Table 3.

Themes and exemplar quotes related to individual-level self stigma.

Theme	Exemplar quotes N (%)
Internalized mental health beliefs
Hopelessness about mental health   treatment.	6 (7.1%) Sometimes I just feel like, well not like giving up because I’ve been to therapy so much, but sometimes it doesn’t help me …. I’ve just went and I felt like I tried and I just felt like they couldn’t help me. Other people just kind of look at me like, you know, it’s [therapy is] worthless. Like you’re wasting your time, ‘cause it’s not going to help you.
Non-disclosure of treatment	10 (11.9%) I think the only thing [barrier to treatment] is my family. I think they’d feel offended if I came and got help like this. [My mother], even other people from her generation, they’re like, ‘Well that doesn’t work. That’ s for the crazy people.’ That’s the first thing they will tell you – that’s for the crazy people. So there is a lot of stigma, especially in Central America. They don’t believe in it because they haven’t grown up knowing about mental health.
Attitudes towards psychotropic   medications	6 (7.1%) Too much treatment is how I feel. I feel like, um, sometimes doctors medicate people for no reason at all. You really honestly don’t need it at all. People just feel like they have to live off that. I mean, there’s always been comments saying like, you know, you don’t need – people use that as an excuse or something like that. Like, or, you know, you don’t need medication to….Like not to take meds because, I don’t know, it makes you some type of way.
Formal supports can be less stigmatizing   than informal supports	20 (23.8%) If I talk to my friends the way I do talk to my therapist, they would be like oh this bitch is crazy. You know like … I don’t want them to think I’m crazy, because I’m very kind, I’m very loyal, I’m very helpful, you know. They don’t see that. They just see the person that is bad-ass. The person that is 100% there if they need me. Like if there was a fight, or if someone would get jumped or something, or they in trouble, I’m there 100%. Like, I won’t hesitate to whoop ass, you know what I mean? And I don’t want that. I want them to see the other side of me.
PTSD literacy	16 (19.0%) Well I think anyone can get [PTSD]. It just [depends on] … how strong your mind is. I don’t know a thing about [PTSD]. I have heard about it, but my mindset was that it only happened to soldiers. Not that I know of. I don’t, again my own knowledge of [PTSD] is soldiers coming home with it. Um, I know that, uh, a war veteran can have PTSD due to the actions that happened in a war they were in or something.