No significant association between self-stigma and telepsychiatry use: a cross-sectional study in Iran

Psychological barriers and self-stigma often prevent individuals with mental health disorders from seeking professional help. These barriers may be mitigated by telepsychiatry. This study compared whether self-stigma levels differ between users of remote and face-to-face psychiatric services and identified predictors of remote service utilization. In this cross-sectional study from October 2022 to April 2024, 347 adult patients receiving psychiatric services at Roozbeh Hospital and two private clinics in Tehran were surveyed. The Self-Stigma of Seeking Help (SSOSH) scale, and demographic and clinical characteristics were also collected. Group differences were analyzed using bivariate statistical tests, and logistic regression was done to identify predictors of remote service use. Of all participants, 44.7% used remote services. Mean SSOSH scores were not significantly different between remote and face-to-face visit users. However, living outside Tehran (OR = 6.042, 95% CI = 3.304–11.049, p-value < 0.001), history of discontinuing treatment (OR = 3.426, 95% CI = 1.952–6.012, p-value < 0.001), higher education (OR = 1.493, 95% CI = 1.084–2.056, p-value = 0.014), and greater satisfaction with care (OR = 1.442, 95% CI = 1.063–1.957, p-value = 0.019) were significantly associated with choosing remote services. Only 2.6% of participants reported self-stigma as a reason for choosing remote services, and telepsychiatry utilization was associated primarily with accessibility and convenience rather than concerns about stigmatization. Therefore, enhancing the quality and usability of remote services may further improve treatment adherence and equitable access to mental health care.