Self-Stigma of Seeking Help Scale (SSSH)
Also known as: SSSH, Vogel Self-Stigma Scale
The Self-Stigma of Seeking Help Scale (SSSH) is a 10-item self-report measure assessing the degree to which individuals experience shame, embarrassment, or fear of judgment related to seeking psychological or mental health help. Developed by David L. Vogel, Nathan G. Wade, and Stephanie Haake in 2006, the SSSH captures self-directed stigma about help-seeking—the belief that seeking help is shameful or will lead to negative judgments by others. The scale is used in research on mental health literacy, treatment-seeking behavior, and barriers to care across diverse populations.
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When to use it
The SSSH is recommended for research on barriers to mental health treatment and on interventions designed to reduce help-seeking stigma (e.g., psychoeducation, peer contact, cognitive interventions). It is useful for screening individuals with high help-seeking stigma who may benefit from targeted counseling about treatment benefits and normalization of help-seeking. In college health, occupational health, and primary care settings, the SSSH can identify populations that may need destigmatization efforts to improve treatment uptake. It is less suited for detailed assessment of other mental health domains; rather, it captures a specific barrier to care.
Strengths & limitations
- Brief (10 items, 3–5 minutes), enabling feasible administration in busy healthcare settings.
- Captures an important barrier to care—self-stigma about help-seeking—distinct from general psychiatric stigma.
- Two-factor structure (Perceived Devaluation and Internalized Shame) identifies distinct mechanisms of help-seeking stigma.
- Good internal consistency (Cronbach's α 0.73–0.85) and test–retest reliability (r=0.72–0.81).
- Responsive to stigma-reduction interventions and psychoeducational programs.
- Widely validated across diverse populations (students, healthcare workers, general population, clinical samples).
- Limited to measurement of self-stigma about help-seeking; does not assess other barriers to care (cost, access, severity) or help-seeking intentions directly.
- Two-factor structure is not universally replicated; some studies report a unidimensional model.
- No established clinical cutoffs or interpretation guidelines specific to at-risk populations.
- May be sensitive to social desirability bias; respondents may underreport stigma in face-to-face administration.
- Primarily validated in English-speaking, Western populations; limited transcultural validation.
Frequently asked
How is self-stigma about help-seeking different from general psychiatric stigma?
General psychiatric stigma involves negative beliefs about having a mental illness (e.g., 'People with depression are weak'). Self-stigma of help-seeking is specific to the act of seeking treatment (e.g., 'I am embarrassed to go to therapy'). Someone might accept that depression is a legitimate condition but still feel ashamed of seeking help. The SSSH captures this distinct barrier.
What is a typical SSSH score?
In general population and college student samples, mean SSSH scores typically range from 18–28 (mild to moderate stigma). In clinical populations actively seeking treatment, scores tend to be lower (12–20). Scores vary by population; for example, military personnel often show higher SSSH scores, reflecting service culture stigma around mental health treatment.
Does a low SSSH score mean someone will definitely seek help?
Not necessarily. A low SSSH score indicates low self-stigma about help-seeking, which removes one barrier. However, other factors—access, cost, awareness of need, symptom severity, treatment beliefs—also influence help-seeking. SSSH is one component of help-seeking decision-making, not a complete predictor.
Can the SSSH be used to identify individuals who need psychoeducation about help-seeking?
Yes. Individuals with SSSH scores >30 may benefit from psychoeducation, contact with mental health consumers, or cognitive interventions addressing shame about help-seeking. Brief interventions (video testimonials, reading materials, peer contact) can reduce SSSH scores and potentially increase help-seeking.
Sources
- Vogel, D. L., Wade, N. G., & Haake, S. (2006). Measuring the self-stigma associated with seeking psychological help. Journal of Counseling Psychology, 53(3), 325-337. DOI: 10.1037/0022-0167.53.3.325 ↗
How to cite this page
ScholarGate. (2026, June 3). Self-Stigma of Seeking Help Scale (SSSH). ScholarGate. https://scholargate.app/en/psychiatric-rehabilitation/self-stigma-seeking-help
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