Perceived stigma toward children with emotional and behavioral problems and their families: The Attitudes about Child Mental Health Questionnaire (ACMHQ).

Abstract

Combating the stigma of mental illness is critical to improving the quality of life of persons with mental health disorders and that of their family associates and to reducing barriers to help-seeking. There is concern that stigma toward mental health problems is even more of a barrier in rural communities. However, little research exists and measures to examine this phenomenon about children and their families are needed. This study describes the development and pilot testing of the Attitudes about Child Mental Health Questionnaire (ACMHQ) to assess perceived public stigma and personal stigmatizing attitudes. We worked with an interdisciplinary expert panel using a Delphi consensus-building process to identify and prioritize the critical dimensions for measurement and then conducted focus groups and cognitive interviews before collecting data in a rural pediatric practice. This process resulted in a conceptually grounded and empirically supported self-report questionnaire for measuring three dimensions of perceived public stigma and one of personal stigmatizing attitudes toward children with emotional and behavioral problems (EBP) and their families. The study documents levels of perceived public stigma and personal stigmatized attitudes in a rural community, including the presence of “stigma by association” for families of children with EBP, with strong stigma by association reported for school settings, and the least for church settings. This research lays the groundwork for examining the relationship between stigma and help-seeking, and for developing interventions to reduce stigma and increase access to appropriate services, which should continue to be a priority in children’s mental health for both rural and urban populations.