Theorising the Intersection of Cultural Stigma and Mental Health Help-Seeking in Nigeria: An Original Socioecological Framework

Mental health help-seeking in Nigeria is profoundly shaped by culturally specific stigma processes that extend beyond the individual-level constructs dominant in Western stigma research, encompassing family honour, spiritual illness attribution, and community surveillance dynamics that operate across ecological levels. This study develops an original Socioecological Framework of Mental Health Stigma and Help-Seeking in Nigeria through a mixed-methods sequential explanatory design. Phase 1 conducts a nationally representative cross-sectional survey of 1,200 adults across six geopolitical zones using the Stigma Scale for Receiving Psychological Help, a Cultural Illness Attribution Scale, and the General Help-Seeking Questionnaire. Multilevel regression modelling identifies zone-level and community-level stigma predictors of help-seeking beyond individual factors. Phase 2 applies systematic qualitative inquiry through 48 purposively sampled interviews across all zones to explore the experiential mechanisms of stigma barriers. Data integration follows a convergent parallel mixed-methods approach. Available mental health stigma literature from Nigeria identifies social shame, spiritual illness normalisation, and fear of social exclusion as Nigeria-specific stigma processes absent from major theoretical models. Link and Phelan's Stigma Theory, Bronfenbrenner's Ecological Systems Model, and the Health Belief Model collectively inform the theoretical synthesis. The original contribution is a Nigerian Socioecological Stigma Model with zone-specific empirical grounding. Findings will reorient national mental health de-stigmatisation campaign design. Keywords: mental health stigma, help-seeking, socioecological framework, cultural stigma, Nigeria.