Mental health stigma, health locus of control, and optimistic bias as predictors of treatment-seeking behaviour among health workers in Akwa Ibom State

Abstract

In Nigeria, reluctance among healthcare workers to seek mental health support remains a major concern, often driven by stigma and cognitive biases. While previous studies have examined these factors separately, limited research has explored their combined predictive influence. This study investigated the extent to which mental health stigma, health locus of control, and optimistic bias predict treatment-seeking behaviour among healthcare professionals in Akwa Ibom State, Nigeria. A descriptive cross-sectional survey design was adopted with 323 participants, including doctors, nurses, community health extension workers, and social workers, selected through multistage sampling across public, missionary, and private health facilities. Standardized instruments were employed: the Stigma-9 Questionnaire (STIG-9), Health Locus of Control Scale (HLoC), Revised Life Orientation Test (LOT-R), and the Attitudes Toward Seeking Professional Psychological Help Scale-Short Form (ATSPPH-SF). Data were analyzed using simple and multiple regression. Findings revealed that mental health stigma significantly predicted treatment-seeking behaviour (β = .20, p < .001), indicating that stigma reduces willingness to seek help. Optimistic bias also significantly predicted treatment-seeking (β = .21, p < .001), suggesting that moderate optimism enhances proactive help-seeking. However, health locus of control showed no significant predictive effect. Collectively, the predictors accounted for 11% of the variance in treatment-seeking behaviour (R = .33, R² = .11, F (3, 319) = 12.78, p < .05). The study concludes that stigma and optimistic bias are key predictors of treatment-seeking among healthcare workers, while locus of control plays a limited role. It recommends institutional strategies to reduce stigma, promote healthy optimism, and foster positive mental health attitudes to improve workers’ well-being and service outcomes.