摘要：Objectives. We examined the degree to which lay beliefs about the causes of disorders may predict beliefs about what constitutes appropriate treatment. Methods. We analyzed randomized vignette data from the MacArthur Mental Health Module of the 1996 General Social Survey (n=1010). Results. Beliefs in biological causes (i.e., chemical imbalance, genes) were significantly associated with the endorsement of professional, biologically focused treatments (e.g., prescription medication, psychiatrists, and mental hospital admissions). Belief that the way a person was raised was the cause of a condition was the only nonbiologically based causal belief associated with any treatment recommendations (talking to a clergy member). Conclusions. Lay beliefs about the biological versus nonbiological causes of mental and substance abuse disorders are related to beliefs regarding appropriate treatment. We suggest areas for further research with regard to better understanding this relationship in an effort to construct effective messages promoting treatment for mental health and substance abuse disorders. Persons with mental health or substance abuse disorders may not seek help, at least not in the form of professional treatment (i.e., psychotherapy, medication), because these treatment options are perceived by the person, family, or social network as inappropriate or undesirable. 1 , 2 The perceived undesirability or inappropriateness of professional treatment sources for mental health and substance abuse disorders by persons with these disorders is a major barrier to adequate treatment of mental health and substance abuse problems. 1 , 2 Previous research indicates that the American lay public overwhelmingly agrees with mental health and substance abuse experts that mental health disorders are serious and that they require treatment. 3 But what type of treatment does the public believe will help? Answering this question is essential so that public health professionals can construct and convey effective public health messages concerning the treatment of mental health and substance abuse disorders to the public. Although recent research has assessed trends in lay beliefs about the causes of mental health and substance abuse problems, 4 few studies have examined lay beliefs about treatment for these disorders. The literature suggests that the lay public demonstrates a preference for informal sources of help and holds a relatively negative view of, or unwillingness to use, professional—and particularly medical—sources of help, such as psychiatry and psychiatric medication. 2 , 5 – 7 However, almost no research has examined the relation between causal beliefs and beliefs about treatment. Nevertheless, a recent study that used a small sample of undergraduates suggests that laypersons are more likely to perceive treatment options for depression, including psychiatric medication, as more helpful if causal beliefs are aligned with treatment focus. 8 Understanding the relation of causal beliefs to beliefs about treatment for these disorders is essential for mental health and substance abuse treatment professionals who must construct effective messages to the public about the appropriate diagnosis and treatment of these disorders. Although beliefs may not be predictive of actual behavior, beliefs do contribute to public sentiment about the cause and appropriate treatment for mental illness and substance abuse disorders, and this in turn provides the context in which individual decisions about treatment are made. 9 Therefore, better understanding the relationship between causal and treatment beliefs may illuminate the relationship between causal beliefs and the actual treatment-related behavior (such as help-seeking, treatment adherence, and continuation) of individuals within a community. Recent messages to the public regarding the treatment of mental health and substance abuse disorders from medical, pharmaceutical, insurance, and some advocacy sources focus on biological causes of these disorders and typically emphasize biologically focused treatment options. Although it may seem logical that biologically focused treatments such as medication and other types of prescribed therapies would be the treatment choice for persons who perceive a biological cause for these disorders, we sought to evaluate this assumption by testing the following related hypotheses: Lay public beliefs regarding the appropriateness of specific treatments vary among 4 mental health conditions (depression, schizophrenia, alcohol abuse, and drug abuse). Beliefs about the cause of a disorder are associated with beliefs regarding the appropriateness of specific treatments. Biologically based (vs nonbiologically based) causal beliefs are more strongly associated with the endorsement of biologically focused treatment options.
