Help-seeking History Research Articles

Acculturation and Depression Help-Seeking Intentions in a Majority Mexican American College Student Sample.

Work has not examined if acculturation or enculturation may predict endorsed benefits, barriers, and intentions to seek mental health services for depression, specifically among Latino students enrolled in a rural and majority Latino immigrant institution of higher education. An improved understanding of factors informing mental health help-seeking is needed to identify possible intervention points to address gaps in accessing depression treatment. Participants (N = 406) read a vignette depicting a person with depressive symptoms. Participants were asked if they would seek help for depression if in the situation described in the vignette. Participants provided text responses about their preferences for managing depression symptoms and their mental health help-seeking history. Additionally, participants completed a self-report depression symptom screener, demographic surveys, acculturation assessment, and questionnaires on perceived benefits and barriers to seeking mental health services. Path analysis was used to test the link between acculturation status and intent to seek services for depression, with benefits and barriers as mediators. The results revealed that higher perceived benefits and lower barriers were directly associated with greater intentions to seek help. Furthermore, an indirect effect of acculturation on help-seeking intentions via higher perceived benefits of seeking care was observed. These findings persisted after controlling for age, gender, depression, and history of seeking care for depression. Future work should test the replicability of this finding with diverse college students living in predominantly immigrant communities. Universities might consider tailoring outreach initiatives to provide information on the range and accessibility of mental health services, the location of mental health service centers, and the procedures for accessing such services.

Familial transmission of mental health help-seeking: Does it “run in the family”?

Familial transmission of mental illnesses and health behaviors is well established. However, little research has examined familial transmission of mental health help-seeking behaviors despite social science theoretical traditions that support its occurrence including social learning theory and the network episode model. Among parent-adolescent dyads, extant literature supports consideration of adolescent-autonomy versus parent-gatekeeping according to whether or not parents recognize a mental health problem in their adolescent. Given this, we examined familial transmission of self-reported mental health help-seeking among parent-adolescent dyads over an 18-month period from a school-based study (N = 422; Texas, USA). Generalized estimating equations tested the effect of multiple forms of parent help-seeking on similar forms of adolescent help-seeking, controlling for personal/family characteristics. We also examined interaction by parent recognition of a mental health problem in their adolescent to discern unique intergenerational processes across these subgroups of parent-adolescent dyads. Owing to effect modification by parent problem recognition (p<0.01), two unique familial transmission of help-seeking pathways emerged. When parent problem recognition was present, parent self help-seeking history reduced adolescent help-seeking net of controls. In contrast, when parent problem recognition was absent, parent self help-seeking history increased adolescent help-seeking net of controls. Our findings provide evidence of familial transmission of mental health help-seeking behaviors, but the direction of influence fundamentally depends on parent recognition of a mental health problem in their adolescent in order to reveal intergenerationally transmitted processes. The findings support our hypotheses that familial transmission of help-seeking starts early in adolescence and is likely influenced by parent modeling and gatekeeping, though explanations for the patterns observed, such as short- and long-term positive and negative mixed impacts of past help-seeking experiences of parents, require further study to ascertain.

Inner Wealth: Predicting Lower Levels of Depression and Anxiety Severity

Anxiety and depression are the two most prevalent mental health issues among adults living in the United States. Consistent with the wellness, prevention, and development pillars of the counseling field, inner wealth (IW) is a strengths-based construct centered on empowering clients to realize their inherent value and potential as people. We investigated the capacity of IW for predicting lower levels of depression and anxiety severity with a national sample (N = 793) of adults in the United States. We also examined demographic differences in IW among U.S. adults. Results revealed support for the capacity of IW for predicting substantially lower anxiety and depression scores. In addition, significant demographic differences in IW emerged by gender and help-seeking history. Results are discussed in terms of the potential utility of IW for edifying the practice of mental health counselors, particularly when working with adults in the United States who are living with anxiety and/or depression.

Measurement Invariance of Scores on the Somatic Symptom Scale-8: National Sample of Non-Clinical Adults in the United States

Objective The aim of the present study was to test the factorial invariance and convergent validity evidence of scores on the Somatic Symptom Scale (SSS)-8 with a national sample of adults living in the United States. Method A data collection contracting service was hired to recruit a national, non-clinical sample (N = 821) of adults in the United States stratified by the census data for age, gender, ethnicity, and geographic location. Results Factorial invariance testing via multiple-group confirmatory factor analysis revealed strong factorial invariance evidence (configural, metric, and scalar) of SSS-8 scores across gender, ethnicity, help-seeking history, education, and income. Convergent validity testing displayed strong correlations between SSS-8 scores and the following established measures: Patient Health Questinaire-9, Generalized Anxiety Disorder-7, and Mental Health Inventory-5. Conclusion Collectively, the results suggest that professional counselors can use the SSS-8 to enhance somatic symptomology screening efforts with adults living in the United States.

Stigma towards mental illness, resilience, and help-seeking behaviours in undergraduate students in Hong Kong.

Early interventions have great impact on reducing burden of mental illness. Young people are however the least likely to seek help for psychological issues. Resilience and stigma towards mental illness have been identified as contributing factors, although previous findings were mixed with potentially complex interaction with symptom severity. We investigated the relationship between stigma, resilience, depressive symptom severity, and help-seeking behaviours in undergraduate students in Hong Kong. A cross-sectional online survey was conducted among undergraduates from a university in Hong Kong (n = 945). The 21-item Stigma and Acceptance Scale, Connor-Davidson Resilience Scale, and the Patient Health Questionnaire-9 were used. History of help-seeking for psychological issues was self-reported. Path analysis was conducted to test a conceptual model of their relationships. Among those with moderate-to-severe depressive symptoms (39.5%), only one-fourth had sought professional help. The path model showed that depressive symptom severity and stigma were positively associated with help-seeking behaviours, while resilience was negatively associated with help-seeking behaviours independently (all p < .001). Subgroup analyses showed differential contribution of stigma and resilience to a history of help-seeking in those with minimal-to-mild symptoms compared with moderate-to-severe symptoms. Stigma may be a barrier for help-seeking particularly in students with moderate-to-severe depression. Higher levels of resilience in young people may be protective and reduce the unnecessary seeking of professional help. Therefore, enhancing resilience among students in general, and reducing stigma and promoting help-seeking behaviours for those who have moderate-to-severe symptoms should be consider in parallel as strategies to enhance mental wellbeing of students.

Understanding the Shared Meaning of Recovery From Substance Use Disorders: New Findings From the What is Recovery? Study.

Substance use disorder (SUD) resolution typically involves a long-term, comprehensive process of change now widely referred to as "recovery." Yet, definitions of recovery vary substantially, producing significant confusion. To support formal recovery definitions, we aimed to systematically identify recovery elements that are central to those in recovery and shared regardless of subgroup/pathway. Data were from the What is Recovery? Study, involving a diverse, national, online survey of people in recovery (N = 9341). Surveys included a 35-item recovery measure reflecting 4 domains; participants reported whether or not each element definitely belonged in their recovery definitions. Analyses examined item endorsements overall and among 30 subgroups defined a priori (by sociodemographics, substance use characteristics, and help-seeking history) to determine where items met study-specific centrality thresholds (ie, endorsement by ⩾80% and top-10 ranking, by endorsement level). We then classified items as "core" if meeting centrality thresholds both overall and for all 30 subgroups, and "prevalent" if meeting centrality thresholds overall and for 26 to 29 subgroups. Four "core" recovery elements emerged, including a process of growth or development; being honest with oneself; taking responsibility for the things one can change; and reacting in a more balanced way. Four "prevalent" recovery elements also emerged, referencing the ability to enjoy life and handle negative feelings without substance use; abstinence and/or nonproblematic substance use; and living a life that contributes. Subgroups differing most in their endorsements included those reporting mild/moderate SUD severity; non-abstinent recovery; and no specialty treatment or mutual-help group attendance. Recovery elements identified here partially reflect some stakeholder definitions, but offer greater specificity and include novel elements (eg, personal integrity). Elements may point to areas of functioning that are damaged in the addiction process and can support an addiction-free life. Findings should inform institutional recovery definitions; SUD services and research; and communications about recovery.

The Role of Residential Early Parenting Services in Increasing Parenting Confidence in Mothers with A History of Infertility.

Mothers with a history of infertility may experience parenting difficulties and challenges. This study was conducted to investigate the role of residential early parenting services in increasing parenting confidence in mothers with a history of infertility. This was a retrospective chart review study using the quantitative data from the clients attending the Karitane Residential Units and Parenting Services (known as Karitane RUs) during 2013. Parenting confidence (using Karitane Parenting Confidence Scale-KPCS), depression, demographics, reproductive and medical history, as well as child's information were assessed from a sample of 27 mothers who had a history of infertility and who attended the Karitane RUs for support and assistance. The data were analyzed using SPSS version 19. More than half of the women (59.3%) reported a relatively low level of parenting confidence on the day of admission. The rate of low parenting confidence, however, dropped to 22.2% after receiving 4-5 days support and training in the Karitane RUs. The mean score of the KPCS increased from 36.9 ± 5.6 before the intervention to 41.1 ± 3.4 after the intervention, indicating an improvement in the parenting confidence of the mothers after attending the Karitane RUs (P<0.0001). No statistically significant association was found between maternal low parenting confidence with parental demographics (including age, country of birth, and employment status), a history of help-seeking, symptoms of depression, as well as child's information [including gender, age, siblings, diagnosis of gastroesophageal reflux disease (GORD) and use of medication]. Having a child after a period of infertility can be a stressful experience for some mothers. This can result in low parenting confidence and affect parent-child attachment. Our findings emphasized on the role of the residential early parenting services in promoting the level of parenting confidence and highlighted the need for early recognition and referral of the mothers with a history of infertility to such centers.

Attitudes Toward Mental Health Help Seeking as Predictors of Future Help-Seeking Behavior and Use of Mental Health Treatments.

The study examined the association of attitudes toward mental health help seeking and beliefs about the effectiveness of treatments with future help-seeking behavior and use of specific services in the general population. Data on attitudes and beliefs at baseline were taken from the U.S. National Comorbidity Survey (NCS), a general population survey conducted in 1990-1992. Help seeking from various providers and use of psychiatric medications and counseling or therapy were examined in the NCS follow-up, in which 5,001 of the original NCS participants were reinterviewed in 2001-2003. Willingness to seek professional help for a serious emotional problem and feeling comfortable talking about personal problems with professionals were significantly associated with future help seeking and treatment use. One-third (33.4%) of participants who stated at baseline that they would "definitely go" to a professional if they had a serious emotional problem sought future help, compared with 20.7% of those who would "definitely not go." Corresponding values were 33.4% and 24.4% for those who reported feeling "very comfortable" and "not at all comfortable," respectively, talking about personal problems with a professional. The associations were consistent among participants with and without a history of help seeking and with and without mood, anxiety, or substance use disorders during the follow-up. Embarrassment if friends found out and beliefs about treatment effectiveness were not associated with future help seeking or service use. Identification of attitudinal factors most closely linked to future mental health help seeking has potential implications for public mental health campaigns.

Screening for Depression in African-American Churches.

Substantial racial/ethnic disparities exist in the identification and management of major depression. Faith-Based Health Promotion interventions reduce disparities in health screenings for numerous medical conditions. However, the feasibility of systematically screening for depression in faith-based settings has not been investigated. The purpose of this study was to assess the feasibility of using a validated instrument to screen for depression in African-American churches. Participants were recruited between October and November 2012 at three predominantly African-American churches in New York City. A participatory research approach was used to determine screening days. The Patient Health Questionnaire-9 (PHQ-9) was administered to 122 participants. Positive depression screen was defined as a PHQ-9 score ≥10. Descriptive statistics were used to report sample characteristics, prevalence of participants who screened positive, and history of help seeking. Logistic regression analyses were conducted to determine the association of positive depression screen and sociodemographic characteristics. Initial analyses were conducted in 2013, with additional analyses in 2014. The prevalence estimate for positive depression screen was 19.7%. More men (22.5%) screened positive than women (17.7%). Total household income was inversely related to positive depression screen. A similar percentage of respondents had previously sought help from primary care providers as from clergy. It was feasible to screen for depression with the PHQ-9 in African-American churches. The prevalence of positive depression screen was high, especially among black men. Churches may be an important setting in which to identify depressive symptoms in this underserved population.

An internet survey of emotional health, treatment seeking and barriers to accessing mental health treatment among Chinese-speaking international students in Australia

The present internet survey examined the demographic characteristics of Chinese-speaking international students in Australia, psychological distress levels as measured by the Kessler-10 (K-10) Item scale, help-seeking history and preferences, as well as treatment barriers. Of the 144 respondents, 54% reported high psychological distress (mean K-10 score = 23.96; SD = 9.03). However, only 9% of those who were highly distressed reported they had sought mental health services in the past year. While the majority preferred help from informal social networks, they tended to favour mental health services over traditional culture-specific forms of help. Common barriers to accessing mental health services reported by respondents with high psychological distress included costs or transportation concerns, limited knowledge of available services, time constraints, the perception that symptoms were not severe enough to warrant treatment, language difficulties and lack of knowledge of symptoms of psychological distress. Although the majority preferred face-to-face treatments over internet treatments, a considerable percentage of respondents were willing to try either treatment modality. Chinese-speaking international students are a high risk group for developing psychological distress, yet they tend to underuse mental health services. Education about the effectiveness of face-to-face and online treatments may increase treatment seeking by this population.

Hesitation to Seek Gambling-related Treatment Among Ontario Problem Gamblers

This study aimed to examine barriers in seeking help for gambling problems. A random digit dialing telephone survey was conducted among adults in Ontario, Canada. Respondents meeting criteria for possible past year gambling problems were asked an open-ended question on why they might hesitate once they had decided to seek help. Of 556 eligible respondents, 47% asserted they would not hesitate to seek help. The most frequently identified possible reasons for hesitation were shame, difficulty acknowledging the problem, and treatment-related issues. Younger gamblers and those with higher problem severity, self-perception of a gambling problem, and past treatment experience were more likely to volunteer shame and treatment-related issues. Gamblers with lower problem severity, no self-perception of a gambling problem, and no history of help seeking more frequently said they would not hesitate to seek help. However, among problem/pathological gamblers, 49% did not self-perceive even a moderate gambling problem; they were more likely than self-perceived problem gamblers in this high severity group to predict no hesitation. In addition to revealing perceived and objective factors that impede help seeking for gambling problems, the identification of possible barriers may indicate, among some disordered gamblers, awareness of gambling problems and consideration given to possible actions. Both tackling barriers and enhancing problem awareness are necessary components of strategies to provide accessible and timely assistance to those with gambling problems.

Service Utilization and Help Seeking in a National Sample of Female Rape Victims

Many women with mental health problems do not seek help. Despite substantial research on predictors of help seeking, little is known about factors associated with help seeking in at-risk populations (for example, rape victims). This study examined various forms of help seeking for emotional problems in relation to key variables in a national sample of female rape victims. Telephone interviews were conducted with a representative sample of 3,001 women (aged 18 to 76 years). All interviews were conducted between January 23, 2006, and June 26, 2006. Those endorsing a lifetime history of rape were included in the analyses presented here (N=556). Demographic characteristics, rape history, rape characteristics, psychopathology, and substance abuse were assessed. Help seeking was assessed by asking whether participants ever sought help for emotional problems, and if so, what types of services were sought (services provided through a medical professional, religious figure, or mental health professional). Help seeking was endorsed by 60% of the sample. The final multivariable model showed that ever seeking help was associated with being white (OR=2.61), being married (OR=.42), and having posttraumatic stress disorder (OR=3.45). Specific forms of help seeking revealed unique predictor sets. Although lifetime history of help seeking among rape victims was high, 40% of respondents had never sought help for emotional problems. Odds of help seeking were generally increased by the presence of a mental disorder. The findings suggest that some respondents may have sought help from general medical professionals or religious figures for emotional problems related to being raped. Education and training regarding rape and associated disorders should be available to other professionals to support provision of care. Public policy should be strengthened regarding professionals' service provision and should include reimbursement for mental health services so victims do not have to pay for services.

Service Utilization and Help Seeking in a National Sample of Female Rape Victims

Many women with mental health problems do not seek help. Despite substantial research on predictors of help seeking, little is known about factors associated with help seeking in at-risk populations (for example, rape victims). This study examined various forms of help seeking for emotional problems in relation to key variables in a national sample of female rape victims. Telephone interviews were conducted with a representative sample of 3,001 women (aged 18 to 76 years). All interviews were conducted between January 23, 2006, and June 26, 2006. Those endorsing a lifetime history of rape were included in the analyses presented here (N=556). Demographic characteristics, rape history, rape characteristics, psychopathology, and substance abuse were assessed. Help seeking was assessed by asking whether participants ever sought help for emotional problems, and if so, what types of services were sought (services provided through a medical professional, religious figure, or mental health professional). Help seeking was endorsed by 60% of the sample. The final multivariable model showed that ever seeking help was associated with being white (OR=2.61), being married (OR=.42), and having posttraumatic stress disorder (OR=3.45). Specific forms of help seeking revealed unique predictor sets. Although lifetime history of help seeking among rape victims was high, 40% of respondents had never sought help for emotional problems. Odds of help seeking were generally increased by the presence of a mental disorder. The findings suggest that some respondents may have sought help from general medical professionals or religious figures for emotional problems related to being raped. Education and training regarding rape and associated disorders should be available to other professionals to support provision of care. Public policy should be strengthened regarding professionals' service provision and should include reimbursement for mental health services so victims do not have to pay for services.

Delay to Seek Treatment for Anxiety and Mood Disorders in an Australian Clinical Sample

AbstractEffective treatments for common anxiety and mood disorders exist, yet epidemiological studies reveal that the unmet need for treatment in the community remains high. This study investigates the significance of the initial delay to first seek professional help in this unmet need for treatment in an Australian sample. Help-seeking history was retrospectively reported by 273 new referrals to a specialist anxiety treatment clinic who had a primary diagnosis of an anxiety (78%) or mood disorder (22%). Clinical, demographic and attitudinal variables were tested as potential predictors of length of the delay. Average help-seeking delay was 8.2 years (range 0–72 years). Younger age at symptom onset and slower problem recognition were associated with delayed help-seeking, and older people were more likely to report longer delays. We conclude that delays to first seek treatment are long and contribute significantly to the unmet need for treatment for anxiety and mood disorders, and that lack of problem recognition is a significant barrier to help-seeking.

Seeking professional help: Etiology beliefs about mental illness across cultures.

In the present study, the authors examined the contributions of cultural beliefs about the etiology of mental illness to the seeking of help from mental health professionals among college students in 4 cultural groups, European Americans, Chinese Americans, Hong Kong Chinese, and Mainland Chinese. Group differences were found in help-seeking history and likelihood, with European and Chinese Americans being more likely to seek help than Hong Kong and Mainland Chinese. Multiple-group path analysis showed that lay beliefs about causes of mental illness and prior help-seeking history significantly predicted help-seeking likelihood, which was related positively to environmental/hereditary causes but negatively to social-personal causes. Our findings demonstrate the importance of understanding help-seeking patterns within specific cultural contexts and the effects of Western influences on shaping help-seeking propensities. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

Significance of a behavioral economic index of reward value in predicting drinking problem resolution.

This study investigated whether a behavioral economic index of the value of rewards available over different time horizons improved prediction of drinking outcomes beyond established biopsychosocial predictors. Preferences for immediate drinking versus more delayed rewards made possible by saving money were determined from expenditures prior to resolution attempts by problem drinkers with different help-seeking experiences (N = 144). As hypothesized, stable resolutions over a 2-year follow-up were associated with proportionally more preresolution discretionary expenditures on savings and less on alcohol compared with unstable resolutions. The relationship held regardless of help-seeking history, and preresolution drinking practices, problems, and income were similar across outcomes. The findings extend experimental work on behavioral economics and indicate that measuring monetary allocation improves prediction of outcomes.

Why wait? Reasons for delay and prompts to seek help for mental health problems in an Australian clinical sample

The initial delay to seek treatment accounts for a significant proportion of the unmet need for treatment of common psychiatric conditions. This study aimed to examine the barriers to initial help-seeking and factors that facilitate help-seeking for anxiety and depression. Help-seeking history was retrospectively self-reported by 233 patients at a specialist anxiety clinic, all of whom had delayed seeking professional treatment for at least one month. Data gathered included age at onset, age at help-seeking, primary reason for the delay, prompt to seek help and first professional contacted. The most frequently endorsed reasons for the delay related to lack of knowledge about mental illness or available treatment. Increasing illness severity or disability was the primary prompt to seek help for the majority of respondents. Reason for the delay showed some relationship with length of the delay, but prompt to seek help did not. A general medical practitioner (GP) was the first professional contacted in 71 % of cases. Lack of public 'mental health literacy' contributes to slow problem recognition. Increasing illness severity eventually facilitates problem recognition and prompts help-seeking. Structural barriers to initial help-seeking are relatively unimportant within the Australian health care system. General practitioners play an important role as gate-keepers to appropriate mental health care.

Different variables are associated with help-seeking patterns and long-term outcomes among problem drinkers

This study investigated variables associated with help-seeking for drinking problems and with long-term drinking outcomes. In a 3×2 design, problem drinkers ( N=167) were selected according to their help-seeking history [no assistance (NA), Alcoholics Anonymous (AA) only, or treatment plus AA (TxAA)] and current drinking status [resolved abstinent (RA) for >2 years or nonresolved (NR) active drinkers]. Drinking practices and problems, influences on help-seeking, and life events were assessed retrospectively during structured interviews. Participant reports were verified through collateral or reliability interviews. Stable resolution was associated with heavier drinking and greater negative life events before resolution. Seeking help, especially from treatment, was associated with greater psychosocial problems and higher dependence levels. The results indicate that different dimensions of drinking problems are associated with help-seeking and drinking outcomes, and suggest ways to increase help-seeking.

Current need versus treatment history as predictors of use of outpatient psychiatric care.

The authors conducted a study of treatment utilization and outcome on a sample of 116 psychiatric outpatients at a Veterans Administration (VA) hospital. Utilization and outcome measures were obtained at a follow-up interview 18 months after a baseline assessment. Comparisons between patients with high and low rates of utilization revealed negligible relationships between use of services and severity of illness, clinical change, or demographics. However, previous use of VA outpatient and inpatient psychiatric services and VA psychiatric disability rating predicted utilization of psychiatric care during the study. The authors conclude that use of VA outpatient psychiatric care may reflect patients' help-seeking history more than their current clinical need.

Relation of depression and help-seeking history to attitudes toward seeking professional psychological help.

Relation of depression and help-seeking history to attitudes toward seeking professional psychological help.