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ArticleSocial psychiatry and psychiatric epidemiology2026

Mental health problem recognition and stigma among emerging adults: Findings from the Voices for Well-Being Study (Project VOW).

Annie B Fox, Jean-Phillipe Laurenceau, E Carly Hill, Valerie A Earnshaw

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Article in Social psychiatry and psychiatric epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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4 authors.

Annie B FoxSchool of Health and Rehabilitation Sciences, Mass General Brigham University of Health Professions, Boston, MA, USA. afox-galalis@mghihp.edu.ORCID http://orcid.org/0000-0002-4776-1873
Jean-Phillipe LaurenceauDepartment of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA.ORCID http://orcid.org/0000-0001-8069-867X
E Carly HillDepartment of Human Development and Family Sciences, University of Delaware, Newark, DE, USA.
Valerie A EarnshawDepartment of Human Development and Family Sciences, University of Delaware, Newark, DE, USA.ORCID http://orcid.org/0000-0002-4147-3301

Funding

Pathways to mental health care: Examining the longitudinal impact of stigma mechanisms on treatment engagement in emerging adultsR01MH126196 · NIMH · UNIVERSITY OF DELAWARE · PI Valerie Ann Earnshaw, Annie Beth Fox · 2022 to 2026
$2.7M
NIMH NIH HHS R01MH126196
6 · The paper itself

Abstract

purposeEmerging adults experience the highest rates of mental health problems but the lowest rates of treatment engagement among U.S. adults. Stigma is a well-known barrier to care, undermining outcomes along the mental health treatment cascade from symptom recognition to treatment seeking. In the present study, we examine differences in experiences of stigma among emerging adults based on the presence, recognition, and/or diagnosis of mental health problems.

methodThe Voices for Well-Being (Project VOW) is a 12-wave longitudinal study of stigma and mental health in emerging adults (ages 18-21) recruited nationally via snowball and convenience sampling, surveyed quarterly for three years. Using baseline data, we classified participants into four groups: (1) no mental health problem history (n = 608); (2) recognized and diagnosed (n = 2566); (3) recognized and undiagnosed (n = 1417) and (4) unrecognized mental health problem (n = 91). We examined demographic profiles and compared groups across stigma mechanisms (stereotypes, prejudice, discrimination, perceived, anticipated, experienced, and internalized stigma) using ANCOVA models.

resultsThe Project VOW Cohort is demographically diverse with a high mental health burden; 54.4% of participants reported a recognized and diagnosed mental health problem. Emerging adults with no or unrecognized mental health problems endorsed greater stereotypes, prejudice, and discrimination than those with recognized problems. Individuals with recognized and diagnosed conditions reported more experienced and internalized stigma than those with recognized but undiagnosed or unrecognized problems.

conclusionFindings highlight the critical role diagnoses play in shaping how people with mental illness are treated and view themselves, informing stigma intervention efforts for emerging adults.

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Emerging adultsMental health problemMental illness stigmaModified labeling theory

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.