Mental Health-seeking Behavior Research Articles

Chinese undergraduates' mental health help-seeking behavior: the health belief model.

The detection rate of mental health problems among undergraduates has recently risen significantly. However, undergraduates underutilize mental health services; approximately a third only of undergraduates in need of treatment use school counseling resources. Based on a social psychological theoretical framework, the health belief model, factors of undergraduates' willingness to seek help when dealing with psychological problems were investigated. A cross-sectional online questionnaire and a snowball sampling method with 446 undergraduates investigated perceived susceptibility, perceived severity, perceived behavioral benefits, perceived barriers, self-efficacy, and cues to action to understand how students' mental health-seeking behaviors are affected. We found that perceived susceptibility (p < 0.01), perceived severity (p < 0.01), perceived benefits (p < 0.01), perceived barriers (p < 0.01), self-efficacy (p < 0.01), and cues to action (p < 0.01) significantly correlated with behavioral intention. Encouragement or counseling from others would be more likely to motivate undergraduates to seek mental health help. In addition, we used a bias-corrected Bootstrap approach to test the significance of the mediating effect, the mediation effect of cues to action between undergraduates' perceived susceptibility and mental health help-seeking behavior was utterly significant [mediation effect value of 0.077, with an SE value of 0.027 and a 95% CI (0.028, 0.133)]. It demonstrated that those who perceived themselves to be at high risk of developing a mental illness and who had received encouragement or counseling to seek mental health help were more likely to be motivated to seek mental health help. Multiple regression analyses indicated that self-efficacy (Z = 5.425, p < 0.01) and cues to action (Z = 6.673, p < 0.01) independently influenced behavioral intentions. Encouragement or counseling from others would be more likely to motivate undergraduates to seek mental health help.

Intersectional analysis of men’s masculinities and mental health-seeking behavior: A novel application of multiple correspondence analysis.

Intersectional analysis of men’s masculinities and mental health-seeking behavior: A novel application of multiple correspondence analysis.

Exploring cross-cultural perspectives on adolescent mental health among Congolese immigrant adults in the USA and Belgium

Purpose This paper aims to explore the intersection of cultural processes and immigration in parental understanding of adolescent mental health and mental health seeking behaviors among African immigrants in Western countries. The present study examines the perspectives of Congolese immigrant parents on adolescent mental health in Brussels, Belgium, and Raleigh, North Carolina, USA – two geographic regions with relatively large Congolese migrant populations. This study highlights a needed understanding of cultural and acculturative context in shaping the beliefs of Congolese immigrants and explores potential barriers of seeking health services. Additionally, it recognizes health issues among this underrepresented and underserved population. Design/methodology/approach Fifteen Congolese immigrant parents, eight in the USA and seven in Belgium, participated in structured qualitative interviews using an adapted version of Kleinman Questions and behavioral scenarios on depression, post-traumatic stress disorder and oppositional defiant disorder. Interviews were audio recorded, and participants were assigned pseudonyms to de-identify responses. English interviews were transcribed verbatim by a trained team of undergraduate research assistants, and French interviews were transcribed verbatim by the first author and a graduate research assistant. Following transcription, the first and second authors used a rapid analytic approach (Hamilton, 2013). The first and second authors conducted a matrix analysis to observe thematic patterns. Findings Parents interpreted adolescent behavior to be more problematic when the scenarios were overtly outside of their cultural realm of values and beliefs. Parents preferred methods of intervention through religious practices and/or family and community efforts rather than seeking mental health services in their host countries as a secondary option. The authors’ findings provide an understanding of the values and beliefs of this underrepresented demographic, which may be useful to guide health professionals on how to support this community in a culturally responsive way. Research limitations/implications Limitations to the current study include the structured nature of the interview guide that did not allow for in-depth qualitative exploration. Interviewed participants had lived in their host countries for more than 10+ years. Thus, the authors’ findings are not reflective of new immigrants’ experiences. Parents’ perspectives were likely shaped by exposure to Western beliefs related to support for mental health (e.g. knowledge of psychologists). Future studies should focus on recent refugees due to exposure to traumatic events and experiences reflective of the Democratic Republic of Congo’s (DRC’s) current socio-political situation, and how these are understood in the context of adolescent mental health. Further, due to the hypothetical nature of the scenarios, the authors cannot be sure that participants would engage in the identified approaches with their children. Additionally, hearing from the youth’s perspective would provide a clearer insight on how mental health and seeking professional help is viewed in a parent–child relationship. Finally, the data for this study were collected in 2019, prior to the COVID-19 pandemic. Although the authors cannot speak directly to Congolese refugee and immigrant experiences during this significant historical period, given the rise in mental health concerns in refugee populations more broadly (Logie et al., 2022), the authors’ findings speak to how parents may have responded to increased mental health symptoms and point to additional barriers that these populations may have faced in accessing support. The authors’ study emphasizes the need for dedicating resources and attention to this population, especially the development of culturally tailored messaging that invites community members to support the mental health needs of their community. Practical implications The authors’ findings provide important implications for mental health professionals. This study provides a clearer understanding of how Congolese immigrant parents view mental health and help-seeking within their cultural frame. Although parents may seek professional help, a distrust of mental health services was expressed across both cohorts. This suggests that mental health professionals should acknowledge potential distrust among this population and clarify their role in supporting the mental health of adolescent immigrants. Clinicians should inquire about familial cultural beliefs that are parent- and child-centered and modify their interventions to fit these belief structures. Originality/value This paper addresses the gap in knowledge about mental health perspectives of Sub-Saharan African immigrant populations, specifically those from the DRC.

Supplemental Material for Intersectional Analysis of Men’s Masculinities and Mental Health-Seeking Behavior: A Novel Application of Multiple Correspondence Analysis

Supplemental Material for Intersectional Analysis of Men’s Masculinities and Mental Health-Seeking Behavior: A Novel Application of Multiple Correspondence Analysis

Mental Health Help-Seeking Behavior of Male Video Game Players: An Online Survey.

Video gaming is a popular pastime for young males, having been shown to have both positive and negative effects on players' mental health. The aim of the current study was to ascertain the rate that male video gamers may seek mental health support for mental ill-health generally. The secondary aims were to (a) identify the most prolific barriers to seeking help; (b) determine how confident this group is to seek help; and (c) whether the variance in help-seeking efficacy be explained, in part, by age, hours gamed, self-esteem, and social capital. The survey included sections on demographic information, standardized measures of self-esteem (The Rosenberg Self-Esteem Scale), social capital (The Social Capital in Gaming Scale), help-seeking efficacy (Self-Efficacy to Seek Mental Health Care Scale), and non-standardized measures of help-seeking behavior and help-seeking barriers. The survey of 2,515 participants had a mean age of 21.37 years. The analysis identified that most participants had not sought mental health support for themselves. The most prolific barriers for this cohort to seek help were cost, confidentiality, and trust. Confidence to seek help was rated the lowest for overcoming embarrassment, understanding information, and coping with others' reactions. Help-seeking efficacy was found to be significantly predicted by age, hours spent gaming, self-esteem, and social capital. Low rates of seeking help, coupled with identifying the significant barriers of this group to seek help, may inform researchers aiming to develop targeted interventions for male youth interested in gaming and who are exhibiting mental ill-health to gain initial access, or engage more often, with mental health services when needed. Further research is recommended for investigating male gamers' insights in determining how to overcome the identified barriers for this cohort to improve mental health seeking behavior rather than avoidant behavior. From this, stigma reduction and ease of access to digital mental health services could be improved.

Religiosity & mental health seeking behaviors among U.S. adults.

The association between religiosity and secular mental health utilization is unclear. Evidence suggests that religious and spiritual leaders (R/S leaders) may be more trusted than secular mental health therapists (SMHTs) and are often the first point of contact for individuals with mental health problems who identify as religious. Generalized equation estimate (GEE) analyses were used to examine the association between religiosity and mental health seeking behaviours in 2,107 participants using t Midlife in the United States Study (MIDUS) data collected between 1995 and 2014. The final model indicated that after adjusting for covariates, higher levels of baseline religious identification and baseline spirituality (assessed in 1995) predicted an increase in visits to R/S leaders from 1995 to 2014 by a factor of 1.08 (95% CI=1.01-1.16) and 1.89 (95% CI=1.56-2.28), respectively. Higher levels of baseline religious identification reduced SMHTs visits by a factor of 0.94 (95% CI=0.90-0.98), whereas higher levels of baseline spirituality increased SMHTs visits by a factor of 1.13 (95% CI=1.00-1.27) during the same timeframe. Higher levels of spirituality and religious identification increased the frequency over time of seeking mental health support from R/S leaders relative to SMHTs. Individuals with mental illness may seek support from religious resources, mental health professionals, or both, underscoring the importance of collaboration between R/S leaders and SMHTs. Mental health training for R/S leaders and collaboration with SMHTs may help alleviate mental health burden, especially among those who highly value their religious and spiritual beliefs.

654-P: Characterizing Mental Health Status and Service Utilization in Chinese Americans with Type 2 Diabetes

Objectives: Mental health issues are common in people with type 2 diabetes (T2D). Yet, the mental health burden of Chinese immigrants with T2D remains unknown. This study examined mental health status, mental health-seeking behaviors, and service utilization among Chinese immigrants with T2D. Methods: We conducted a telephone-based cross-sectional survey among 66 Chinese immigrants with T2D recruited from the diabetes registry in NYC. Participants’ mental health status including anxiety, depressive symptoms, general stress, and diabetes-specific distress were measured using the Hospital Anxiety and Depression Scale-Anxiety subscale, Patient Health Questionnaire-9, Perceived Stress Scale, and Diabetes Distress Scale, respectively. Information related to mental health-seeking behaviors and service utilization was also collected. Descriptive statistics were used. Results: Most participants (mean age 56.1±10.5 years) were female (57.6%), currently married (80.3%), foreign born (100%), high school graduate or less (77.3%), with annual household income &amp;lt; $25,000 (50.8%), and limited English proficiency (95.5%). About 9%, 25.7%, and 23.7% reported moderate or higher depressive symptoms, general stress, and diabetes-specific distress, respectively. Only 11.5% with elevated symptoms have ever seen a mental health professional and 3.8% were currently seeking mental health services. Not seeking mental health services was attributed to no need (92.4%), not knowing where to find Chinese-speaking providers (4.5%), cost (1.5%), and time (1.5%). Conclusions: Mental health issues, especially general stress and diabetes-specific stress were high among Chinese immigrants with T2D. However, very few of them have ever sought or are currently seeking mental health services. Future research needs to gain a better understanding of the barriers and design culturally tailored programs to serve the needs of this minority group. Disclosure Y.Shi: None. B.Wu: None. N.Islam: None. M.Sevick: None. A.Shallcross: None. H.Bao: None. X.Xu: None. Y.Jiang: None. L.Hu: None. Funding National Institutes of Health (P50MD017356)

Film Animasi “Kanca Cilik” Sebagai Intervensi dalam Perilaku Mencari Bantuan Kesehatan Jiwa Pada Usia Remaja

Background: Post-adolescent mental health problems in Indonesia are currently experiencing an increase from 2013 to 2018. Efforts and forms of intervention that can be carried out are through increasing the behavior of seeking mental health assistance. Such efforts can be health promotion. Proper health promotion for adolescent with film media. the animated film "Kanca Cilik" is a medium to promote the behavior of seeking mental health assistance in adolescents. Purpose: The purpose of this research is to develop the animated film "Kanca Cilik" as an intervention for adolescents in seeking mental health assistance. Method: The method used by developing two stages. The first stage is to make an animated film "Kanca Cilik" with 3 episodes and an average duration of 3 minutes/episode. Then in the second stage, a perception test was carried out on mental health nurses, community, and animation experts. The test results use the Intraclass Correlation Coefficients (ICC) test. Result: The result of this development research is the animated film "Kanca Cilik" which consists of three episodes, namely the first episode is behavior seeking mental health assistance from peers, the second episode is behavior seeking mental health assistance to family and the last episode is behavior seeking mental health assistance to professionals. . statistical analysis was obtained at 0.896 and the average value of the 3 reviewers was 0.978&gt; 0.5 (high stability). Conclusion: The conclusion of this study is that the film "Kanca Cilik" as a behavior intervention seeking mental health assistance in adolescents is good for use as an effort to promote mental health. and suggestions for this research to be used as an intervention in increasing mental health seeking behavior in adolescents.

Addressing Suicide Risk: A Systematic Review of Motivational Interviewing Infused Interventions

Purpose: Brief interventions have been applied to the problem of suicide. This systematic review quantitatively and qualitatively examined the effectiveness of motivational interviewing (MI)-infused interventions. Methods: PRISMA guidelines were followed throughout. Results: 147 studies were initially identified, with nine meeting the final inclusion criteria. All studies blended MI with other interventions and were primarily located in triage settings. MI-infused interventions were not significantly stronger in lowering suicidal ideation or behavior. However, such interventions were significantly more likely to result in follow-up care post intervention. Discussion: MI-infused interventions are not linked to statistically significantly lowered risk for suicide ideation or behavior despite increased mental health-seeking behavior post intervention. However, MI-infused interventions may be valuable for suicidal behavior in hospital settings because they increase a key intervention target: following up with mental health care. The literature on MI-infused interventions for suicide is in an early stage with many unanswered questions.

Determinants of Mental Healthcare-Seeking Behavior of Postpartum Women in Ibadan, Nigeria.

The mental healthcare-seeking behavior of postpartum mothers has received little attention in Nigeria. Previous studies in the country have focused on determinants of physical health-seeking behavior, choice of maternal healthcare provider, prevalence, and determinants of maternal mental illness, yet, determinants of maternal mental health-seeking behavior among Nigerian women has been understudied. This study, therefore, examined the determinants of mental health-seeking behavior among postpartum women in Ibadan, Nigeria. Maternal mental illness, which was proxied using postpartum depression, was computed using the Edinburgh Postpartum Depression Scale. Data for the study were obtained through a survey method using a 9-page questionnaire. A 3-stage sampling technique was employed. The first stage was a stratified sampling to disaggregate the health facilities offering postnatal and immunization services on the basis of ownership of public and private healthcare providers. In the second stage, seven healthcare facilities comprising three (3) private and four (4) public healthcare were purposively selected based on the number of attendees. The final stage was a random selection of 390 postpartum mothers attending postnatal and immunization clinics across seven healthcare facilities. The prevalence of depression among the mothers was 20.8%. While only 39.5% of the depressed women sought care, 22.3% of the non-sufferers also sought mental healthcare. This revealed that both sufferers and non-sufferers sought mental healthcare. Also, a higher incidence of postpartum depression among the sufferers increased the likelihood of seeking mental healthcare. Age, family history of postpartum depression, and having the desired gender of child were determinants of mental health-seeking behavior. Among the sufferers of postpartum depression who failed to seek care, a low perceived need for mental healthcare, the perception that the depressive symptoms will go on their own, as well as fear of being stigmatized as a “weak mother”, were reasons for not seeking mental healthcare. Thus, to promote mental healthcare, the non-cost factors, like availability and accessibility to a mental healthcare facility should be addressed. To achieve this, mental healthcare sensitization programs should be integrated into maternal healthcare at all levels, and mothers attending antenatal clinics should be routinely screened for early symptoms of depression in the postpartum period.

Mental Health Seeking Behavior Among Muslims in The United States of America

Since the 9/11 terrorist attacks, Muslims in the United States of America (MIA) have experienced increasing encounters with discrimination, hate crimes, and violence. This places them a higher risk for mental health symptoms. Although current research explores factors that impact mental health seeking behaviors of ethnic and racial minorities, there is a paucity of research examining the utilization of mental health services among religious minorities. The purpose of our study was to examine the relations between acculturation to Islamic values, acculturation to American values, and mental health seeking behaviors of MIA. We also sought to identify sources of support MIA utilize when experiencing religious adversity. We had three findings. First, we found a significant negative relation between Islamic values and likelihood of seeking mental health services. In other words, MIA who adhered to more Islamic values were less likely to seek mental health treatment. Second, we found a significant positive relation between acculturation to American values and the likelihood of seeking mental health services. Thus, MIA who were more acculturated to American values were more likely to seek mental health services compared to MIA who were less acculturated. Third, we found that the top ranked sources of support for MIA were family, self-care, religion (e.g., prayer), or not seeking support at all. MIA in our study were less likely approach friends, community (e.g., mosque), or professionals (e.g., therapy). The implications of our findings are discussed.

Exploring the potential of delivering mental health care services using digital technologies in Bangladesh: A qualitative analysis

BackgroundBangladesh is a lower-middle-income country affected by a severe lack of mental health service availability due to a scarcity of mental health experts, limited mental health literacy, and community stigma. In other low and middle-income countries, the online provision of mental health care services has addressed issues affecting service availability, accessibility, mass awareness of services, and stigma. ObjectiveThe current study sought to understand stakeholders' perceptions of the potential of digital media-based mental health care delivery in strengthening Bangladesh's mental health system. MethodOnline in-depth interviews were conducted with seven psychiatrists and eleven people with lived experiences of mental health issues. In addition, two online focus groups were conducted with ten psychologists and nine mental health entrepreneurs. A thematic analysis of the audio transcriptions was used to identify themes. ResultStakeholders perceived that the benefits of digital media-based mental health services included the potential of increasing the awareness, availability, and accessibility of mental health services. Participants recommended: the rehabilitation of existing pathways; the use of social media to raise awareness; and the implementation of strategies that integrate different digital-based services to strengthen the mental health system and foster positive mental health-seeking behaviors. ConclusionGrowing mental health awareness, combined with the appropriate use of digital media as a platform for distributing information and offering mental services, can help to promote mental health care. To strengthen mental health services in Bangladesh, tailored services, increased network coverage, and training are required on digital mental health.

Law Enforcement Pathways to Mental Health: Secondary Traumatic Stress, Social Support, and Social Pressure.

The mental health of law enforcement officers (LEO) is critical to the safety and well-being of the officers and the public they serve. However, LEO face significant on-the-job stressors that undermine mental health, and there is a lot to be learned about when and how LEO seek and enter mental health services. The present study sought to explore variables related to mental health seeking behavior, the role of social engagement and social pressure in the decision to seek mental health services, and the most common pathways into mental health utilized by LEO. A small sample of 86 LEO were recruited from the social media page of a law enforcement nonprofit support organization to take several self-report measures on past mental health service usage and intentions to seek future services, the Inventory of Attitudes Toward Seeking Mental Health Services, the Professional Quality of Life Survey, and a measure of social engagement on mental health topics. Results indicate that while a number of factors are associated with intentions to seek future services, the primary factor in past mental health seeking behavior was secondary traumatic stress. Those who sought mental health services reported higher social engagement and social pressure to seek help. LEO entered mental health services for a variety of reasons and through a variety of provider options, such that no one provider source was preferred. Though the present study was limited by a small sample size, reliance on self-report measures, and occurred during a time of civil unrest that sparked the “defund the police” movement, the results serve as a starting point for understanding the pathways into mental health services for LEO and the roles of secondary trauma and prior mental health service experience.

Trends in Psychiatric Emergency Department Visits in Northern Israel During the COVID-19 Outbreak.

Background: During the spread of coronavirus disease (COVID-19), mandatory quarantines increased social isolation and anxiety, with inevitable consequences on mental health and health seeking behavior. We wished to estimate those trends.Methods: We examined all psychiatric visits to the emergency department (ED) during March, April 2020, compared to identical months in 2018, 2019. We evaluated both number and nature of referrals.Results: Throughout the years, psychiatric referrals comprised about 5% of the total number of ED visits. In March-April 2020, 30% decreases were observed in overall ED visits and in psychiatric referrals in the ED. Compared to 2018–2019, in 2020, the proportions of these diagnoses were higher: anxiety disorders (14.5 vs. 5.4%, p < 0.001), personality disorders (6.7 vs. 3.2%, p = 0.001), psychosis (9.5 vs. 6.7%, p = 0.049), post-traumatic stress disorder (3.2 vs. 1.5%, p = 0.023). Compared to 2018–2019, in 2020, proportions were lower for adjustment disorder (5.8 vs. 8.9%, p = 0.036) and for consultation regarding observation (11.7 vs. 31.6%, p < 0.001). Differences were not observed between 2018-2019 and 2020 in the proportions of other diagnoses including suicide and self-harm disorders. Referrals concerning suicide and self-harm in a rural hospital and community clinic were 30% lower in the COVID-19 lockdown than in the same months in 2018, 2019.Conclusion: Psychiatric ED visits decreased by the same proportion as overall visits to the ED, apparently driven by fears of COVID-19. Referrals relating suicidality and self-harm shown nominal decrease, but their proportioned share remained constant. Increased anxiety and delayed care may eventually lead to increased mental health needs.

Impacts of nocturia on quality of life, mental health, work limitation, and health care seeking in China, Taiwan and South Korea (LUTS Asia): Results from a cross-sectional, population-based study

While nocturia has been proposed to be related to various systemic diseases and even mortality, there has been little information of the impact of nocturia in other aspects of physical and mental well-being. We evaluated the impact of nocturia on quality of life (QoL), mental health, work limitation, and health-care seeking behavior. An internet-based self-administered survey was distributed among individuals aged ≥40 years with the ability to use a computer and to read the local language. Survey questions included demographic details, International Continence Society symptom definitions and the international prostate symptom score. Impact on nocturia on health-related QoL physical and mental health domain, Hospital Anxiety and Depression Scale (HADS) score and Work Limitations Questionnaire (WLQ) measures was evaluated. There were 8284 participants (women, 51%) of whom 34% were aged ≥60 years. Prevalence of nocturia ≥2 was 35% in men and 37% in women. Across both genders, QoL decreased with increasing frequency of nocturia. Besides nocturia, hypertension, presence of neurological disorder, lower urinary tract symptom measures and female gender were also associated with HADS anxiety and depression scores of ≥8. Nocturia significantly impacted work ability across WLQ measures. Though the utilization of prescription medications increased with the increase in frequency of nocturia, it was also noted that up to 30% of participants who reported nocturia frequency of ≥3 did not seek any treatment for their complaints. Nocturia significantly affects QoL, work productivity, and mental well-being. However, healthcare utilization remains low and warrants increased awareness and education in the patients, caregivers and physicians.

Parental Barriers in Seeking Mental Health Services for Attention Deficit Hyperactivity Disorder in Children: Systematic Review

Objective: Many children at risk for negative outcomes related to untreated attention deficit hyperactivity disorder (ADHD) do not receive necessary mental healthcare. Parents’ mental health-seeking behavior is important in the early identification of ADHD and preventing comorbidities with ADHD. Parents may experience some barriers that may delay or stop parents from seeking mental healthcare for their children. Method: This systematic review summarized existing evidence of parents’ barriers to seeking mental healthcare for their children at risk of ADHD. Results: This review included 21 studies that address different parental barriers under the three levels of the social-ecological model, including individual, interpersonal, and community levels. Conclusion: Raising parents’ awareness of the process of seeking mental healthcare has the potential to help identify children at risk for ADHD earlier. Developing psychoeducational intervention that improves parents’ seeking behavior and reduces barriers toward seeking mental healthcare is needed.

Understanding Mental Health Services and Help-Seeking Behaviors Among College Students in Vietnam

Objective: Due to the significant higher prevalence, yet less attention of mental health problems among Asian college students, we decided to investigate the effectiveness and efficiency of mental health services and help-seeking behaviors in Vietnamese universities. By conducting this study, we hope to contribute to current literature on the factors that contribute to professional mental health taking behavior of college students in Vietnam as well as suggest strategies to reduce possible barriers that prevent them from seeking professional help.&#x0D; Design: We first conducted a pilot study to test the reliability and validity of our measurements. We then made necessary adjustments and distributed the final questionnaires to a university in Ho Chi Minh City, Vietnam. Collected data was analyzed through exploratory factor analysis.&#x0D; Results: Among the three measurements of psychological openness, help-seeking propensity, and indifference to stigma, results indicated that the model explains students’ help-seeking intention reasonably well than others.&#x0D; Conclusions: Using theory of planned behavior, this study aims at examining predictors of professional mental health seeking behavior among college students in Vietnam. Our findings indicate that help-seeking propensity significantly influences Vietnamese students’ intention to seek professional healthcare. Through this study, we suggest some guidance to the school administrators the factors that encourage students to take professional mental care.

The Change of Mental Health Status and Health-Seeking Behaviors of Psychiatric Outpatients in General Hospital During the COVID-19 Outbreak in China: A Retrospective Study from Unaware of the Outbreak Till Control

Background: The aim of current study was to retrospectively compare the change of mental health status and health-seeking behaviors among psychiatric outpatients during the period of three months from January till March, 2020 when the epidemic developed from beginning till the stability phase in China. Methods: A retrospective cross-sectional, hospital-based survey of registered psychiatric outpatients was conducted from January 1, 2020, to March 31, 2020. Outcomes: There were a total of 3027 registered psychiatric outpatients included. Major depressive disorder (MDD), general anxiety disorder (GAD), insomnia, and panic disorder (PD) were the main disorders in the psychiatric clinic in the three months, accounted for respectively 97.2%, 98.6%, 97.5%. The percentage of PD increased gradually from February, and reached the highest level significantly in March. The percentages of both remission and mild patients in MDD or GAD were significantly decreased in February and March. The severe percentages of MDD in February and March were increased dramatically and significantly, even it was doubled in March. The percentages of moderate and severe patients with GAD since February were increased significantly. The percentages of relapse in GAD in February and March were significant higher than that in January. Correlation analysis showed time was positively related to the severity of MDD or GAD. Interpretation: The longer the duration of COVID, the worse the status of MDD and GAD. The mental health status of psychiatric outpatients has worsened during the COVID outbreak. Secondly, health-seeking behavior of psychiatric outpatients in general hospital has changed during the outbreak. Funding Statement: This work was supported by Grant 2018YFC 1314400 from National Key R&D Program of China, Grant 81660235, 81971288 from the National Natural Scientific Foundation of China. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: Approval from the clinical research ethics committee of the Second Affiliated Hospital of Kunming Medical University was received before the initiation of this study. The survey was anonymous, and confidentiality of information was assured. This retrospective study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline.

A community\u2013based system dynamics approach for understanding factors affecting mental Health and Health seeking behaviors in Beirut and Beqaa regions of Lebanon

BackgroundAvailable evidence on mental health and psychosocial problems in Lebanon is limited. Recent quantitative data suggests a high prevalence among Syrian refugees and their Lebanese host communities, with significant treatment gaps in both populations. This study aims to determine how Lebanese host and Syrian refugee communities perceive mental health, and identify health seeking behaviors and barriers to health access in two contrasting contexts of fragility.MethodsA comparative qualitative study design was adopted whereby a total of 36 semi-structured interviews with Lebanese host and Syrian refugees’ community members were conducted, followed by a series of four participatory group model building (GMB) sessions. Participants were recruited from two contrasting fragility contexts: Beirut and Beqaa regions. During these sessions, causal loop diagrams were elicited depicting shared understandings of factors prompting the onset of mental health and psychosocial issues; health seeking behaviors, pathways and elements affecting the rate of health improvement and maintenance were also identified.ResultsCommunity members in both settings had similar perceptions of factors contributing to mental health. Participants named long-term effects of exposure to wars, political and social effects of conflicts, and financial constraints at the household level as precipitating factors prompting the onset of mental health and psychosocial stressors. Gender and integration related challenges between communities were identified as factors that affect condition onset and associated care seeking. Pathways for health seeking were found to be shaped by trust, the advice and support of loved ones, and the need to ensure confidentiality of affected individuals. Recurrent themes in discussion highlighted major barriers to healthcare access including significant delays in health care seeking from the formal health system, widespread social stigma, prohibitive service costs, lack of health coverage, limited awareness of mental health service availability and limited trust in the quality of services available.ConclusionMental health and psychosocial support strategies need to be gender- and integration-sensitive, primarily focused on condition prevention and awareness raising in order to strengthen health-seeking behaviors.

Factors Influencing Knowledge and Attitude Among the Caregivers of Patients with Schizophrenia at Mathari Teaching and Referral Hospital, Kenya

Schizophrenia is a mental disease that affects how a person feels, behaves and thinks. About 51 million people worldwide suffer from Schizophrenia globally. The main objective of the study was to determine factors that influence the knowledge and attitude of the caregivers of schizophrenic patients at Mathari Teaching and referral Hospital. Caregiver’s knowledge facilitates recognition of mental illness and health-seeking behavior. A cross- sectional descriptive study design was carried out to assess factors influencing knowledge and attitude among the caregivers of patients with schizophrenia at Mathari teaching and referral hospital, Kenya. To generate qualitative information, on knowledge and attitude the nurse in charge of the ward was selected as key informants. Data was collected using questionnaire and key informant interview. Qualitative data were analyzed through content analysis, similar themes were grouped. Schizophrenia was diagnosed using diagnostic and statistical manual of mental disorder (DSM-V-TR) criteria. A total of 303 caregivers visiting the patients with schizophrenia in the wards were selected for study using systemic sampling technique. Pearson correlation coefficient, logistic regression and multiple regression was used to determine the magnitude of the correlation between dependent and independent variables. Most (72%) of the participants did not know the name of the condition which the patient was suffering from. Majority, 164 (54.1%) of the caregivers had a positive attitude towards schizophrenia. There was a perfect positive correlation with the length of time the patient had suffered from the condition (.08423 zero order) with the knowledge of the caregiver. From the study finding, there was a perfect positive correlation with age, gender, highest level of education and nature of occupation (.06543, .04186, .0088 and .0039) with the knowledge of the caregiver. There was also a perfect positive correlation with age, gender religion, relationship to client, and nature of occupation (.0054, .0009.0357, .0574 and 0068 zero orders respectively). Study findings indicated a positive correlation between knowledge and the attitude since a caregiver with more knowledge had a positive attitude. The study recommends, treatment literacy classes for caregivers of schizophrenia patients.