AUTHOR=Zehnder Mara , Mutschler Jochen , Rössler Wulf , Rufer Michael , Rüsch Nicolas 

TITLE=Stigma as a Barrier to Mental Health Service Use Among Female Sex Workers in Switzerland

JOURNAL=Frontiers in Psychiatry

VOLUME=10

YEAR=2019

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2019.00032

DOI=10.3389/fpsyt.2019.00032

ISSN=1664-0640

ABSTRACT=<p><bold>Background:</bold> Many sex workers suffer from mental health problems, but do not seek help.</p><p><bold>Aim:</bold> To examine stigma-related and non stigma-related barriers to care and perceived need for treatment among female sex workers in Switzerland.</p><p><bold>Methods:</bold> Mental health service use, barriers to care, perceived need and presence of illness, symptoms, and psychiatric diagnoses were assessed among 60 female sex workers in Zürich, Switzerland.</p><p><bold>Outcomes:</bold> Mental health service use was defined as use of psychiatric medication, psychotherapy, or substance use services for at least 1 month during the past 6 months.</p><p><bold>Results:</bold> Adjusting for symptom levels, mental health service use was predicted by lower stigma-related, not by structural, barriers as well as by more perceived need for treatment and higher age.</p><p><bold>Clinical Implications:</bold> Sex workers with mental health problems would benefit from non-stigmatizing mental health care as well as from interventions to reduce public and self-stigma associated with mental illness and sex work.</p><p><bold>Strengths and Limitations:</bold> Limitations are the cross-sectional data, limited sample size, and recruitment from an information center for sex workers.</p><p><bold>Conclusion:</bold> Interventions that aim to increase mental health service use among sex workers should take stigma variables into account.</p>