Mental health disorders in children and adolescents are highly prevalent yet undertreated. A detailed understanding of the reasons for not seeking or accessing help as perceived by young people is ...crucial to address this gap. We conducted a systematic review (PROSPERO 42018088591) of quantitative and qualitative studies reporting barriers and facilitators to children and adolescents seeking and accessing professional help for mental health problems. We identified 53 eligible studies; 22 provided quantitative data, 30 provided qualitative data, and one provided both. Four main barrier/facilitator themes were identified. Almost all studies (96%) reported barriers related to young people’s individual factors, such as limited mental health knowledge and broader perceptions of help-seeking. The second most commonly (92%) reported theme related to social factors, for example, perceived social stigma and embarrassment. The third theme captured young people’s perceptions of the therapeutic relationship with professionals (68%) including perceived confidentiality and the ability to trust an unknown person. The fourth theme related to systemic and structural barriers and facilitators (58%), such as financial costs associated with mental health services, logistical barriers, and the availability of professional help. The findings highlight the complex array of internal and external factors that determine whether young people seek and access help for mental health difficulties. In addition to making effective support more available, targeted evidence-based interventions are required to reduce perceived public stigma and improve young people’s knowledge of mental health problems and available support, including what to expect from professionals and services.
Patient‐reported helpfulness of treatment is an important indicator of quality in patient‐centered care. We examined its pathways and predictors among respondents to household surveys who reported ...ever receiving treatment for major depression, generalized anxiety disorder, social phobia, specific phobia, post‐traumatic stress disorder, bipolar disorder, or alcohol use disorder. Data came from 30 community epidemiological surveys – 17 in high‐income countries (HICs) and 13 in low‐ and middle‐income countries (LMICs) – carried out as part of the World Health Organization (WHO)’s World Mental Health (WMH) Surveys. Respondents were asked whether treatment of each disorder was ever helpful and, if so, the number of professionals seen before receiving helpful treatment. Across all surveys and diagnostic categories, 26.1% of patients (N=10,035) reported being helped by the very first professional they saw. Persisting to a second professional after a first unhelpful treatment brought the cumulative probability of receiving helpful treatment to 51.2%. If patients persisted with up through eight professionals, the cumulative probability rose to 90.6%. However, only an estimated 22.8% of patients would have persisted in seeing these many professionals after repeatedly receiving treatments they considered not helpful. Although the proportion of individuals with disorders who sought treatment was higher and they were more persistent in HICs than LMICs, proportional helpfulness among treated cases was no different between HICs and LMICs. A wide range of predictors of perceived treatment helpfulness were found, some of them consistent across diagnostic categories and others unique to specific disorders. These results provide novel information about patient evaluations of treatment across diagnoses and countries varying in income level, and suggest that a critical issue in improving the quality of care for mental disorders should be fostering persistence in professional help‐seeking if earlier treatments are not helpful.
Background
Mental disorders are widespread among students. However, mental health help‐seeking remains low. Several reviews and meta‐analyses have shown that the main barrier to seeking help from ...mental health professionals is stigma. This paper aimed to assess stigma in a sample of students, and its association with help‐seeking intentions and comfort with disclosing a mental illness.
Method
The ‘Community Attitudes toward the Mentally Ill’, the ‘Mental Health Knowledge Schedule’, and the ‘Reported and Intended Behaviour Scale’ were administered to a total of 714 college students (62.2% female; mean age = 20.9).
Results
We found that 43.8% of students agreed that one of the main causes of mental illness is a lack of self‐discipline and willpower, 21.9% did not consider depression as a mental illness, and 39.6% felt that they would be 'unlikely' or 'very unlikely' to seek the help of a health professional for mental health problems. Females had higher scores in help‐seeking intentions (p < .001) and knowledge of mental illness (p = .019). Students' age negatively correlated with knowledge (p < .001, r = −.147). Pearson correlations indicated that help‐seeking intentions positively correlated with more favourable future intentions of being in contact with a person with a mental illness (p < .001, r = .103) and greater mental health knowledge (p < .001, r = .163); and that comfort with disclosing significantly and negatively correlated with attitudes (p < .001, r = −.125).
Conclusion
To date, few young people see mental health professionals as a preferred source of support, and action is needed to change this perception or reform mental health services to make them more attractive to this age group.
Many families worldwide have at least one member with a behavioral or mental disorder, and yet the majority of the public fails to correctly recognize symptoms of mental illness. Previous research ...has found that Mental Health Literacy (MHL)-the knowledge and positive beliefs about mental disorders-tends to be higher in European and North American cultures, compared to Asian and African cultures. Nonetheless quantitative research examining the variables that explain this cultural difference remains limited. The purpose of our study was fourfold: (a) to validate measures of MHL cross-culturally, (b) to examine the MHL model quantitatively, (c) to investigate cultural differences in the MHL model, and (d) to examine collectivism as a predictor of MHL. We validated measures of MHL in European American and Indian samples. The results lend strong quantitative support to the MHL model. Recognition of symptoms of mental illness was a central variable: greater recognition predicted greater endorsement of social causes of mental illness and endorsement of professional help-seeking as well as lesser endorsement of lay help-seeking. The MHL model also showed an overwhelming cultural difference; namely, lay help-seeking beliefs played a central role in the Indian sample, and a negligible role in the European American sample. Further, collectivism was positively associated with causal beliefs of mental illness in the European American sample, and with lay help-seeking beliefs in the Indian sample. These findings demonstrate the importance of understanding cultural differences in beliefs about mental illness, particularly in relation to help-seeking beliefs.
Previous research has found cultural differences in the frequency of support seeking. Asians and Asian Americans report seeking support from their close others to deal with their stress less often ...compared to European Americans. Similarly, other research on professional help seeking has shown that Asians and Asian Americans are less likely than European Americans to seek professional psychological help. Previous studies link this difference to multitude of factors, such as cultural stigma and reliance on informal social networks. The present research examined another explanation for cultural differences in professional help seeking. We predicted that the observed cultural difference in professional help seeking is an extension of culture-specific interpersonal relationship patterns. In the present research, undergraduate students in Japan and the United States completed the Inventory of Attitudes toward Seeking Mental Health Services, which measures professional help seeking propensity, psychological openness to acknowledging psychological problems, and indifference to the stigma of seeking professional help. The results showed that Japanese reported greater reluctance to seek professional help compared to Americans. Moreover, the relationship between culture and professional help seeking attitudes was partially mediated by use of social support seeking among close others. The implications of cultural differences in professional help seeking and the relationship between support seeking and professional help seeking are discussed.
•Japan has a high suicide rate but concerningly low use of professional services.•Beliefs, attitudes and intentions for help seeking for suicidal ideation were examined.•High suicide literacy, low ...stigma, and low self-reliance associated with more positive attitudes.•Specific subgroups of the Japanese population with increased risk were identified.•There is a need to develop public health messaging to increase professional service use.
Despite high suicide rates in Japan, many people do not seek professional help for suicidal thoughts. We identified modifiable factors associated with help-seeking beliefs, attitudes, and intentions for suicidal ideation, and examined characteristics associated with suicidal ideation. Participants were 217 Japanese adults recruited online. We assessed beliefs, attitudes and intentions regarding professional help seeking, and recent suicidal ideation. Greater suicide exposure and less social support were associated with more negative help-seeking beliefs. More positive help-seeking attitudes were associated with less education, no religious affiliation, greater suicide literacy, lower suicide stigma, and lower self-reliance. No significant correlates of help-seeking intentions were identified. Recent suicidal ideation was associated with non-binary gender, less education, negative beliefs/attitudes towards help-seeking, poorer mental health, lower mastery, less social support, greater self-reliance, and greater suicide normalisation. Interventions to improve help-seeking in Japan emphasise the limits of self-reliance, and increase knowledge around suicide prevention and professional psychological services.
Studies show that people bereaved by suicide often feel a strong need for professional help. It is hypothesized that aspects related to suicide bereavement, such as stigmatization, shame or guilt, ...hinder help-seeking process of the bereaved. However, little is known about help-seeking behaviors of people who has lost someone due to suicide.
This study was conducted to attain a better understanding of the contributing factors, including the specific features of grief following suicide, to help-seeking behaviors of the bereaved by suicide.
The sample consisted of 82 adults bereaved by suicide (64 female; average age 37.79,
= 14.33). Instruments assessing stigmatization, shame, guilt levels, well-being, tendency to disclose emotional distress and attitudes toward seeking professional psychological help were used. The participants were also asked an open-ended question what professional help-seeking barriers they had encountered. Comparisons between the groups, logistic regression analysis and thematic analysis of the qualitative data were performed.
The findings revealed that bereaved participants who sought professional psychological help reported experiencing stigmatization and feeling guilty after the loss significantly more often. Also the results showed that attitudes toward mental health specialists had the highest prognostic value in predicting help-seeking behaviors of the bereaved. The participants themselves identified the gaps in the health care system as main barriers to seeking help.
The results challenge previously spread notion that stigmatization, guilt and shame after suicide can act only as help-seeking barriers.
This study investigated the effects of a brief video intervention on attitudes toward counseling services. Two hundred and seventy-seven participants were divided into four groups ...(anxious-preoccupied, dismissive-avoidant, fearful-avoidant, and secure) by their attachment scores. Then, the participants of each group were randomly assigned to three conditions (stigma-reducing, utility-enhancing, and control). A split-plot factorial design was performed to examine the intervention effects. The results indicate that the stigma-reducing video intervention was more effective for the anxious-preoccupied group, whereas the utility-enhancing video intervention was more effective for the dismissive-avoidant group than other groups. These results suggest the importance of implementing strategies tailored to each attachment group.
Background
Research has shown that stigmatization of professional psychological help-seeking is an important factor influencing attitudes toward seeking professional psychological help (ATSPPH). ...However, how perceived social support (PSS) and optimism have a mediating role is not clear.
Objective
Examine the associations between ATSPPH, self-stigmatization of seeking help, PSS, and optimism in a cohort of Chinese high-school students (HSSs).
Methods
An offline survey was conducted in three high schools in Chongqing (China) from 20 February to 20 May 2023. Participants were HSSs recruited through their teachers. A total of 2,159 HSSs completed a survey on demographic information as well as the Self-Stigmatization of Seeking Help (SSOSH) score, ATSPPH, Perceived Social Support Scale (PASS), and Life Orientation Test (LOT). Mediation analyses were conducted using the “Process” macro in SPSS 26.0 to estimate the direct and indirect effects of self-stigmatization of seeking psychological help on ATSPPH.
Results
Self-stigmatization of seeking psychological help was significantly and negatively related to ATSPPH among HSSs. Self-stigmatization of psychological help-seeking influenced ATSPPH through three pathways: (a) separate mediating effect of PSS (effect = −0.029); (b) separate mediating effect of optimism (effect = −0.069); (c) chain-mediating effect of PSS and optimism (effect = −0.017). These data suggested that self-stigmatization of psychological help-seeking could influence ATSPPH directly and indirectly through PSS and optimism.
Conclusion
PSS and optimism mediated the relationship between self-stigmatization of seeking help and ATSPPH. Improving the ability of HSSs to perceive social support and cultivating optimism could help improve the self-stigmatization of help-seeking and promote a positive attitude toward professional help-seeking.
A low intention of professional help seeking hinders the effective treatment of depression. The factors are from the perspectives of the social, family, and individual; however, an understanding of ...how they interact to predict professional help-seeking intention (PHSI) is not clear.
The objectives of the study was to investigate PHSI toward depression in a Chinese community-dwelling population and construct a predictive model of the PHSI to explore the various factors involved.
Stratified random sampling and Kish table methods were used to identify 2,000 community residents. Participants completed a series of questionnaires to measure general characteristics, PHSI, professional help-seeking attitude, depression stigma, depression knowledge, family function, and depression symptoms. Analyses included descriptive statistics and Pearson correlation analysis using SPSS 26.0 and a Structural Equation Model using Amos 22.0.
The score of the PHSI was 14.92 ± 9.574. Professional help-seeking attitude (
= 0.291,
< 0.001) and depression knowledge (
= 0.077,
= 0.002) were positively related to PHSI, while a negative correlation was found between stigma (
= -0.149,
< 0.001) and PHSI. The model of the PHSI indicated a good fit with a CMIN/DF = 2.740 and RESEA = 0.032. The total effect of the influencing factors on the PHSI was listed in the following order: professional help-seeking attitude (0.676) > stigma (-0.143) > depression knowledge (0.088) > depression symptoms (-0.009) > family function (0.005). The total effect of depression knowledge on PHSI included a direct negative effect (Beta = -0.266,
< 0.001) and an indirect positive effect (0.354) through professional help-seeking attitude and stigma. Also, depression knowledge was negatively associated with stigma (Beta = -0.153,
< 0.001). Depression symptoms were negatively associated with family function (Beta = -0.282,
< 0.001), depression knowledge (Beta = -0.252,
< 0.001), and stigma (Beta = -0.102,
< 0.001), indicating that people with less severe depression symptoms had good family function, depression knowledge, and higher stigma. Family function contributed a positive effect on depression knowledge directly (Beta = 0.145,
< 0.001) and a totally positive effect (0.033) on stigma.
The PHSI toward depression is low among Chinese community residents. Professional help-seeking attitude, depression knowledge, and family functioning were facilitators of PHSI, and stigma and the severity of depression symptoms were barriers to PHSI. This study provides reference for the development of policies and guidelines to promote community residents to actively seek professional mental health help. Future policies can focus on multicollaboration among the government, mental health services, and families to increase the mental health resources, improve family functioning, enhance mental health literacy (MHL) of the public, and reduce depression stigma to ease the burden of this mental health issue.
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