Mental Health Help-seeking Behavior Research Articles

Pharmacy and Medical Students’ Mental Health Symptoms, Experiences, Attitudes and Help-Seeking Behaviors

Objective. To examine and compare the prevalence of mental health problems, help-seeking attitudes, and perceptions about mental health problems among US pharmacy and medical students. Methods. A cross-sectional analysis was conducted using existing, anonymous survey data collected in the Healthy Minds Study during the 2015-2016 academic year. The analysis included 482 students (159 pharmacy students and 323 medical students) from 23 institutions in the United States. Analyzed topics included demographic characteristics, mental health status and symptoms, substance abuse, stigma related to mental health, help-seeking behaviors and attitudes, and mental health treatment perceptions. Results. Pharmacy and medical students experienced similar rates of depression (18% met clinical cut-offs), but pharmacy students were more likely to meet clinical cutoffs for anxiety (21% vs 11%). Pharmacy students were less likely to seek help from student counseling services (only 11% vs 49%) and also less likely to know where to seek help on campus if needed. Pharmacy students also reported having higher levels of stigma regarding mental health treatment. Conclusion. There are differences between pharmacy and medical students with regards to their experience of mental health symptoms, willingness to seek help, and perception of stigma. Despite the small sample, this analysis of national data indicates that opportunities exist to improve campus-based mental health education and offerings for pharmacy and medical students.

Dua Ti Dawa Ti: understanding psychological distress in the ten districts of the Kashmir Valley and community mental health service needs

BackgroundAn extensive body of research exists looking at the level of psychological distress in populations affected by political conflict. Recommended response to psychological distress in humanitarian crises is still based on frameworks for interventions developed in western/European contexts including psychological first aid, counselling and group therapy. While there is growing, but limited, evidence that culturally modified interventions can lead to reduction in symptoms of psychological distress in conflict affected populations, there is a need to understand mental health help-seeking behaviour and mental health service needs from the perspective of affected communities.MethodsThis study employed a qualitative exploratory research design based on principles of grounded theory. A combination of convenience and snowball sampling was used to recruit 186 adults from the general population to 20 focus group discussions; 95 men, median age 40 years, interquartile range (IQR): 27–48 years and 91 women, median age 40 years IQR: 32–50 years. Trained Kashmiri facilitators used a semi-structured interview guide to ascertain community perceptions on mental illness, help-seeking and service needs from the perspective of communities in the Kashmir Valley. Content analysis of transcripts resulted in the identification of seven overarching themes.ResultsCommon locally recognized symptoms of psychological distress were synonymous with symptoms listed in the Hopkins Symptoms Checklist (HSCL-25) and the Harvard Trauma Questionnaire (HTQ). Protracted political insecurity was highlighted as a major perceived cause of psychological distress in communities. Mental health help-seeking included traditional/spiritual healers in combination with practitioners of western medicine, with access highlighted as the main barrier. Divergent views were expressed on the effectiveness of treatment received. Participants’ expressed the need for investment in mental health literacy to improve the community’s capacity to recognize and support those suffering from psychological distress.ConclusionsOur findings demonstrate the universality of symptoms of psychological distress whilst simultaneously highlighting the importance of recognizing the cultural, spiritual and contextual framework within which psychological distress is understood and manifest. Co-constructed models of community based mental health services are needed.

Do Digital Health Interventions Improve Mental Health Literacy or Help-seeking Among Parents of Children Aged 2-12 Years? A Scoping Review.

Digital Health Interventions (DHIs) can improve mental health literacy (MHL) and help-seeking behaviour in teens and adults. However, it is unclear whether DHIs improve parental MHL, help-seeking behaviour or access to mental health services for their children. To perform a scoping review of DHIs aiming to improve MHL, help-seeking behaviour or access to mental health services among parents of 2-12-year-olds with behavioural and emotional problems (BEP). A search of Ovid MEDLINE found four original articles meeting inclusion criteria. One of the four articles was a randomised controlled trial, which showed a significant improvement in some measures of MHL, but no change in help-seeking attitudes. The other three studies evaluated interventions, in uncontrolled pre-test and post-test evaluations, on attention-deficit/hyperactivity disorder knowledge. Two of these studies showed a significant change in ADHD knowledge. There was no consistency in MHL measures between studies. There is preliminary evidence that DHIs may improve MHL in parents of children with BEP. How this translates to help seeking, access to mental health services or improved outcomes is unknown.

Seeking help when transgender: Exploring the difference in mental and physical health seeking behaviors between transgender and cisgender individuals in Ireland

Background: While there is growing awareness of the need to support the physical and mental wellbeing of transgender people, some may be reluctant to seek help from healthcare professionals. Little is understood about the mechanisms that influence help-seeking behavior in this group.Aims: This study aimed to compare transgender and cisgender participants in their likelihood to seek help for both physical and mental health conditions, and to explore whether this help-seeking behavior is predicted by a range of sociodemographic and psychological variables.Methods: 123 participants living in Ireland (cisgender= 67; transgender= 56) completed a questionnaire which included demographic questions, as well as measures of optimism (LOT-R), self-esteem (RSES), psychological distress (GHQ-12), attitudes towards seeking psychological help (ATSPPH-SF), and attitudes towards seeking help for a physical health problem (Attitudes Towards Seeking Medical Help Scale- Action/Intervention subscale). Associations between predictor variables and mental and physical health seeking were explored using correlation analysis and stepwise regressions.Results: Transgender participants were less likely to seek help for a physical health issue than cisgender participants, but did not differ in mental health help-seeking behaviors. Results suggest that this may be due to differences in optimism, self-esteem and psychological distress. Transgender participants had significantly lower optimism and self-esteem, which were two factors linked to poorer physical health seeking behaviors. Optimism also emerged as a significant predictor in mental health seeking behaviors.Discussion: The lack of a significant difference for mental health help-seeking between the transgender and cisgender participants is encouraging, as it suggests that there is less stigma surrounding mental illness than expected, however findings also contradict previous findings suggesting that physical health is less stigmatized. This could be due to stigma relating to gender-specific healthcare and suggests that healthcare professionals should acknowledge the specific healthcare needs and concerns among transgender individuals.

Mental Health Literacy, Help-Seeking Behaviour and Wellbeing in Young People: Implications for Practice

Research indicates that individuals who have high levels of mental health literacy engage in help-seeking for mental health issues more in comparison to those with low mental health literacy. It is therefore important to ensure that young people are able to identify signs of psychological distress and identify appropriate supports and resources when necessary. Preliminary research has identified gender differences in help-seeking and identification of mental health problems. This study aimed to investigate the relationship between mental health literacy, help-seeking intentions and wellbeing in senior high school students. The sample consisted of 22 females and 10 male students, ranging from 16–18 years. Findings indicated a positive correlation between wellbeing and general help-seeking, as well as wellbeing and help-seeking for suicidal ideation. Gender differences were identified for aspects of mental health literacy and help-seeking intentions. Results of this research have implications for practitioners in fostering positive outcomes and developing targeted interventions towards improving mental health literacy and help-seeking behaviour in the future.

Mental Health Help-Seeking Experiences of Hispanic Women in the United States: Results from a Qualitative Interpretive Meta-Synthesis

ABSTRACTThe purpose of this study was to conduct a qualitative interpretive meta-synthesis to examine the experiences and perceptions of mental health help-seeking behaviors by Hispanic women in the United States. Synthesis of five studies resulted in one major theme of determinants of mental health help-seeking organized into three subthemes: (1) societal determinants, (2) health services system, and (3) individual determinants. These results provide a more holistic understanding of the mental health help-seeking experiences of Hispanic women, an important consideration when developing interventions to address the disparities in access to and quality of mental health treatment experienced by this unique population.

Chinese American Women's Experiences with Postpartum Depressive Symptoms and Mental Health Help-Seeking Behaviors.

The objective of this study was to explore the perspectives of postpartum depression (PPD) and mental health help-seeking behaviors among Chinese American women. Using a qualitative design, Chinese American women, who had given birth in the past year, participated in a semistructured interview (English or Mandarin). Depressive symptoms and mental health services questionnaires were also conducted. All 15 participants were married and between 29 and 39 years of age. Content analysis revealed two main themes including culture-specific postpartum traditions and mental health help-seeking. Nine reported sadness or PPD symptoms, including three who scored above the cutoff of the Edinburgh Postnatal Depression Scale (EPDS score ≥9) for risk of PPD and others who disclosed such information during the interview. Many women shared that they experienced postpartum depressive symptoms, but some did not believe depression was applicable to Chinese women. Healthcare professionals working with Chinese American women must be aware of culture-specific childbearing traditions to promote maternal-infant well-being outcomes.

Evaluation of a Social Media Strategy to Promote Mental Health Literacy and Help-Seeking in Youth

In Canada, it is estimated that 15-21% of youth have at least one diagnosable mental illness and less than one third access the mental health services they need. Social media (SM) may present a unique opportunity to promote mental health for young people. mindyourmind, a web-facilitated program with a comprehensive SM presence, was designed to raise awareness of mental health issues and improve access to services for youth dealing with mental health concerns. This article presents an evaluation of their SM strategies with the intent to better understand their influence on youth mental health literacy (MHL) and help-seeking behavior.

Exploring the role of rurality and rural identity in mental health help-seeking behavior: A systematic qualitative review.

Exploring the role of rurality and rural identity in mental health help-seeking behavior: A systematic qualitative review.

Help-seeking Behavior in Socially Conservative and Christian Suicide Decedents.

The purpose of this study was to examine the relationship between religious affiliation, political beliefs, and lifetime mental health help-seeking behavior in a sample of suicide decedents. We hypothesized that Christian decedents would be less likely to have sought help than non-Christians, and socially conservative individuals would be less likely to have sought help than socially liberal or moderate individuals. Smaller samples (N=147 for political analyses, N=218 for religion analyses) were drawn from a larger sample of 267 suicide decedents, for whom data were collected from loss survivors. Logistic regression analyses showed that Christian and non-Christian individuals did not differ significantly in help-seeking behavior prior to death by suicide. Individuals who identified as socially liberal were significantly more likely to have sought mental health care than were individuals who identified as socially conservative. This is the first study to examine the association between social conservatism and a lack of help-seeking behavior. These findings show the importance of implementing interventions to increase help-seeking behavior for suicidality within demographic groups that stigmatize help-seeking behavior, specifically socially conservative individuals. They also stress the importance of suicide prevention tactics that do not require disclosing suicidal intent within these groups.

Feasibility and acceptability of strategies to address mental health and mental ill-health in the Australian coal mining industry

BackgroundTo evaluate the feasibility, acceptability and effectiveness of implementing a peer-based, multi-component mental health program in the Australian coal mining industry.MethodsThe multicomponent program included MATES in mining (a peer-based mental health and suicide prevention program) and supervisor training. Eight Australian coal mines participated in the research, with four mines receiving the mental health program. Primary outcome variables including mental health stigma, help-seeking behaviour and perception of the workplace commitment to mental health were measured prior to program implementation, and then again 10 months following using a paper based survey. Process evaluation of the mental health program was measured using a pre-test/post-test survey.ResultsMATES in mining 1275 miners participated in the MATES general awareness and connector training. Participants were more confident that they could identify a workmate experiencing mental ill-health; help a workmate, family member or themselves identify where to get support and were more willing to start a conversation with a workmate about their mental health. Supervisor training 117 supervisors completed the supervisor training and were subsequently more confident that they could: identify someone experiencing mental ill-health in the workplace; identify and recommend support services to a person experiencing mental ill-health; and have an effective conversation about performance issues that may be due to mental ill-health.ConclusionsOur findings show evidence to support the use of peer-based mental health programs in the mining industry, and for male-dominated industry more broadly.

Nonfatal Suicidal Behaviors of Chinese Rural-to-Urban Migrant Workers: Attitude Toward Suicide Matters.

To examine the attitude toward suicide (ATS) and its influence on nonfatal suicidal behaviors of Chinese rural-to-urban migrant workers (MWs). Altogether, 3031 MWs completed the positive ATS Scale and structured questions regarding lifetime suicide ideation, plan, and attempt. Mental health help-seeking behaviors of MWs were also investigated. Overall, MWs held a more negative ATS than the Chinese general population. The lifetime prevalence of suicide ideation, plan, and attempt was 5.5%, 1.3%, and 1.1%, respectively. After controlling for lifetime depressive disorders and other covariates, a negative ATS was still significantly associated with lower risk of lifetime suicide ideation (OR=0.32), plan (OR=0.22), and attempt (OR=0.26). MWs with a negative ATS were more likely to talk to others and seek help by online/telephone consultation for their mental health and suicidal problems (p<.05). A more positive ATS was significantly associated with male gender, low education level, ethnic minority of Miao, low monthly income, and originating from western China. The majority of MWs hold a negative ATS, which significantly contributes to their relatively low risk of nonfatal suicidal behaviors. The more help-seeking from others and online/telephone consultation in MWs with a negative ATS may lower their risk of nonfatal suicidal behaviors.

Mental health literacy, stigma, and help-seeking behaviors among male college students

ABSTRACTObjective: Mental health literacy (MHL) is low in college-aged men potentially resulting in impaired mental wellbeing. This study assessed MHL, psychosocial determinants, and help-seeking behaviors among male university students. Participants: Male undergraduate and graduate students were surveyed in Spring 2017 (n = 1,242) at a large southeastern university in the United States. Methods: Preexisting validated scales for MHL, psychosocial determinants, and help-seeking intention were used in measurement and demographic variables were collected. T-tests and one-way ANOVA were performed to measure differences between groups. Results: Participants showed low scores for all constructs with statistically significant differences between undergraduate and graduate students, as well as between races and major classifications. Undergraduate men had moderate MHL and low intentions to seek professional care. Conclusions: Interventions focusing on increasing mental health knowledge and improving beliefs can improve MHL among male college students. Further, interventions should be tailored for racial groups and major classifications.

Beyond Silence: A Randomized, Parallel-Group Trial Exploring the Impact of Workplace Mental Health Literacy Training with Healthcare Employees.

This study sought to evaluate whether a contact-based workplace education program was more effective than standard mental health literacy training in promoting early intervention and support for healthcare employees with mental health issues. A parallel-group, randomised trial was conducted with employees in 2 multi-site Ontario hospitals with the evaluators blinded to the groups. Participants were randomly assigned to 1 of 2 group-based education programs: Beyond Silence (comprising 6 in-person, 2-h sessions plus 5 online sessions co-led by employees who personally experienced mental health issues) or Mental Health First Aid (a standardised 2-day training program led by a trained facilitator). Participants completed baseline, post-group, and 3-mo follow-up surveys to explore perceived changes in mental health knowledge, stigmatized beliefs, and help-seeking/help-outreach behaviours. An intent-to-treat analysis was completed with 192 participants. Differences were assessed using multi-level mixed models accounting for site, group, and repeated measurement. Neither program led to significant increases in help-seeking or help-outreach behaviours. Both programs increased mental health literacy, improved attitudes towards seeking treatment, and decreased stigmatized beliefs, with sustained changes in stigmatized beliefs more prominent in the Beyond Silence group. Beyond Silence, a new contact-based education program customised for healthcare workers was not superior to standard mental health literacy training in improving mental health help-seeking or help-outreach behaviours in the workplace. The only difference was a reduction in stigmatized beliefs over time. Additional research is needed to explore the factors that lead to behaviour change.

Sexual Assault Disclosure: The Effect of Victim Race and Perpetrator Type on Empathy, Culpability, and Service Referral for Survivors in a Hypothetical Scenario.

The aftermath of sexual assault warrants further attention surrounding the responses provided by those to whom survivors disclose, especially when perpetrator type or victim race may affect whether the bystander response is supportive or attributes culpability to the victim. Disclosure responses have significant consequences for survivors' posttrauma mental health and formal help-seeking behavior. The current study used a sample of 348 self-report, paper-and-pencil surveys administered during the fall 2015 semester to a purposive sample of undergraduate students with a mean age of 20.94 years old at a midsized, Southern public university. Survey design included a randomly assigned 2 × 2 hypothetical sexual assault disclosure vignette. The objective of the study was to assess the effect of perpetrator type (stranger vs. acquaintance) and victim race (White vs. Black) on empathic concern, culpability attributions, and resource referral. Between-subjects factorial ANOVA and multivariate ordinary least squares (OLS) regression models were estimated to identify the role of vignette manipulations, participant-sexual victimization history, and rape myth acceptance on empathy, culpability, and resource referral for the sexual assault survivor portrayed in the vignette. Multivariate analyses included main effects and moderation models. Findings revealed increased culpability and decreased resource referral for victims of acquaintance rape as compared with stranger rape, independent of victim race. Although no direct victim race effects emerged in the multivariate analyses, race moderated the effect of culpability on resource referral indicating culpability attributions decreased resource referral, but only when the victim was Black . Implications from the results presented here include a continued focus on bystander intervention strategies, empathy-building techniques, and educational programming targeting potential sexual assault disclosees and race stereotypes that disadvantage victims of color.

Maternal mental health priorities, help-seeking behaviors, and resources in post-conflict settings: a qualitative study in eastern Uganda

BackgroundLimited knowledge exists to inform the selection and introduction of locally relevant, feasible, and effective mental health interventions in diverse socio-cultural contexts and health systems. We examined stakeholders’ perspectives on mental health-related priorities, help-seeking behaviors, and existing resources to guide the development of a maternal mental health component for integration into non-specialized care in Soroti, eastern Uganda.MethodsWe employed rapid ethnographic methods (free listing and ranking; semi-structured interviews; key informant interviews and pile sorting) with community health workers (n = 24), primary health workers (n = 26), perinatal women (n = 24), traditional and religious healers (n = 10), and mental health specialists (n = 9). Interviews were conducted by trained Ateso-speaking interviewers. Two independent teams conducted analyses of interview transcripts following an inductive and thematic approach. Smith’s Salience Index was used for analysis of free listing data.ResultsWhen asked about common reasons for visiting health clinics, the most salient responses were malaria, general postnatal care, and husbands being absent. Amongst the free listed items that were identified as mental health problems, the three highest ranked concerns were adeka na aomisio (sickness of thoughts); ipum (epilepsy), and emalaria (malaria). The terms epilepsy and malaria were used in ways that reflected both biomedical and cultural concepts of distress. Sickness of thoughts appeared to overlap substantially with major depression as described in international classification, and was perceived to be caused by unsupportive husbands, intimate partner violence, chronic poverty, and physical illnesses. Reported help-seeking for sickness of thoughts included turning to family and community members for support and consultation, followed by traditional or religious healers and health centers if the problem persisted.ConclusionOur findings add to existing literature that describes ‘thinking too much’ idioms as cultural concepts of distress with roots in social adversity. In addition to making feasible and effective treatment available, our findings indicate the importance of prevention strategies that address the social determinants of psychological distress for perinatal women in post-conflict low-resource contexts.

Depression literacy and help-seeking in Australian police.

To assess depression literacy, help-seeking and help-offering to others in members of the police force in the state of Victoria, Australia. All staff in police stations involved in a cluster randomised controlled trial of an integrated workplace mental health intervention were invited to participate. Survey questions covered sociodemographic and employment information, recognition of depression in a vignette, stigma, treatment beliefs, willingness to assist co-workers with mental health problems, help-giving and help-seeking behaviours, and intentions to seek help. Using the baseline dataset associated with the trial, the paper presents a descriptive analysis of mental health literacy and helping behaviours, comparing police station leaders and lower ranks. Respondents were 806 staff, comprising 618 lower-ranked staff and 188 leaders. Almost 84% of respondents were able to correctly label the problem described in the vignette. Among those who had helped someone with a mental health problem, both lower ranks and leaders most commonly reported 'talking to the person' although leaders were more likely to facilitate professional help. Leaders' willingness to assist the person and confidence in doing so was very high, and over 80% of leaders appropriately rated police psychologists, general practitioners, psychologists, talking to a peer and contacting welfare as helpful. However, among both leaders and lower ranks with mental health problems, the proportion of those unlikely to seek professional help was greater than those who were likely to seek it. Knowledge about evidence-based interventions for depression was lower in this police sample than surveys in the general population, pointing to the need for education and training to improve mental health literacy. Such education should also aim to overcome barriers to professional help-seeking. Interventions that aim to improve mental health literacy and help-seeking behaviour appear to be suitable targets for better protecting police member mental health.

Survey on the use of mental health services and help-seeking behaviors in a community population in Northwestern China

There is little research into the patterns of mental health services use, related factors, and barriers in help-seeking behaviors among the community population in northwestern China. We conducted a community-based survey among the general population in Xi’an City with the stratified two-stage systematic selection scheme using the World Health Organization Composite International Diagnostic Interview version 3.0 computer-assisted personal interview (CIDI-CAPI 3.0). We interviewed 2447 individuals aged 16 years or older. The lifetime prevalence estimate of mental disorders was 21%. However, the lifetime use rate of mental health services of the 2447 responding subjects was 2.45% and 4.67% among those subjects who reported a mental disorder. Several variables were associated with lower use of mental health services: rural residence and divorced or unmarried. Among the group with mental disorders, 15/21 sought help from non-mental health specialty services such as a general physician (13/21). The high prevalence rate of mental disorders but low rate of mental health services use raises a significant public health issue in northwestern China. Reduction in the resource gap and encouraging people to seek treatment remain a challenge to the mental health services system.

Asian American Mental Health Care: With a Special Focus On the Chinese Population

The Chinese population has a high prevalence of mental illness, but the treatment gap is high; identifying the barriers to mental health services utilization can improve access and promote better mental health care. Very few empirical studies systematically examined the barriers to help-seeking in the Chinese population. Therefore, the purpose of the study was to review the literature on the utilization of mental health services by the Asian American population in order to understand the barriers in seeking professional mental health care among the Chinese. As part of this study, a mix method research survey comprising 10 demographic questions and 26 multidimensional questions pertaining to barriers for accessing mental health services was conducted. This survey combined open-ended and closed-ended questions. The results revealed that people of Chinese descent are less likely to use mental health services due to the critical influence of its culturally-oriented values and beliefs in perceptions of mental health issues and help-seeking behaviors. The practical implications include more culturally appropriate services, changing policy, and addressing stigma through interventions. Since it is a pilot study focus on preliminary data collection with a small sample to test out the survey questionnaire, so further studies with a larger sample population of Chinese especially in China should be carried out to better examine the barriers to mental health services by the former.

Chinese college freshmen's mental health problems and their subsequent help-seeking behaviors: A cohort design (2005-2011).

Based on cohort data obtained from 13,085 college freshmen’s (2005 to 2011) SCL-90 (the Symptom Check-List-90) reports and their subsequent 4-year psychological counseling help-seeking records, this study examined the association between college students’ mental health problems and help-seeking behaviors across four college years. Female students’ mental health problems and help-seeking behaviors increased from the 2005 to the 2011 cohorts and no changes emerged for male students across cohorts. Overall, male students reported higher levels of mental health problems than did female students in the first college year, whereas female students reported more help-seeking behaviors than did male students in the following four college years. College students’ mental health problems was associated positively with help-seeking behaviors. College students were more likely to seek help from the college psychological counselling center when they experienced relatively few or quite a lot of mental health issues (i.e., an inversed U shape). Implications for future studies and practices are discussed.