Need For Professional Help Research Articles

Older Adults Are Less Likely to Identify Depression Without Sadness

Many older adults do not identify depression or the need for professional treatment. Late-life depression frequently occurs without dysphoria (i.e., depressed mood or sadness); in such cases, older adults may have particular difficulty identifying depression, leading to poor health outcomes. The aims were to examine the hypotheses that older adults would be more likely to identify depression and need for professional help in a vignette of a depressed older adult with sadness versus without sadness. In a randomized experiment, 244 community-dwelling older adults (60+) read one of two vignettes and answered questions about their perceptions of the problem, solutions, and their own background. Less than half (40.98%) identified the person as depressed (sad vignette: 48.33%; vignette without sadness: 33.87%). Participants were more likely to identify depression if they had personal mental health experience, more positive expectations regarding aging, and read the sad vignette. They were more likely to recommend professional help if they identified depression. Older adults’ identification of depression and need for professional help remain low, particularly in the absence of dysphoria.

A survey of Dutch GPs' attitudes towards help seeking and follow-up care for relatives bereaved by suicide

Background. Relatives who are bereaved by suicide likely consult their GP when they feel the need for professional help. GPs may play a key role in establishing who is at risk for adverse consequences of the loss as they are familiar with relatives’ possible psychiatric vulnerabilities. The availability of evidence-based services for relatives of suicide victims is limited. Successful implementation of services needs analysis of key factors considered critical in the achievement of changes. We investigated GPs’ management of help requests of relatives bereaved by suicide and examined determinants of GPs willingness to refer for evidence-based follow-up care.Methods. A cross-sectional survey among 488 GPs in the northern part of The Netherlands.Results. A 44% response was achieved (n = 214) during the last 3 years, 38 (18%) were exposed to suicide, 21 (10%) to help requests without being exposed to suicide and 52 (24%) to both suicide and help requests. Out of 106 requests, 69 (65%) were handled by the GP; 60 (57%) were either directly or additionally referred, principally for mental health care. Suicide exposure and female gender were associated with the doctor's perception that follow-up care following a loss through suicide is useful. The perception that help is useful increased the likelihood of GPs’ referral for evidence-based follow-up care.Conclusions. GPs support the availability of evidence-based follow-up care for relatives of suicide victims. To modify GPs’ key role in referring relatives for it, GPs should be well informed of its usefulness and to whom.

To seek or not to seek professional help? School leaders' dilemma

PurposeSchool leaders are professionals who need professional help to enable them better to cope with the ever‐changing challenges characteristic to their daily routine. Yet, in considering their hierarchical position in schools, they may be reluctant to ask for professional assistance even when help is available and needed, attempting to maintain their power and firm image. The purpose of this study, therefore, is to explore how school leaders cope with this assumed dilemma.Design/methodology/approachIn‐depth open interviews were conducted with Israeli school principals. These interviews were structured around a set of key issues that the literature identified as being related to help‐seeking behavior.FindingsData indicate principals' loneliness on the job and need for professional help. Yet it appears that the threat implied in exposing one's weaknesses, lack of reliable sources of help within the formal system, personal inhibitions and fears of damaging self‐image and losing capacity to influence are barriers undermining their inclination to formally seek help. Therefore, they prefer to informally ask the assistance of lay individuals, but even then adopt various strategies such as avoidance, buffering and differentiation, attempting to prevent the assumed negative consequences associated with help‐seeking behaviors.Originality/valueTheoretically, it is possible to conclude that those who are most in need due to their hierarchical position and role complexity are least likely to become involved in help‐seeking behaviors. Creating an organizational culture that will encourage school principals to ask for help and establishing a discreet channel within the formal system that will provide professional advice are further discussed.

Factors related to adolescents' seeking help from social workers in mental health settings

This secondary data analysis of 1288 adolescents investigated how their use of social work services for mental health was affected by (a) the disorder involved, (b) their personal beliefs, (c) their families' finances, (d) their proximity to services, (e) social-structural factors, and (f) their demographic characteristics. Multinomial logistic regression of the data showed that adolescents were likely to seek help from social workers for an anxiety, mood, or attention-deficit/disruptive behavior disorder or when they were involved with the justice system or perceived a personal need for professional help. The findings also show that adolescents were likely to turn to other professionals for (a) an attention-deficit/disruptive behavior disorder or when (b) they perceived no stigma in mental health services, (c) they were white, older, and/or male, or (d) the family was small, with well-educated parents. Implications for the social work profession are discussed.

Bachelor of Nursing students' beliefs about prognosis and outcomes for people with schizophrenia: A longitudinal study

Many nursing students have unfavourable attitudes towards people with mental illness. This study aimed to examine if Australian Bachelor of Nursing students' beliefs about prognosis and long-term outcomes for people with schizophrenia changed through their course. The Attitudes and Beliefs about Mental Health Problems: Professional and Public Views questionnaire, which included a vignette about a person with schizophrenia, was used with a convenience sample of students. An interrupted time series approach to data collection was used, with data collected three times between 2005 and 2007. A university ethics committee approved the study. Data were analysed using SPSS version 15. Overall, the students recognized the person's need for professional help. By third year, students were more pessimistic about prognosis if the person did not receive professional help than in their earlier years of study. By third year, students also rated the long-term outcome to be 'creative or artistic' more favourably than in earlier years. The findings showed no significant differences in perceived overall negative and positive long-term outcomes across the three data collection points. The findings reinforce the need for theoretical and clinical education in mental health to be included and progressively increased in all years of study if attitudes are to be improved.

Changes in formal help seeking for psychological distress: The OsLof study

Background: Data from the Norwegian HUNT suggests that only 10–13% of individuals suffering from depression and anxiety have sought professional help, fuelling concerns that only a fraction of individuals with clinically significant mental health problems receive adequate treatment in Norway. Aim: The aim of this study was to examine formal help seeking for psychological distress in two communities in Norway (one urban and one rural) over time, in relation to the prevalence of distress. In addition, the proportion with potential unmet need for professional help was examined. Methods: A randomly drawn selection of individuals from Oslo (urban) and Lofoten (rural), the OsLof study, were interviewed about help seeking and administered the Hopkins Symptom Checklist (HSCL-25) in 1990 and 2001. Results: Results showed a significant shift in help seeking over time, whereas the prevalence of distress (HSCL-25 ≥ 1.75) remained stable in both communities, ranging between 13% and 16%. A significant increase occurred in the proportion seeking help from psychiatrists/psychologists, together with a significant decrease in help seeking from GPs and non-medical services. Conclusion: Multiple explanatory factors might account for the decline in overall formal help seeking, such as the improvement in the economical situation observed across the decade. No urban–rural difference in help seeking was observed, despite Oslo having a higher calculated man-labour year in psychiatric services. Even though potential unmet need has been decreasing among the psychologically distressed, only 40% had sought help from mental health professionals in 2001, indicating the need of the speciality health services to address this issue further.

Only a Manic Depressive!: The Zone of the Untouchable and Exceeding Limits in Acute Psychiatric Care

This article addresses psychotic patients' fragile boundaries and need for professional help to restore their personal untouchable zone. We examine how nurses move into this inviolable zone and re-establish limits. Empirical data are drawn from an acute psychiatric setting and focus on one patient in different situations and on her relationships with nurses. Data from nurses' discussions and the researcher's experience are also included. The concept of the zone of the untouchable, by the Danish theologian and philosopher K. E. Løgstrup, guides interpretation. Analysis shows how and with which critical and constructive consequences the diagnosis-oriented understanding affects the patient-nurse relationship. Conclusions include premises that can guide nurses moving into the patient's untouchable zone.

Perceived Barriers to Mental Health Service Utilization in the United States, Ontario, and the Netherlands

Although rates of mental health service utilization differ dramatically across countries, little information is available about differences in self-reported barriers to mental health service utilization. Perceived barriers were examined in three locations with differing health care systems. Data came from three methodologically similar population-based surveys of adults conducted in the 1990s in Ontario, Canada (N=6,261), the United States (N=5,384), and the Netherlands (N=6,031) that assessed DSM-III-R nonpsychotic mental disorders with the Composite International Diagnostic Interview. Respondents who reported a need for professional help were asked to indicate reasons for not seeking care. Multiple logistic regression analyses were used to determine the sociodemographic, mental disorder, and location-specific correlates of each perceived barrier. The pattern of reported barriers to mental health service utilization was similar across locations: attitudinal barriers (thoughts that the problem would get better on its own) were more prevalent than structural barriers (inability to get an appointment). Fear of stigmatization was not commonly endorsed. With adjustment for sociodemographic factors and type of mental disorder, low-income respondents were significantly more likely to report a financial barrier in the United States than in either Ontario or the Netherlands. Across locations, attitudinal barriers were more likely to be endorsed than structural barriers to service utilization. The most striking reported cross-national difference was structural, with many more U.S. respondents (especially those with low incomes) reporting financial barriers than respondents in either Ontario or the Netherlands.

Help-Seeking Process of Parents for Psychopathology in Youth With Moderate to Borderline Intellectual Disabilities

To study the help-seeking process of parents for emotional or behavioral problems in their child with borderline to moderate intellectual disabilities. In 2003, in a special education-based sample of 522 youths (ages 10-18 years, response = 77.9%), we studied the parents' perception of their child's problems, their subsequent felt need for professional help, actual help-seeking, and the factors possibly related to taking these steps. Even when parents indicated their child's emotional or behavioral functioning as "neither good nor bad," in about 70%, these problems were present according to standardized measures. Of the 213 parents (40.8%) who perceived problems, 70.6% felt a need, and 55.2% of these parents subsequently sought professional help. Parents more often sought help when their child had problems of anxiety and depression, experienced negative life events, and when parents perceived child psychopathology before the past year. Reported barriers to seeking help predominantly related to parents' evaluation of the severity of these problems and wanting to solve the problems themselves. Clinicians and other service providers should address parents' concerns regarding their child's emotional/behavioral functioning and treatment seeking. Also, they should provide information on treatment options and on signs and potential negative prospects of their child's problems.

Aufmerksamkeitsdefizit-/ Hyperaktivitätsstörungen bei Drei- bis Sechsjährigen in der ärztlichen Praxis - eine bundesweite Befragung

The aim of the study is to calculate prevalence rates of symptoms and diagnoses of Attention Deficit-/Hyperactivity Disorders (ADHD) in preschoolers, and to assess functional impairment as well as comorbid symptoms by means of parents and teacher symptom checklists. N = 708 kindergarten- and preschool-children were recruited nationwide by pediatricians or child and adolescent psychiatrists. The U8/U9 sample (n = 521 children) was assessed during a routine pediatric screening. The clinical sample consisted of n = 187 children who were rated as having ADHD problems by the physician. The children were assessed by age-adapted ADHD Symptom-Checklists (Fremdbeurteilungsbogen für Aufmerksamkeitsdefizit-/Hyperaktivitätsstörungen im Vorschulalter FBB-ADHS-V) rated by parents and teachers. Additionally, the physicians rated ADHD symptoms and comorbid symptoms. Based on diagnosis criteria of DSM-IV and the parental ratings in U8/U9, 11.3% of the children fulfilled the criteria for one of the three ADHD diagnoses (ICD 10: 3.8%). The prevalence rate was lower in teacher ratings (6.6%) (ICD 10: 1.5%), and in both the parent and teacher ratings 4.2% of the children fulfilled the DSM-IV criteria for ADHD (ICD 10: 1.2%). Higher prevalence rates and comorbidities were found in the clinical sample. The need for professional help (counseling/treatment) is much higher than the treatment the parents and children actually received. International prevalence rates can be applied. Despite methodological restrictions, such as a lack of representativeness and possible pre-selection effects, this study demonstrates the relevance of prevention and intervention programmes.

Project Liberty: New York's Crisis Counseling Program Created in the Aftermath of September 11, 2001

Project Liberty: New York's Crisis Counseling Program Created in the Aftermath of September 11, 2001

Mental health and resiliency following 44 months of terrorism: a survey of an Israeli national representative sample

BackgroundIsraeli citizens have been exposed to intense and ongoing terrorism since September 2000. We previously studied the mental health impact of terrorism on the Israeli population (Bleich et al., 2002), however the long-term impact of ongoing terrorism has not yet been examined. The present study evaluated the psychological sequelae of 44 months of terrorism in Israel, and sought to identify factors that may contribute to vulnerability and resilience.MethodsThis was a telephone survey using strata sampling of 828 households, which reached a representative sample of 702 adult Israeli residents (84.8% contact rate). In total, 501 people (60.5%) agreed to participate. The methodology was similar to that of our previous study. Exposure to terrorism and other traumatic events, number of traumatic stress-related symptoms (TSRS), percentage of respondents with symptom criteria for post-traumatic stress disorder (PTSD), traumatic stress (TS) resiliency and feelings of depression, anxiety, optimism, sense of safety, and help-seeking were the main outcome measures.ResultsIn total, 56 participants (11.2%) were directly exposed to a terrorist incident, and 101 (20.2%) had family members or friends exposed. Respondents reported a mean ± SD of 5.0 ± 4.5 TSRS; 45 (9%) met symptom criteria for PTSD; and 72 (14.4%) were TS-resilient. There were 147 participants (29.5%) who felt depressed, 50 (10.4%) felt anxious, and almost half (235; 47%) felt life-threatening danger; 48 (9.7%) felt the need for professional help. Women and people of Arab ethnicity had more TSRS, more PTSD, and less TS resiliency. Injury following a life-threatening experience, a major stressful life event, and a major loss of income were associated with PTSD. Immigrant status, lower education, low sense of safety, low sense of social support, high societal distress, and injury following life-threatening experiences were associated with TSRS. TSRS did not increase with exposure severity. This study revealed less depression and functional impairment, similar rates of PTSD, increased help-seeking and poorer TSRS and TS resiliency than our initial study, 2 years previously.DiscussionThe response of people in Israel to 4 years of terrorism is heterogeneous. Vulnerability factors change over time; Arab ethnicity, immigrant status and less education, not found to be risk factors in our previous study, were found in the present study to contribute to trauma-related distress. Prior experience of highly stressful events increases vulnerability to adverse psychological effects of terror.

Grief Shortly After Suicide And Natural Death: A Comparative Study Among Spouses and First‐Degree Relatives

Chronic dysfunction after complicated grief is not rare and emphasizes the need to identify bereaved individuals at risk. Three months following bereavement, self-reported psychiatric and general health of 153 relatives of 74 suicides was worse than of 70 relatives of 39 natural deaths. Moreover, the felt need for professional help was higher among the former, even after adjustment for expectedness of death, sociodemographic differences, and relatives'/spouses' neuroticism. This suggests that suicide-bereaved individuals may constitute a high-risk group of mourners in need of targeted postvention.

DEPRESSION AMONG MOTHERS WITH PRETERM INFANTS AND THEIR STRESS-COPING STRATEGIES

This study examined the level of maternal depressive symptoms and ways of coping among mothers with preterm infants as compared with those of 50 mothers with full-term babies. It was conducted in a hospital in Pretoria, South Africa, using the Edinburgh Postnatal Depression Scale (EPDS; Cox, Holden, & Sagovsky, 1987) and the Ways of Coping Questionnaire (Folkman & Lazarus, 1988). No significant difference was found in the level of depression between the two groups. The overall level of depression found with both combined groups, was 2–3 times higher than those suggested in the literature. A positive correlation was found between the “Seeking Social Support” coping strategy and higher levels of depression among mothers of preterm infants. A positive correlation was also found among mothers of full-term infants who used the “Accepting Responsibility” coping strategy and higher levels of depression. The high number of mothers in this study identified as suffering from a depressive illness of varying severity raises concern. A clear need for professional help among this population is emphasized. Future research in this area is needed in order to better understand and effectively address this problem.

Compliance with Mental Health and Other Specialty Care Referrals among Medicare/Medicaid Dual Enrollees

To examine and compare non-compliance with mental health and other specialty referrals among low-income elderly. A survey of 2,128 community-dwelling elderly assessed mental health and other specialty referral in the past year and compliance with these referrals. Non-compliant participants and those who had encountered difficulties in arranging referral appointments were asked about the barriers. 16.7% with mental health referrals vs. 4.8% with other specialty referrals did not comply (p < .001). The main reason for non-compliance with mental health referrals was lack of perceived need. Lack of perceived need for professional help is a major barrier to specialty mental health care.

Use of Health and School-Based Services in Australia by Young People With Attention-Deficit/Hyperactivity Disorder

To examine use of health (including psychiatric) and school-based services by children and adolescents who met symptom criteria for attention-deficit/hyperactivity disorder (ADHD), the factors associated with service use, and barriers to service access. The relationship between parents' perceptions of children's need for professional help, the impact of children's problems on children and parents, and services used during the previous 6 months were examined in a national sample of 398 children and adolescents with ADHD symptoms aged 6 to 17 years (70% response rate). Information was obtained from parents who completed the Diagnostic Interview Schedule for Children Version IV and standard questionnaires. Data collection took place between February and May 1998. Only 28% of those with ADHD symptomatology had attended health or school-based services. Among these, 41% had attended both health and school-based services, 39% had attended only health services, and 20% had attended only school-based services. Sixty-nine percent of parents attending health services wanted additional help. Parental perceptions that children needed professional help, children's functional impairment, the impact of problems on parents, and comorbid depressive or conduct disorders had a significant and independent relationship with service use. A minority of children and adolescents with ADHD symptomatology receives professional help for their problems in Australia. Counseling is the most frequent help provided, with many parents wanting additional help beyond that already provided. Factors other than children's ADHD symptomatology have a significant relationship with service attendance. Practical issues, including the cost of services and waiting lists are the most common barriers cited by parents as hindering access to services.

Effects of gender and sex role orientation on help-seeking attitudes

This study investigated the effects of gender and sex role orientation (masculinity and femininity) on attitudes toward seeking professional psychological help in a sample of 163 student trainee teachers (52 males and 111 females) in Singapore. The mean age of students was 25.39 years (SD = 3.80). ANOVAs revealed statistically significant main effects for gender and femininity on attitudes toward help-seeking. Specifically, females were reported to have more positive overall attitudes toward professional help-seeking and were more willing to recognize a personal need for professional help compared to males. Femininity significantly influenced students’ level of stigma tolerance. These findings suggest that both gender and sex role orientation play an independent role in influencing help-seeking attitudes. In addition, these variables appear to have a differential impact on different aspects of helpseeking.

Use of and Need for Professional Help for Emotional and Behavioral Problems Among Preadolescents: A Prospective Cohort Study of 3- to 12-Year-Old Children

To determine the effect of child-, parent- and family-related factors on the use of and need for mental health services by 12 years of age. A prospective population-based questionnaire study of 1,287 first-born children was launched in Finland in 1985. The Child Behavior Checklist (CBCL) was completed by 1,086 parents when the children were aged 3 years. At the age of 12, the CBCL, the Youth Self-Report, and other potential determinants of service need and use were obtained from 908 parents and 900 children (80% response rate). Of the total sample, 7.2% had used professional services, and 3.3% had needed services without obtaining them. Elevated scores on the age 3 CBCL Total Problems and Externalizing scale predicted independently later service use but not perceived need of services. In cross-sectional data at age 12, parental ratings of the child's problem behavior were associated with both the need for and use of services. Poor social competence and parental distress were independently associated with use of services. Recognizing behavior problems in early childhood and evaluating family stress factors are important in social and health care systems designed for children.

Parent-adolescent disagreement regarding psychopathology in adolescents from the general population as a risk factor for adverse outcome.

This study investigated whether parent-adolescent disagreement regarding adolescents' behavioral and emotional problems predicted adverse outcome. A Dutch sample of 15- to 18-year-olds was prospectively followed across a 4-year interval. The Child Behavior Checklist (CBCL: T. M. Achenbach, 1997) and Youth Self-Report (YSR; T. M. Achenbach, 1991b) were administered at initial assessment, and the following signs of poor outcome were assessed 4 years later: police/judicial contacts, expulsion from school/job, suicidal ideation, unwanted pregnancy, suicide attempts, deliberate self-harm, referral to mental health services, report of having a behavioral or emotional problem, and feeling the need for professional help without actually receiving help. Twenty CBCL syndrome scores, 23 YSR syndrome scores, and 16 discrepancy scores were significant predictors of poor outcome. It was concluded that to determine the prognosis of psychopathology in adolescents, discrepancies between informants may be important.

Adolescents in rural communities seeking help: who reports problems and who sees professionals?

This study examined whether adolescents who were at various stages of the help-seeking process differed on demographic characteristics, use of informal helpers, and markers of emotional and behavioral adjustment. Youths (N = 644; Grades 7-12) living in three rural communities completed a survey at school. Three comparisons were made: teenagers who reported having serious problems versus few or no problems in the past year; teenagers who felt that they did or did not need professional help with these problems; and teenagers who had or had not sought professional help. Rural youths with serious problems were more likely to be girls and to be living with someone other than a parent, were less likely to talk to family members about problems, and reported more negative emotional and behavioral adjustment. Teenagers who perceived a need for professional help also reported poorer emotional and behavioral adjustment. Adolescents who sought professional help were more likely to be in senior high, were less likely to talk to others about problems, and were lower on anxiety. Rural adolescents' demographic characteristics, use of informal helpers, and markers of emotional and behavioral adjustment each contribute to our understanding of their help-seeking behavior. Future studies must examine how these and other variables combine to discern who reports problems, who perceives a need for help, and who sees professionals.