, Eisenberg, Gollust, & Golber-
stein, 2009). Recent surveys found that about 50% of college
students have a diagnosable mental disorder (Blanco et al.,
2008; Zivin et al., 2009), but treatment-seeking rate was low
among these individuals, ranging from less than 25% (Blanco et
al., 2008) to slightly below 50% (Zivin et al., 2009). Racial and
ethnic minority (REM) college students were found to underuse
mental health service even more than nonminority students and
tended to hold less favorable attitudes toward seeking profes-
sional psychological help (Loya, Reddy, & Hinshaw, 2010;
Masuda et al., 2009) even while reporting more distress. In a
survey of 1,166 help-seeking college students from over 40
universities, European American students were found to attend
more counseling sessions than all REM groups; in terms of
psychological distress, Asian Americans reported the grea-
test distress level, followed by Latino Americans, African
Americans, and European Americans on the Outcome
Questionnaire-45 at intake (Kearney, Draper, & Barón, 2005).
College enrollment of REM students has increased from 15% in
1976 to 33% in 2010 (U.S. Department of Education, 2012). As
the number of REM students continues to increase on college
campuses, there needs to be a better understanding of the factors
and challenges related to seeking psychological help so that the
specific needs of these students can be addressed by college mental
health professionals. Fear of stigmatization is the most mentioned
reason for not seeking professional psychological help (Corrigan,
2004). In this study, we investigated stigma associated with seek-
ing psychological help in a sample of African American, Asian
American, and Latino American college students. We specifically
focused on how psychological distress and psychocultural vari-
Hsiu-Lan Cheng, Department of Counseling and Educational Psychol-
ogy, New Mexico State University; Kwong-Liem Karl Kwan, Department
of Counseling, San Francisco State University; Todd Sevig, Counseling
and Psychological Services, University of Michigan.
We thank Eve Adams for her helpful comments on an earlier version of
this article.
Correspondence concerning this article should be addressed to Hsiu-Lan
Cheng, Department of Counseling and Educational Psychology, College of
Education, MSC 3CEP P.O. Box 30001, New Mexico State University, Las
Cruces, NM 88003. E-mail: hlcheng@nmsu.edu
Journal of Counseling Psychology © 2013 American Psychological Association
2013, Vol. 60, No. 1, 98 –111 0022-0167/13/$12.00 DOI: 10.1037/a0031169
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