Help-seeking Decisions Research Articles

Immigrant Sanctuary Policies and Crime-Reporting Behavior: A Multilevel Analysis of Reports of Crime Victimization to Law Enforcement, 1980 to 2004

Sanctuary jurisdictions have existed in the United States since the 1980s. They have recently reentered U.S. politics and engendered contentious debates regarding their legality and influence on public safety. Critics argue that sanctuary jurisdictions create conditions that threaten local communities by impeding federal immigration enforcement efforts. Proponents maintain that the policies improve public safety by fostering institutional trust among immigrant communities and by increasing the willingness of immigrant community members to notify the police after they are victimized. In this study, we situate expectations from the immigrant sanctuary literature within a multilevel, contextualized help-seeking framework to assess how crime-reporting behavior varies across immigrant sanctuary contexts. We find that Latinos are more likely to report violent crime victimization to law enforcement after sanctuary policies have been adopted within their metropolitan areas of residence. We argue that social policy contexts can shift the nature of help-seeking experiences and eliminate barriers that undermine crime victims’ willingness to mobilize the law. Overall, this study highlights the unique role social policy contexts can serve in structuring victims’ help-seeking decisions.

Exploring factors associated with HIV secondary stigma among adolescents and young adults in Uganda: A cross-sectional study

ABSTRACT HIV stigma is a public health problem. It refers to irrational judgments and attitudes towards people living with or at risk of HIV. Among adolescents and young adults living with HIV, stigma can negatively influence help-seeking decisions and impede HIV prevention efforts. The present study aimed to explore social-ecological factors associated with HIV-related stigma using a cross-sectional study design. Data used were from the 2016 Uganda Demographic and Health Survey [UDHS] of young men (n = 2214) and young women (n = 8058) aged 15–24 years. We conducted a gender disaggregated multivariable logistic regression to understand social-ecological factors associated with HIV secondary stigma. An overwhelming majority of participants (85%) indicated that secondary HIV stigma was associated with factors such as gender, ethnicity, education, wealth, cultural attitudes, and testing experiences. The study concludes that many young people living with HIV experience stigma in Uganda. Therefore, the government of Uganda, health professionals, and researchers should consider developing interventions that address HIV stigma and discrimination. Supportive programmes, such as peer support services and community-based interventions, are needed to help young people living with HIV learn to cope with the illness.

Chinese Male Survivors of Intimate Partner Violence: A Three-Pillar Approach to Analyze Men's Delayed Help-Seeking Decisions.

Intimate partner violence (IPV) literature has addressed differential socialization for designing interventions, mainly helping female victims and male perpetrators. From a gender-specific perspective, this study examines the abused men's postponed decisions to disclose victimization or seek help. Through individual interviews, 10 Chinese male IPV survivors in Hong Kong described their help-seeking journey. A three-pillar approach is applied to guide the analysis in terms of psychological factors, cultural barriers, and decisional challenges when men are seeking help. Results reveal negative influences bearing on male survivors' help-seeking behaviors and support how men can rebuild positive personal strengths after experiencing the impact of abuse on oneself and the family. Service providers must identify barriers of delayed help-seeking decisions and treat IPV survivors with respect and acceptance to facilitate abuse disclosure.

Influences on help-seeking decisions for behavioral child sleep problems: Why parents do and do not seek help.

Behavioral sleep problems affect 25% of children and impact functioning, but little is known about help-seeking for these problems. We identified (1) predictors for sleep problem perception and help-seeking, using nested-logit regression and (2) reasons why parents did not seek professional help for sleep problems, using chi-square. Parents (N = 407) of children (2-10-years-old) completed the study online. Parents indicated whether their child had no sleep problem, a mild problem, or a moderate-to-severe problem and completed additional questionnaires on parent/child functioning. Overall, 5.4% ± 2.2% of parents sought professional help for a child sleep problem. Greater child sleep problem severity and greater child socioemotional problems were significant predictors of parents perceiving a sleep problem. Among parents who perceived a sleep problem, greater parental socioemotional problems significantly predicted professional help-seeking. Parents who perceived no problem or a mild sleep problem reported not needing professional help as the main reason for not seeking help; parents who perceived a moderate-to-severe problem reported logistic barriers most often (e.g. treatment unavailability, cost). Problem perception and help-seeking predictors resemble the children's mental health literature. Differences in barriers, based on problem severity, suggest differential help-seeking interventions are needed (e.g. education vs access).

A Survey on Public Attitudes Toward Mental Illness and Mental Health Services Among Four Cities in Saudi Arabia.

PurposeOur objectives are to assess the public attitude toward mentally ill people and mental health services and to compare the attitudes of those who have past history of mental illness, those who have been exposed to mentally ill people, and those who have not.Materials and MethodsWe conducted a cross-sectional study among subjects (n=1268) in four Saudi Arabian cities (Riyadh, Abha, Dammam, and Jizan), recruiting participants from malls and parks. All participants were administered “the knowledge and attitudes toward mental illness and mental health services scale”.ResultsParticipants were divided into three groups; non-exposed to mental illness group (n=687, 54.1%), exposed to mental illness group (n=305, 24%), and having past history of mental illness group (n=276, 21.8%). Results revealed that non-exposed group had the lowest knowledge about mental illness (p <0.001). Exposed group had the best attitude toward mentally ill people (p=0.002), mental health services (p< 0.001), the lowest impact of traditional beliefs (p<0.001), and the best help-seeking decisions (p = 0.001). Regression models show the variables that predicted attitude toward the mentally ill were the attitude toward mental health services (p=0.001), impact of traditional beliefs (p=0.001), and residency (p=0.04). The predictors of attitude toward mental health services were impact of traditional beliefs (p<0.001), knowledge (p<0.001), and residency (p=0.028). And the variables that account for predicting future decisions were impact of traditional beliefs (p<0.001), attitude toward mental health services (p=0.001), and having past history of mental illness (p=0.006).ConclusionThis study demonstrates significant differences in attitudes toward mental illness among different groups of participants. Lesser impact of traditional beliefs and better knowledge about mental illness were the factors most associated with better attitudes toward mentally ill people and mental health services and with better help-seeking behavior.

Speaking Truth to Power: Mental Health Service Users’ Experiences of Participation in their Diagnosis and Treatment

In a qualitative study, long-term mental health service users shared their views on the concept of ‘participation’ as shaped by their personal histories of contact with mental health services in Ireland. Adopting a narrative methodology, the study participants were asked to draw on their experiences with mental health services to illustrate their general views on participation by service users in mental health care contexts.In this study, the research participants recounted positive experiences of participation in which their expressed views regarding their symptoms and treatment needs were incorporated into the service responses they received. The data revealed that service users perceived open and inclusive communication by service providers as an important factor in optimising their ability to participate in help-seeking, diagnosis and treatment plans. However, the study also illuminated the chilling effect on participation when service users’ views were not heeded or acknowledged by service providers. The findings highlight how the failure to include service users’ insights can negatively encroach on service user participation. The service user narratives collected in this study exposed the often uneasy juxtaposition of the service user’s personally held ‘truth’ regarding their lived experience of mental distress versus the powerful system of expert diagnosis and treatment. This article focuses on reporting selective findings from the study regarding participation in the contexts of help-seeking, diagnosis and treatment decisions.

'What a dog will see and kill, a cat will see and ignore it': An exploration of health-related help-seeking among older Ghanaian men residing in Ghana and the United Kingdom.

Health care utilization rates are lower among men; however, little is known about how men's health care utilization is affected by migration. The aim of this study was to explore health-related help-seeking decisions among older Ghanaian men residing in the United Kingdom and in Ghana. Twenty-six men aged 50years or over were recruited from community locations within two large cities in the UK and Ghana. Face-to-face semi-structured interviews were undertaken to explore the illness and help-seeking experiences of older men. Help-seeking experiences differed among the Ghanaian men living in the UK and in Ghana. Three themes were identified that impacted on help-seeking decisions: (1) pluralistic approaches to managing health and illness and (2) perceptions of formal health services in Ghana and UK and (3) financial constraints and masculinity norms as barriers to help-seeking. This is the first study to look at help-seeking decisions among older men residing in the UK and Ghana. Findings highlight how older migrant men's explanatory models of their health encompass enduring faith-based beliefs around causation of illness and approaches to management, as well as the use of pluralistic approaches to managing health. This study supports the call for culturally sensitive community-based interventions to increase engagement and facilitate improved health outcomes for migrant populations, particularly older men.

When Stay-at-Home Orders Leave Victims Unsafe at Home: Exploring the Risk and Consequences of Intimate Partner Violence during the COVID-19 Pandemic

The novel coronavirus pandemic (hereafter COVID-19) is likely to have unprecedented impacts on the incidence and impacts of crime and violence globally. This includes impacts to the risk, consequences, and decision-making of women experiencing violence by an intimate partner (hereafter IPV). Most importantly, the COVID-19 pandemic, and its impact on the risk of IPV is likely to differentially impact vulnerable populations, including minority women and those with long histories of victimization and mental health issues. This review paper explores the potential short- and long-term implications of COVID-19 on the risk of IPV, highlighting some of the most recent preliminary data. The economic impact of the COVID-19 pandemic, record levels of male unemployment, added stressors in the home, including the care and home schooling of children, and the social distancing measures required by the epidemiological response, may serve to undermine the decades of progress made in keeping women and children safe at home. Victim police reporting, help-seeking decisions, and social service utilization during the pandemic are likely to be impacted by stay-at-home orders and social distancing requirements. The paper concludes with a discussion of the implications for providing safety planning and self-care for victims and their children.

The Patterns and Influencing Factors of Help-Seeking Decisions among Women Survivors of Intimate Partner Violence in China

Although there has been a growing body of empirical research that examines the prevalence rates of intimate partner violence (IPV) and associated factors in Chinese societies, few studies have examined IPV survivors’ help-seeking patterns. Drawing on data from a nationwide survey among the general public in mainland China, the present study sought to investigate help-seeking decisions and associated factors among Chinese women survivors of IPV. The sample consisted of 488 IPV survivors who self-identified as heterosexual women in China. Logistic regression analyses were conducted to identify factors influencing participants’ help-seeking decisions (help-seeking versus non-help-seeking) and non-help-seeking reasons. A latent class analysis (LCA) was used to explore help-seeking patterns among those who sought help. Multinomial logistic regression analyses, as part of the 3-step LCA approach, were employed to locate significant factors associated with distinct help-seeking patterns identified in the LCA. Over two-thirds of the survivors (73.4%) did not seek help. Among the 26.6% of survivors who sought help, the majority sought support from family and friends, rather than professional services. The main reasons for not seeking help include (a) the belief that they could handle the situation by themselves, (b) not knowing to whom they could turn for help, and (c) the belief that the violence experienced was not severe. IPV type and several relationship-related factors stood out as key predictors for different help-seeking decisions. Implications for future research and practice in the context of China are discussed.

Factors for Formal Help-Seeking among Female Survivors of Intimate Partner Violence

Intimate partner violence (IPV) results in numerous negative physical and mental health consequences. Research shows that many factors affect survivors’ help-seeking decisions. Previous studies were limited by small samples, and by excluding multiple forms of IPV consequences and multiple types of help sources. This study attempted to fill this gap by using a nationally representative dataset that collected data on multiple consequences of violence and formal sources of help. This study used the National Crime Victimization Survey to examine factors for female survivors’ help-seeking (n = 474). The main variables were formal help-seeking (medical, legal), types of victimization and consequences, and demographics. All were examined through logistic regression analyses. Black/African American survivors sought more formal help than their White counterparts. Sexually victimized survivors used less legal help than those victimized by physical violence. These results suggest that survivors’ formal help-seeking should be viewed in a broad health context, including their experienced victimization, subsequent medical needs, and the circumstances and conditions underlying their decision to seek a particular type of help. Future research needs to examine the circumstances and outcomes of both formal and informal help-seeking by racial/ethnic minorities. Law enforcement officers may be able to collaborate with medical care systems to ensure that survivors receive proper treatment. Future research is needed to better understand survivors’ help-seeking as navigating through complicated webs of their experienced victimization, subsequent medical needs, and the circumstances and conditions underlying their decision to seek which type of help.

Help-seeking among lesbian, gay, bisexual and/or transgender victims/survivors of domestic violence and abuse: The impacts of cisgendered heteronormativity and invisibility

Despite growing research into domestic violence and abuse (DVA) in lesbian, gay, bisexual and/or trans (LGB and/or T) people’s relationships, LGB and/or T people remain largely invisible in DVA policy and practice. Research evidence indicates that they primarily seek help from privatised sources such as counsellors/therapists and friends. The gap in knowledge about LGB and/or T victims/survivors’ help-seeking reflects and reinforces the success of neoliberal trends in privatising social problems by promoting self-care and individual responsibility. Using qualitative data from a mixed-methods UK study, this article offers an ecological analysis of LGB and/or T victims/survivors’ help-seeking decisions and barriers, demonstrating how cisgendered heteronormativity and LGBT invisibility permeate help-seeking at individual, interpersonal and socio-cultural levels. The conclusion argues for LGBT DVA to be recognised as a social problem rather than a private trouble. Recommendations are offered for necessary steps towards better recognising and supporting LGB and/or T victims/survivors.

Role of primary care in supporting older adults who self-harm: a qualitative study in England.

Self-harm and suicide are major public health concerns. Self-harm is the strongest risk factor for suicide, with the highest suicide rates reported in older populations. Little is known about how older adults access care following self-harm, but they are in frequent contact with primary care. To identify and explore barriers and facilitators to accessing care within primary care for older adults who self-harm. An exploratory qualitative methods study using semi-structured interviews with older adults and third-sector workers in England. Older adults were invited to participate in one follow-up interview. Interviews occurred between September 2017 and September 2018. These were audio-recorded, transcribed verbatim, and data analysed thematically. A patient and public involvement and engagement group contributed to the study design, data analysis, and interpretation. A total of 24 interviews with nine older adults and seven support workers, including eight follow-up interviews with older adults, were conducted. Three themes emerged: help-seeking decision factors; sources of support; and barriers and facilitators to accessing primary care. Despite older adults' frequent contact with GPs, barriers to primary care existed, which included stigma, previous negative experiences, and practical barriers such as mobility restrictions. Older adults' help-seeking behaviour was facilitated by previous positive experiences. Primary care is a potential avenue for delivering effective self-harm support, management, and suicide prevention in older adults. Given the complex nature of self-harm, there is a need for primary care to work with other sectors to provide comprehensive support to older adults who self-harm.

Metacognitive monitoring and help-seeking decisions on mathematical equivalence problems

Metacognition is central to children’s cognitive development. However, there is conflicting evidence about children’s ability to accurately monitor their performance and subsequently control their behavior. This is of particular interest for mathematics topics on which children exhibit persistent misconceptions—that is, when children’s knowledge of a topic is inaccurate, yet resistant to change. This study investigated elementary school children’s metacognitive regulation on mathematical equivalence problems (N = 52, ages 6.7–9.8 years), including their ability to accurately monitor their certainty and their ability to control their behavior by making strategic help-seeking decisions. Results revealed that children were exceedingly confident—even when their answers were incorrect—resulting in relatively low accurate monitoring scores. However, their help-seeking decisions were largely strategic—reflecting children’s tendency to not ask for help when feeling confident—resulting in relatively high control scores. Additionally, individual differences in accurate monitoring and in strategic control were positively correlated with children’s comprehensive knowledge of mathematical equivalence, and the correlation with accurate monitoring held up after controlling for baseline accuracy, certainty, and help-seeking. Collectively, these results suggest that children may face unique, but critically important, metacognitive challenges when solving mathematical equivalence problems.

A conceptual model of urgent care sense-making and help-seeking: a qualitative interview study of urgent care users in England

BackgroundTheoretical models have sought to comprehend and conceptualise how people seek help from health professionals but it is unclear if such models apply to urgent care. Much previous research does not explain the complex interactions that influence how people make sense of urgent care and how this shapes service use. This paper aims to conceptualise the complexity of sense-making and help-seeking behaviour in peoples’ everyday evaluations of when and how to access modern urgent care provision.MethodsThis study comprised longitudinal semi-structured interviews undertaken in the South of England. We purposively sampled participants 75+, 18–26 years, and from East/Central Europe (sub-sample of 41 received a second interview at + 6–12 months). Framework analysis was thematic and comparative.ResultsThe amount and nature of the effort (work) undertaken to make sense of urgent care was an overarching theme of the analysis. We distinguished three distinct types of work: illness work, moral work and navigation work. These take place at an individual level but are also shared or delegated across social networks and shaped by social context and time. We have developed a conceptual model that shows how people make sense of urgent care through work which then influences help-seeking decisions and action.ConclusionsThere are important intersections between individual work and their social networks, further shaped by social context and time, to influence help-seeking. Recognising different, hidden or additional work for some groups may help design and configure services to support patient work in understanding and navigating urgent care.

Characterizing the Digital Health Citizen: Mixed-Methods Study Deriving a New Typology.

BackgroundA key challenge for health systems harnessing digital tools and services is that of digital inclusion. Typically, digital inequalities are conceptualized in relation to unequal access or usage. However, these differences do not fully explain differences in health behavior as a result of health-related internet use.ObjectiveOur objective was to derive a new typology of health internet users based on their antecedent motivations and enablers, to explain how individuals’ different orientations influence their health behavior.MethodsWe used a mixed-methods design using (1) qualitative data from 43 semistructured interviews about individuals’ general and health-related internet use, and how this influenced their health perception and their help-seeking decisions, and (2) quantitative data from the Oxford Internet Surveys (OxIS), a household survey of 2150 adults in England about their internet use and other characteristics. We used the interview data to identify constructs that described motivations and enablers affecting how internet use shaped respondents’ health perception and health service use. We then used these constructs to identify variables in OxIS, which provided a quantitative measure of these constructs. We then undertook a hierarchical cluster analysis of these constructs, using the numerical variables, to derive a proposed typology of health information seekers.ResultsBoth the qualitative findings and the subsequent cluster analysis suggested the existence of 6 types of individuals, categorized as learners, pragmatists, skeptics, worriers, delegators, and adigitals. Learners had a strong desire to understand health better. They used the internet to make decisions about whether they needed to see a professional and to learn about their and others’ health. Pragmatists primarily used the internet to decide whether seeing a doctor was worthwhile. Skeptics were skeptical of physicians and the medical system and valued the internet for solving health problems that doctors may not be able to deal with. Worriers found it difficult to interpret health information online, described health information seeking online as frightening, and reported a critical attitude toward online health information despite seeking it frequently. Delegators comprised nonusers and users valuing the internet as an information source, but not necessarily wanting or being able to use the internet themselves. Adigitals comprised many nonusers, but also users, who did not see the internet as a useful information tool and presented strong views on its low suitability for health care.ConclusionsThis research supports a shift in the understanding of the digital divide in health, away from only access and usage issues, toward also conceptualizing an outcomes divide, whereby different types of health behavior result from the differing orientations of internet users accessing online health information. This new typology can be used to inform digital inclusion policies in health systems.

Pluralism and practicality: village health workers’ responses to contested meanings of mental illness in Southern Malawi

The individual and social construction of psychological distress is fundamental to help-seeking and the extent to which interventions are seen as credible. Where pluralistic attributions for mental health problems predominate, the development of global mental health (GMH) interventions in the form of task-shifting approaches create increased access to new ways of understanding and responding to distress. However, little is known about how participants in these initiatives manage these encounters. This qualitative study in Malawi explored village-based health workers’ (HSAs) and patients’ and carers’ views of the causes of distress and how these beliefs influenced help-seeking and the health workers’ response.Eight HSAs and nine paired patients/carers were interviewed separately to enable each of nine experiences of distress to be explored. Findings revealed a complex set of personal, social and cultural influences that informed causative attributions and help-seeking decisions. Patients/carers viewed psychosocial stresses as compelling explanations and readily reported others attributing their distress to supernatural causes (bewitchment). Yet attributional beliefs alone were not the only influence over help-seeking, which evolved pragmatically in response to the impact of treatments and social pressure for conformity. In turn HSAs navigated the interactions with patients/carers by emphasising the biomedical approach and discrediting bewitchment attributions. This caused tensions when biomedical interventions were unhelpful or the traditional healers’ approach proved beneficial.Conclusions add to the call for such task-shifting approaches to work with communities to discern authentic and practical responses to mental distress that mirror the ‘pluralism and pragmatism’ found in the communities they serve.

Asking an Embarrassingly Simple Question: When Online P3 Communities Diminish Consumers’ Willingness to Request Needed Help

The current research investigates how consumers consider the personal and social implications of posting a question when seeking help via online peer-to-peer problem solving communities. Although P3 communities seem like an efficient technology that greatly increases the availability of consumer help, we show that they are still plagued by the problem of consumers not asking their questions due to the presence of certain cues on the forums. Four studies show that consumers perceive competence expectations while viewing the questions posted by existing forum participants. As a result, consumers tend to become reluctant to post questions that seem to fall short of competence expectations due to anticipated embarrassment. To mitigate such reluctance, we have created an intervention feature in the P3 forum called self-disclaimer, which requires each participant to publicly evaluate the level of their own question (novice¬–expert levels) before posting. Drawing on work from the symbolic interactionist and impression management theories, we show that the public self-disclaimer facilitates help-seeking decisions by communicating the shared awareness of the forum’s competence norm. We discuss the implications of our findings to promote consumers’ learning of products via P3 communities, which has ultimate consequences in enhancing the well-being of individual and communities of consumers.

The interaction of stigma and distress: predicting the help-seeking attitudes of United States students

ABSTRACTHelp-seeking stigma predicts more negative attitudes towards seeking psychological help, yet it remains unclear how distress levels might impact this relationship. Increased distress could diminish the relationship between stigma and help-seeking attitudes, as the potential benefits of seeking psychological help might outweigh the potential risks. Alternatively, increased distress could strengthen the relationship between stigma and more negative help-seeking attitudes, as help-seeking decisions become more personally relevant. The current study examined the effects of anticipated help-seeking self-stigma and psychological distress on help-seeking attitudes. Results indicated that there was an interaction of distress and stigma, such that for those reporting higher levels of distress, there was a weaker relationship between stigma and help-seeking attitudes than for those with lower levels of distress.

Ayúdame! Who can help me? the help-seeking decisions of battered undocumented latinas

This study considers the relationship between immigration status and the help-seeking behavior of Latinas victimized by intimate partner violence (IPV). In particular, comparisons were made within two areas: (1) help-seeking decision making and (2) experiences with police response. A representative sample of 173 battered Latinas was recruited: 119 with undocumented immigration status and 54 U. S. citizens. We found undocumented victims were more likely to ask for help from informal groups, while formal help-seeking did not differ regardless of immigration status. In addition, undocumented Latinas were significantly more likely to experience negative police response than their documented counterparts.

Mass media and risk factors for cancer: the under-representation of age

BackgroundIncreasing age is a risk factor for developing cancer. Yet, older people commonly underestimate this risk, are less likely to be aware of the early symptoms, and are more likely to be diagnosed with advanced stage cancer. Mass media are a key influence on the public’s understanding health issues, including cancer risk. This study investigates how news media have represented age and other risk factors in the most common cancers over time.MethodsEight hundred articles about the four most common cancers (breast, prostate, lung and colorectal) published within eight UK national newspapers in 2003, 2004, 2013 and 2014 were identified using the Nexis database. Relevant manifest content of articles was coded quantitatively and subjected to descriptive statistical analysis in SPSS to identify patterns across the data.ResultsRisk was presented in half of the articles but this was rarely discussed in any depth and around a quarter of all articles introduced more than one risk factor, irrespective of cancer site. Age was mentioned as a risk factor in approximately 12% of all articles and this varied by cancer site. Age was most frequently reported in relation to prostate cancer and least often in articles about lung cancer. Articles featuring personal narratives more frequently focused on younger people and this was more pronounced in non-celebrity stories; only 15% of non-celebrity narratives were about people over 60. Other common risks discussed were family history and genetics, smoking, diet, alcohol, and environmental factors. Family history and genetics together featured as the most common risk factors. Risk factor reporting varied by site and family history was most commonly associated with breast cancer, diet with bowel cancer and smoking with lung cancer.ConclusionAge and older adults were largely obscured in media representation of cancer and cancer experience. Indeed common risk factors in general were rarely discussed in any depth. Our findings will usefully inform the development of future cancer awareness campaigns and media guidelines. It is important that older adults appreciate their heightened risk, particularly in the context of help-seeking decisions.