Mental Health Help-seeking Research Articles

It’s Time to Bring Mental Health Literacy Education into the Postsecondary Curriculum

In the last twenty years, research on post-secondary students’ mental health and well-being has grown substantially, with a dramatic increase in publications over the past decade. Likewise, concerns about declining mental health on our campuses have risen; the mental well-being of postsecondary students is now widely recognized as a major public health issue. Over the last two decades, Canadian higher education has largely addressed these concerns by promoting mental health awareness through extracurricular means. Critically, a new movement towards mental health literacy has emerged across the nation: not just supplementary outreach, but education embedded into the curriculum. To put recommendations into practice, in 2020, one of the authors [CZ] developed and taught an undergraduate course on mental health literacy with a class of 106 students. In the first offering, we conducted a pre-post study to examine if this new course would be associated with changes in mental health knowledge, stigma, and help-seeking. Of the forty students who participated in the study, ten completed measures at both the start (T1) and the end of the course (T2). Within-subjects analyses showed that students made significant gains from T1 to T2, with a large effect size, in terms of attitudes toward seeking mental health services. Feedback on the course was very positive, both in students’ ratings and their comments. Looking ahead, student well-being will depend on how institutions approach and engage with mental health literacy. We recommend firmly integrating mental health literacy education into the post-secondary curriculum.

“I don’t have time”: an exploration of the role of time pressures in acceptance of internet interventions for mental health

Background Internet interventions for common mental disorders are widely available, effective, and economical, yet community uptake remains low. One consistently cited reason for not engaging in mental health interventions is lack of time. Aims This research examined whether lack of time as a rationale for not using online interventions reflects real time scarcity, and whether time availability impacts intention to use interventions. Methods A nationally representative sample (N = 1094, 51% women) reported their time use in activity categories for a typical week. Participants rated their acceptance and likelihood of use of mental health internet interventions, and completed mental health symptom, help-seeking and stigma measures. Results Amount of leisure time reported by participants was not associated with acceptance or likelihood of use of internet interventions for mental health. However, respondents who worked longer hours ranked time and effort factors as more influential in their intention to use internet-based mental health programs. Younger respondents and those with greater help-seeking attitudes reported higher acceptance of use. Conclusion These findings suggest lack of time is not a direct barrier to use of internet interventions, and that perceived time scarcity may be masking real barriers to uptake.

Understanding experiences of mental health help-seeking in Arab populations around the world: a systematic review and narrative synthesis

BackgroundRacial and ethnic disparities in mental health service utilisation and access is well established. Mental illness is common among Arab populations globally, but most individuals display negative attitudes towards mental health and do not seek professional help. The aim of this systematic review was to determine 1) help-seeking behaviours 2) help-seeking attitudes and 3) help-seeking barriers and facilitators, related to mental health services among Arab adults.MethodA pre-defined search strategy and eligibility criteria allowed for database searching using terms related to: mental health, Arabs, help-seeking, as well as experiences and behaviours. Seventy-four articles were included and analysed through narrative synthesis. Results were reported using the PRISMA guidelines. The review protocol was registered prospectively on PROSPERO (CRD42022319889).ResultsArabs across the world have negative attitudes towards formal help-seeking and are reluctant to seek help, despite the presence of psychological distress. There is little information on factors that influence help-seeking behaviours and rates of service use. Preference for informal help sources such as family and friends were expressed and considered more acceptable. Low mental health literacy, stigma, gender, age, education, religion, acculturation, and immigrant status were the most common factors influencing help-seeking attitudes. Barriers to help-seeking included stigma, privacy and confidentiality, trust, mental health literacy, language, logistics, and culture related barriers. Increasing societal and family awareness, external support and encouragement, shared culture between the client and therapist, quality of doctor patient relationship, and feelings of connectedness with the host country among refugees were mentioned facilitators. Mixed findings for the role of religion, and family and community, in relation to facilitating or hindering help-seeking were reported.ConclusionsThere is an increased likelihood and preference to seek informal sources of psychological support among Arabs. Contextual and cultural factors impeding help-seeking for Arabs are common across the world. Future research should address actual utilisation rates of services to better understand factors that influence help-seeking behaviours and facilitators to help-seeking. Increasing mental health literacy and developing anti stigma campaigns is necessary. Developing culturally informed interventions should inform future efforts to promote help-seeking among this population.

Mental health help-seeking preferences and behaviour in elite male rugby players

ObjectivesMental health symptoms and mental illnesses are common in elite athletes. There is an urgent need to develop care systems to support the mental health of elite athletes. Understanding elite...

The Complexities of Mental Health Help Seeking Among Latinx College Students: Qualitative Inquiry Using the Theory of Planned Behavior

Current Latinx college students seek mental health treatment at much lower rates compared to the general student population. This is particularly concerning, as these rates have remained stubbornly low, even as the COVID-19 pandemic exacerbated existing sources of anxiety. Thus, university officials and mental health practitioners across the country have emphasized the need for interventions encouraging these students to utilize campus mental health resources. However, additional research is needed to form a foundation of knowledge for help seeking interventions. This investigation applies the theory of planned behavior to understand Latinx students’ help-seeking perspectives. Findings revealed that Latinx students viewed campus mental health resources as lacking value for them. Additionally, cultural norms established by family members represented a barrier to help seeking. Finally, Latinx students faced steep challenges navigating US health care systems and felt that mental health resources were not designed to serve minorities. This key insight can guide mental health help-seeking interventions.

Improving Mental Health Help-Seeking Among Male University Students: A Series of Gender-Sensitive Mental Health Feasibility Interventions.

One-third of students experience a mental health condition associated with decreased academic functioning and increased risk of dropping out. While mental health difficulties are lower among male students, they are twice as likely to die by suicide. Although the importance of gender-sensitive interventions for male students has been emphasized, feasible and effective approaches are unexplored. This investigation conducted three gender-sensitive feasibility interventions for male students to evaluate acceptability, changes to help-seeking and mental health outcomes. Three interventions were delivered to 24 male students. The interventions included the following: Intervention 1-a formal intervention targeting male students, Intervention 2-a formal intervention that adopted gender-sensitive language and promoted positive masculine traits, and Intervention 3-an informal drop-in offering a social space providing health information. These were evaluated for acceptability, attitudes to help-seeking, and mental health outcomes. All interventions were equally acceptable. The informal drop-in was more acceptable, having better engagement from male students who have greater conformity to maladaptive masculine traits, more negative attitudes to help-seeking, higher levels of self-stigma, who were less likely to have used mental health support before and belonged to an ethnic minority. These findings indicate differences in acceptability, particularly uptake, for hard-to-engage male students. Informal strategies help reach male students who would otherwise not engage with mental health support, familiarize them with help-seeking, and connect them with pre-existing mental health interventions. More work needs to be carried out using larger samples to investigate the efficacy of informal interventions to engage male students.

What facilitates collegiate athletes seeking mental health care? Athletic trainers’ perceptions

Objective: To assess athletic trainers’ (ATs) perceptions regarding the importance of athletes’ beliefs and athletic department stakeholders in facilitating help-seeking for mental health (MH) care. Participants: 534 ATs within collegiate athletic departments (M age = 35.50 years; 64.2% women; 87.3% White). Methods: ATs were asked to indicate the extent to which they believed 10 student-athlete beliefs about MH (e.g. confidence MH treatments work) and 10 stakeholders (e.g. teammate) would facilitate student-athletes’ help-seeking for MH care (1, Strongly Disagree, to 5, Strongly Agree). Results: We conducted separate two-way mixed design ANOVAs, one for each set of 10beliefs and 10 stakeholders; each was significant (p’s < .002). The ATs perceived confidentiality as the most facilitative belief and viewed ATs as the most facilitative stakeholder. Conclusions: ATs differentiate among student-athletes’ beliefs and stakeholders on how facilitative each might be in help-seeking, suggesting pathways for improving MH climate within athletic departments through education and policies.

Syrian Refugee Women's Maternal Mental Health Perceptions, Coping Strategies, and Help-Seeking Practices in Lebanon.

Globally, 27 million female refugees of reproductive age are subjected to numerous socio-ecological factors that increase their risks of mental health issues, especially during the postpartum period. This study seeks to explore Syrian refugee mothers' experiences and perceptions of postpartum depression. We used a qualitative phenomenological approach to interview purposively sampled typical postpartum Syrian mothers living in informal camps in Lebanon to evaluate their maternal mental health perceptions, coping strategies, and help-seeking practices. Results revealed three major themes: conceptualizing maternal depression as extraordinary and ordinary, cultural perceptions of mental health help-seeking, and coping with negative emotions. Findings are critical to Lebanon and other Muslim refugee-hosting countries as they can inform future health policies, health care delivery models, and community interventions. Utilizing culturally and religiously appropriate frameworks in assessing and providing mental health services to this vulnerable group can substantially improve mental health services' acceptance, utilization, and impact.

Lockdown and psychological stress in Wuhan, China.

Wuhan was the epicenter of the Coronavirus Disease 2019 (COVID-19), outbreak in China. We aimed at surveying the general public in China to better understand their levels of psychological state and its influencing factors after the Wuhan shutdown on January 23. The cross-sectional survey was conducted online and 4,701 respondents participated in this survey. Of them, 3,803 respondents were considered for final analysis. Data on subjective indicators of daily life changes were collected, and individual scores on changes in anxiety, depression, and stress were tested by 8-item, 11-item, and 6-item questionnaires, respectively. Multivariable regression analyses showed that living in the rural areas, living in the other regions except Hubei, and higher education were independent correlates of less negative emotions. Besides, the level of attention, self-assessed infection risk, impact on the daily life and mental health help-seeking tended to be positively associated with the scores of anxiety, depression, and stress. City of residence, education, marital status, monthly income, level of attention, self-assessed infection risk, impact on daily life and mental health help-seeking were important correlates of anxiety, depression, and stress scores.

Co-designing a peer-led model of delivering behavioural activation for people living with depression or low mood in Australian farming communities.

Farmers face a range of factors that negatively influence their mental health and suicide risk, yet have limited access to appropriate support. Behavioural activation (BA) is an evidence-based therapy that can be effectively delivered by nonclinical workers. Working with members of farming communities to deliver BA to their peers has the potential to overcome many well-established barriers to mental health help-seeking and improve outcomes for this at-risk group. This paper describes the findings of a co-design phase informing the development of a peer (farmer)-led approach for delivering BA for farmers living with depression or low mood. This qualitative study used a co-design approach involving members of the target community. Focus groups were transcribed and analysed using Thematic Analysis and the Framework approach. Ten online focus groups with 22 participants were held over 3 months. Four overarching, interlinked themes were identified: (i) filling the gap in rural mental health support; (ii) alignment with the farming context-tailoring how, where and when we engage about mental health; (iii) the 'messenger' is as important as the message; and (iv) sustainability, governance and support. Findings suggest BA could be a contextually appropriate model of support for the farming community-given its practical and solution-focused approach-and could help improve access to support. Having peer workers deliver the intervention was viewed as appropriate. Ensuring governance structures are developed to support peers to deliver the intervention will be essential to facilitate effectiveness, safety and sustainability. Insights gained through co-design have been critical to the success of developing this new model of support for members of farming communities experiencing depression or low mood.

Magico-religious beliefs, stigma and help-seeking for adolescent mental health at the community level – A multi-stakeholder qualitative exploration in southern India

Background: Almost half of all mental health disorders begin before the age of 14. However, several barriers exist to seeking help for mental health conditions among adolescents in the Indian context. The present study aimed at exploring multi-stakeholder perspectives on adolescent mental health and help-seeking behavior as well as referral. Methods: Our study adopted a qualitative design with focus group discussions (FGDs) and in-depth interviews (IDIs) conducted over a span of one year among 70 participants using purposive sampling. Participants included parents of adolescents, adolescents aged 14–16 years, high school teachers, and mental health professionals (MHP) and a pediatrician. The study was conducted in selected educational blocks of Udupi taluk. Parental written informed consent and assent from adolescents were obtained. Data was transcribed and thematic analysis was performed using Atlas.ti (version 8) to identify codes and code families following which themes were identified. Results: Our findings elicited community-held beliefs and attitudes indicating pathways and barriers to seeking care. Participants perceived that increased device use, accessing pornographic material, experiencing bullying, academic stress and negative perceptions surrounding mental health with the addition of magico-religious beliefs contributed to delayed help-seeking. Barriers to help-seeking included stigmatizing cultural perceptions. A considerable proportion of families found traditional healing more acceptable in the community. Conclusions: Stigma related to mental health continues to be one of the major barriers to early intervention. School counselors, teachers and even religious leaders in the community were found as effective liaisons in providing referrals to MHP. Recommendations for future studies and the way forward are discussed.

Theory-based behaviour change intervention to promote mental health help-seeking among older adults in Australia: Initial dissemination and acceptability.

Rates of help-seeking for mental health problems among older adults are low and initiatives to increase help-seeking in older populations are limited. To our knowledge, no interventions have aimed to promote help-seeking among older adults by tapping internal motivations to seek help. In this paper, we describe the development of a theory-based intervention designed to promote mental health help-seeking among older adults in Australia, using an internal motivation paradigm. The intervention was co-designed through a consultative process with nine key stakeholders who represented five main groups: primary health-care providers, mental health professionals, health-care executives, community organisations and consumers. Development was an iterative process, based on best practice guidelines. Nineteen older adults (≥65 years) provided feedback on the acceptability of the intervention. The intervention consisted of a help-seeking brochure with behaviour change messages based on the Theory of Planned Behaviour (TPB). Messages targeted older adults' attitudes towards help-seeking, subjective norms, perceived behavioural control and barriers to seeking help. Most participants (74%) responded with agree/strongly agree to 10 items measuring the acceptability of the intervention, indicating the intervention is relevant, clear, appropriate and appealing. The present intervention appears to be an acceptable way to promote help-seeking for mental health problems among older adults. A larger, robust trial is warranted to determine the effectiveness of the intervention in improving help-seeking attitudes, intentions and behaviour. The intervention has the potential to increase older adults' engagement with mental health support and improve health outcomes in this population.

Families’ experiences of supporting Australian veterans to seek help for a mental health problem: a linked data analysis of national surveys with families and veterans

Background Families play a critical role in supporting currently serving and transitioned veterans’ wellbeing and help-seeking for mental health concerns; however, little is known about families’ experiences. Aims This study used Australian national survey linked-data (n = 1217) from families (Family Wellbeing Study-FWS) and veterans (Mental Health Wellbeing Transition Study-MHWTS) to understand veteran-family help-seeking relationships. Methods Veterans’ and family members’ responses to mental health and help-seeking questions in FWS and MHWTS datasets from perspective of family members were cross-tabulated. Help-seeking support provided by family members was compared by veterans’ probable disorder. Results Results highlighted high levels of involvement and continuous assistance provided by families. Two in three family members thought the veteran had probable mental health concerns although they have never been diagnosed or treated. Clear disparities between family and veteran perspectives regarding mental health concerns indicates the extent of non-treatment seeking in this population, missed opportunities for early intervention, and need for greater support to families to promote help-seeking. Conclusions Encouraging help-seeking is complex for veteran families particularly where veterans’ reluctance to seek help may lead to family relationship strain and conflict. Families need early information, support, and recognition by service agencies of the role of the family in encouraging help-seeking.

What’s up with everyone?’: The effectiveness of a digital media mental health literacy campaign for young people

Background In 2021, the Arts and Humanities Research Council commissioned a mass-media mental health campaign called “What’s up With Everyone?” Here, innovative co-created messages were professionally storied and animated by an internationally recognized production company and focused on improving mental health literacy in five core areas: competition, social media, perfectionism, loneliness and isolation, and independence. Aims This study examines the impact of the “What’s up With Everyone?” campaign on young people’s mental health awareness. Methods Seventy-one (19 males, 51 females, M age = 19.20 years, SD = 1.66, range = 17–22) young people completed a one-sample, pre-post experiment to measure changes in knowledge, attitudes, confidence, and stigma of mental health struggles, as well as help-seeking for mental ill-health before and following exposure to animations. Results Paired and one-sample t-tests revealed that knowledge, attitudes, confidence, and willingness to seek support improved at post-test. There were also significant reductions in the stigma towards depression following the animations. Conclusions Continued long-term investment in campaigns such as “What’s up With Everyone?” seems warranted given the impact on mental health awareness, help-seeking, and stigma.

Mental health help-seeking after a sexual assault: A dyadic study of sexual assault survivors and informal support providers.

Mental health help-seeking after a sexual assault: A dyadic study of sexual assault survivors and informal support providers.

Mental Health Stigma and Help-Seeking Intentions in Police Employees.

Mental health problems among police employees are exacerbated by negative attitudes and beliefs around mental health help-seeking that are perpetuated by police culture. We collected anonymous survey data from 259 civilian and commissioned police employees in a mid-sized, Midwestern U.S. city to test hypothesized relationships among help-seeking stigma, help-seeking attitudes, and intended help-seeking behavior. Results demonstrated that mental help-seeking stigma was negatively associated with help-seeking attitudes, and in turn with reduced mental health help-seeking intentions. Structural equation modeling provided support for a model linking help-seeking stigma, help-seeking attitudes, and intentions to seek help. This path model was moderated by psychological distress and previous participation in mindfulness training, which had opposing effects on help-seeking stigma and (indirectly) on intended help-seeking. Results provide insight into policies, practices, and interventions that police agencies may enact to combat stigma, positively influence mental health help-seeking, and improve the mental health and well-being of police employees and the broader community.

The Often-Circuitous Path to Affirming Mental Health Care for Transgender and Gender-Diverse Adults.

We describe recent research regarding access to affirming mental health services for transgender and gender-diverse (TGD) adults and explore new resources available for therapists to inform evidence-based practice with TGD clients. Barriers and facilitators at all socioecological levels impact TGD adults' mental health help-seeking. TGD adults often interface with mental health providers while accessing gender-affirming medical care, though new standards of care are likely to alter this typically common path to mental health services. Efforts to improve therapist education, such as therapy manuals, are increasingly available and a necessary step to increase the number of competent, affirming therapists. More work-both advocacy and research-is needed to fully expand accessible, affirming mental health services for TGD adults. Better understanding factors impacting different steps of the mental health help-seeking process and conducting randomized controlled trials of affirming mental health services are important next steps.

Stress, Anticipatory Anxiety, and Mental Health Help-Seeking among Chinese Students in United States at the Beginning of COVID-19: A Thematic Analysis

The COVID-19 pandemic brought numerous negative effects towards people’s mental health. The current study explored the influence of pandemic on Chinese international students in the U.S. at the beginning of the pandemic. Interview method was used in this study. Interview questions included the influence of pandemic, the influence of panic caused by pandemic, the influence of Asian-hates events, and mental health help-seeking behaviour. As the result, three main themes were narrowed down: stress, anticipatory anxiety, and help-seeking behaviour. The current study found that the most frequent stressor was the risk of infection. The other direct stressors were difficulty of traveling between China and the U.S., negative influence of academic life, and shortage of medical supplies. More indirect stressors were found: worries about Chinese students in the U.S. being infected by parents, worries about discrimination by parents, discriminating experiences of friends, and infection history of friends and of relatives in China. Three anticipatory anxieties were found: getting in touch with others, anti-Asian events, and different strategies to cope with disease. All participants reported no professional help-seeking behaviour. Five of eight participants reported the non-professional help-seeking. Three of eight participants reported they used self-regulation to cope with the stress and anxiety. The results demonstrated the unique experience and coping strategy of Chinese international students. Although they had lived in the U.S. for many years, their coping strategies still identified with Chinese culture. Future study could explore more associations of stress, anxiety, and help-seeking to understand and help Chinese international students better. This study can provide some guidance for future intervention studies and practices regarding the mental health situation of Chinese international students in other countries during the pandemic.

A Gift You Give Yourself: A Preemptive Intervention for Student Mental Health.

Burnout, stress, and compromised mental health are known issues for clinical trainees. Various interventions have shown efficacy, but they are generally training-based and therefore not practical for "just in time" use when a student is struggling. Stigma surrounding mental health is another challenge to this aspect of wellness. At the beginning of their training, physician assistant (PA) students from 3 cohorts at Butler University wrote short reflections on resiliency and their motivation for training. This, along with an encouraging note from a faculty member, was placed in a box and wrapped. Students then kept the box to open during a time of stress or self-doubt. An anonymous survey about this intervention was sent to these students in April 2021. Almost all survey respondents remembered the activity and had a positive impression of it. Nearly half opened the gift box during their training, with a majority opening it during the didactic phase rather than the clinical phase. Most of those who opened the gift box viewed it favorably. Participants reported high levels of self-stigma regarding mental health and help-seeking. The gift box intervention was well-received and used by many students. This is a "just in time" intervention to support struggling learners when they need it most, as opposed to most interventions that are more structured in their delivery and use. The high level of self-stigma for mental health help-seeking is a concern and warrants continued investigation.

A study to Assess Knowledge, Attitude toward Mental Illness, and Mental Health Help-Seeking among the Adult Population in a Selected District of Assam

Background: Mental health problems are neither a new disorder nor a disease condition. However, it has been ignored or neglected since the older days. People with adequate knowledge and positive attitude toward mental illness only will lead to increase their intention of seeking help for it. Aim: To assess knowledge, attitude toward mental illness, and mental health help-seeking among the adult population in the selected district of Assam. Materials and Methods: A quantitative research approach with a descriptive research design was adopted. There were a total of 100 adult participants. The data were collected by using the Modified Version of the Knowledge of Mental Illness Questionnaire, Community Attitudes toward the Mentally Ill Scale, and Mental Help-Seeking Intention Scale (MHSIS). Results: The study revealed that participants have adequate knowledge of mental illness (17.92 ± 4.607) and have a positive attitude toward it which includes authoritarianism (31.54 ± 3.295), benevolence (BE 33.93 ± 3.307), social restrictiveness (SR 24.74 ± 4.550), and community mental health ideology (CMHI 34.34 ± 4.326) and also shows high intention to seek help for mental health problems (6.53 ± 1.436). There was a statistically significant association of knowledge with occupation (χ 2 = 15.203,P= 0.001). It also showed a significant positive correlation between knowledge and BE domains (r = 0.242,P= 0.015) followed by a significant negative correlation between knowledge and SR domains (r= −0.345,P= 0.000) and a significant positive correlation between MHSIS score and CMHI domains (r = 0.207,P= 0.039) of attitude scale. Conclusion: The adults from the selected areas have an adequate knowledge on mental illness, positive attitude toward it and a high intention to seek help for mental health problems.