TPC Journal-Vol 10- Issue 2-FULL ISSUE

222 The Professional Counselor | Volume 10, Issue 2 (16.1%); the possibility that their neighbors or community would have negative opinions (15.7%); concern about confidentiality (15.3%); and not wanting others to find out (12.6%). Given these responses and statistics, it is logical to infer that the commonly held public perception of seeking help for mental health concerns and substance use is still very negative and that many still experience significant fear of discrimination from others (e.g., loss of job or a negative impact on social opportunities) as a result of seeking help for AOD issues. The responses also indicate the harmful influence this public stigma has on individuals’ decisions regarding whether to seek psychological treatment for substance use. Furthermore, these findings suggest that respondents possibly internalized negative public attitudes toward seeking professional help for both mental health and substance use concerns, resulting in self-stigma. The respondents’ decision not to receive needed substance use treatment in the previous year in order to avoid negative reactions from others and their lack of belief in the utility of treatment indicate self-stigma surrounding help seeking. This corresponds to previous literature reporting the effects of self-stigma on help-seeking behaviors and attitudes (Vogel & Wade, 2009). Purpose of the Present Study The existing research is clear that stigma has some influence on substance use and recovery. However, there is a lack of research explicating the causal pathways that shape this influence. Another area that is unexplored is the relationship between self-stigma and AOD use, and there is no research that we know of that explores the relationship between help-seeking attitudes and AOD use. Given that self-stigma for mental illness and self-stigma for help seeking are often related in the literature (Mullen & Crowe, 2017), and that a large portion of individuals with SUDs have a co-occurring mental illness (39.1%; Center for Behavioral Health Statistics and Quality, 2015), it is reasonable to suspect that the stigma of mental illness influences help seeking in AOD users. A greater understanding of the relationships between these constructs will allow counselors and other helping professionals to develop better strategies for combatting substance abuse by addressing issues related to stigma and attitudes toward help seeking. Therefore, the aim of this study was to examine the relationships between self- stigma of mental health concerns, attitudes toward help seeking, and AOD use. Specifically, we tested the following research hypotheses: Hypothesis 1 —Self-stigma toward mental health concerns will have a negative direct effect on attitudes toward help seeking and a positive indirect effect on drug and alcohol use as mediated by attitudes toward help seeking; Hypothesis 2 —Self-stigma of help seeking will have a negative direct effect on attitudes toward help seeking and a positive indirect effect on drug and alcohol use as mediated by attitudes toward help seeking; and Hypothesis 3 —Attitudes toward help seeking will have a negative direct effect on drug and alcohol use. Method Participants We acquired 406 participants using Amazon’s Mechanical Turk (MTurk). Most of the participants were male ( n = 213; 52.5%) followed by female ( n = 191; 47.0%) and transgender/gender nonconforming ( n = 2; 0.5%). The mean age of the participants was 34.39 years ( SD = 10.02, range = 20 to 67). In addition, most participants indicated they lived in the United States at the time of the study ( n = 349, 86%) with 57 (14%) participants who lived internationally. As for ethnicity, participants included American Indian or Alaska Native ( n = 12; 3%), Asian ( n = 79; 19.5%), Black or African American ( n = 24; 5.9%), Hispanic or Latino ( n = 20; 4.9%), Multiracial ( n = 5; 1.2%), Other ( n = 2; 0.5%), Native Hawaiian or Other Pacific Islander ( n = 1; 0.2%), and White ( n = 263; 64.8%). Table 1 displays additional demographic information.