Psychiatric Help-seeking Research Articles

Macroeconomic antecedents of racial disparities in psychiatric-related emergency department visits.

To test whether monthly declines in aggregate employment precede a rise in African American psychiatric-related ED visits (PREDVs) relative to white visits among low-income, working-age populations. This study used repeated cross-sectional time series data for 6.7 million PREDVs among African Americans and white individuals from the State Emergency Department Database in 48 Metropolitan Statistical Areas (MSAs) across four states (Arizona, California, New York, New Jersey) from 2006 to 2011. MSA-level monthly employment data were obtained from the US Bureau of Labor Statistics. The outcome was specified as the race of a PREDV (African American = 1, white = 0). The exposure was operationalized as monthly percent change in MSA-level aggregate employment lagged by 0 to 3 months. Analysis included logistic regressions with county, month and year fixed effects, and clustered standard errors to examine the relation between odds of an African American PREDV (relative to white) following 0 to 3 months lag of MSA-level aggregate employment change. Logistic regression results indicate that the odds of PREDVs for publicly insured, working-age African Americans (relative to white individuals) increase 3 months after ambient employment decline (OR: 0.994, 95% CI: [0.990 0.998]). Economic downturns may marginally increase psychiatric help-seeking in EDs among publicly insured (low-income), working-age African Americans relative to white individuals. Findings from this study may contribute to the theoretical understanding of dynamic drivers of racial disparities in psychiatric ED visits.

Help-seeking during 1-year follow-up in Chinese patients diagnosed with type 2 diabetes mellitus comorbid major depressive disorder.

Previous research has revealed a bidirectional relationship between type 2 diabetes mellitus (T2DM) and major depressive disorder (MDD). A very limited proportion of patients with T2DM comorbid MDD received adequate psychiatric intervention. This study investigated the help-seeking behaviors of patients with T2DM comorbid with MDD during one-year follow-up. At a medical center in China, a cohort of outpatients with T2DM were assessed and diagnosed for comorbid depression at baseline and after one year. The Mini International Neuropsychiatric Interview was used to diagnose MDD, while The Patient Health Questionnaire-9 (PHQ-9) and The Hamilton Depression Scale 17-item (HAMD-17) were used for depression assessment. Mental health help-seeking behaviors of patients during follow-up period were also evaluated. Out of the 203 patients with T2DM at baseline, 114 (56.2%) completed the follow-up. The prevalence of MDD in participants with T2DM was 12.8% at baseline and 22.8% at follow-up. Patients who completed the follow-up had a lower baseline PHQ-9 score (test statistic -2.068, p=0.039), HAMD-17 score (test statistic -2.285, p=0.022) than those who did not complete the follow-up. A total of 26 patients had comorbid MDD during the follow-up period, among which 8 patients (30.8%) voluntarily visited psychiatric clinics, while others did not seek assistance. The level of HbA1c at follow-up was higher in patients who sought help than in those who did not (8.1 ± 1.8% vs. 7.0 ± 0.7%), although the difference was not statistically significant. Voluntary psychiatric help-seeking for Chinese patients with comorbid T2DM and MDD is uncommon. It is crucial to increase awareness of depression among patients and healthcare professionals alike.

Perceived barriers to psychiatric help-seeking in South Korea by age groups: text mining analyses of social media big data

BackgroundThe psychiatric treatment gap is substantial in Korea, implying barriers in seeking help.ObjectivesThis study aims to explore barriers of seeing psychiatrists, expressed on the internet by age groups.MethodsA corpus of data was garnered extensively from internet communities, blogs and social network services from 1 January 2016 to 31 July 2019. Among the texts collected, texts containing words linked to psychiatry were selected. Then the corpus was dismantled into words by using natural language processing. Words linked to barriers to seeking help were identified and classified. Then the words from web communities that we were able to identify the age groups were additionally organized by age groups.Results97,730,360 articles were identified and 6,097,369 were included in the analysis. Words implying the barriers were selected and classified into four groups of structural discrimination, public prejudice, low accessibility, and adverse drug effects. Structural discrimination was the greatest barrier occupying 34%, followed by public prejudice (27.8%), adverse drug effects (18.6%), and cost/low accessibility (16.1%). In the analysis by age groups, structural discrimination caused teenagers (51%), job seekers (64%) and mothers with children (43%) the most concern. In contrast, the public prejudice (49%) was the greatest barriers in the senior group.ConclusionsAlthough structural discrimination may most contribute to barriers to visiting psychiatrists in Korea, variation by generations may exist. Along with the general attempt to tackle the discrimination, customized approach might be needed.

Does message content interact with the physical environment? An exploratory study on the influence of noise and noise-related visual cues on message elaboration

This study seeks to examine the influence of noise and noise-related visual cues on message elaboration of psychiatric help-seeking (PHS) information. We conducted a randomized trial comparing two noise (High: 75 dB LAeq, low: 30 dB LAeq) and two message (noise-related visual cue or not) conditions. Participants (n = 200) were exposed to one of two noise conditions and one of two message conditions. Key outcome measures included participants’ message elaboration of PHS information (primary) and willingness to seek psychiatric help and PHS attitudes (secondary). There was an interaction effect of noise-related visual cues and the noise condition on message elaboration. Increased message elaboration of the PHS information did not enhance willingness to seek psychiatric or PHS attitudes. A message with a noise-related visual cue in a noisy environment can enhance self-reported message elaboration. This novel finding highlights the potential value to examining how messages interact with the physical environment. (148 words).

Efficacy of value-expressive messages at improving attitudes toward psychiatric help seeking for depression treatment among young adults

Guided by the functional theory of attitude, this study examined the utility of value-expressive messages at improving young adults’ attitude toward psychiatric help-seeking (PHS). A randomized between-subject experiment (n = 148) was conducted with three message conditions: health or self-direction value-expressive messages and a control message. The acceptance and processing of value-expressive messages differed as a function of message recipients’ motivational goals. Specifically, the health value-expressive message (vs. the control) was perceived as more persuasive among those with a higher motivational goal to be healthy. Message inductions successfully established the connection between help-seeking attitudes and the goal of being healthy or self-directed (enhanced goal relevance), which in turn increased perceived argument strength and positive attitude toward PHS. Study findings highlight the importance of selecting matching values in developing value-expressive messages and offer practical implications for endorsing PHS as an important means toward depression treatment.

The Prevalence of Psychiatric Disorders Distribution of Subjects Gender and its Relationship with Psychiatric Help-Seeking.

The aim of this study was to investigate the prevalance of psychiatric disorders and psychiatric help-seeking behaviours in central Eskisehir according to sociodemographic variables. In this study, for the purpose of revealing the psychiatric disorder profile of Eskisehir city and evaluating the prevalance of psychiatric disorders according to gender differences and psychiatric help-seeking behaviours; The Primary Care Evaluation of Mental Disorders (PRIME-MD) scale and psychiatric help questionnaire were administered to 1475 subjects who were randomly selected from 24 primary health care centers in Eskisehir. The prevalence of psychiatric disorders was as follows: at least one mood disorder 37%, anxiety disorders 29%, somatoform disorders - 8.6% and, possible alcohol abuse 7.7%. All diagnoses except possible alcohol abuse were found to be more frequent in women than men. Also It was found that in subjects who were thougth to have a psychiatric disorder, 64% of mood disorder patients, 67% of anxiety disorder patients, 70% of somatoform disorder patients and, 61% of possible alcohol abuse patients can receive appropriate treatment. Since psychiatric disorders are common, it is important to direct such patients to appropriate treatment. Therefore, new studies are necessary to find out the prevalance of psychiatric disorders and risky groups as well as to identify the reasons that why such people do not seek for help in different regions of our country.

Depression and mental health help‐seeking behaviors in a predominantly African American population of children and adolescents with epilepsy

To determine whether previously undetected symptoms of depression and psychiatric help-seeking behaviors are associated with demographic or epilepsy-related variables in a predominantly African American sample of pediatric epilepsy patients. Ninety-six serially recruited parent-child dyads (55% African American, 39% Caucasian) completed the Short Mood and Feelings Questionnaire (SMFQ). Regression analyses determined whether depressive symptoms measured by the SMFQ were associated with demographic (age, gender, and ethnic background) or epilepsy-related variables (age of seizure onset, duration of epilepsy, seizure type, time since last seizure, and number of antiepileptic drugs). Dyads with positive SMFQ screens (score > or = 12) received information about depression and were advised to seek mental health services. Six months later, parents completed follow-up interviews to ascertain mental health service utilization. Thirty-five participants (36.5%) screened positive for probable depression. Greater number of antiepileptic drugs was the only predictor variable independently associated with greater (worse) depression scores (p = 0.005). At 6-month follow-up, 12 patients (36.4%) had received mental health care, whereas 21 guardians (63.6%) denied depressive symptoms in their child and never sought mental health services (two dyads lost to follow-up). Logistic regression analyses found no associations between demographic, epilepsy-related, or depressive variables and psychiatric help-seeking. This study indicates the necessity and feasibility of screening for previously undetected symptoms of depression in pediatric epilepsy clinics serving diverse populations, particularly among patients receiving antiepileptic polytherapy. Additional research on the correlates of depressive symptoms and determinants of psychiatric help-seeking is needed to develop evidence-based interventions for youths with epilepsy and symptoms of depression.

Psychosocial consequences of rejection and stigma feelings in psoriasis patients.

Many studies as well as clinical experience indicate that patients often feel stigmatized by their psoriasis and may experience rejection due to their skin disease. In this study of connections between feelings about having psoriasis, rejection by others, and the impact on work experience, alcohol use, and psychiatric help-seeking, 100 adults with moderate to severe psoriasis responded to a specially designed questionnaire. Multiple regression analysis is used to determine whether, and how, rejection experience and stigma feelings are associated with the three psychosocial outcomes after controlling for psoriasis severity. Nineteen percent of the subjects experienced 50 episodes of gross rejection as a result of their psoriasis, most often from a gym, pool, hairdresser, or job. Rejection experience leads to feeling stigmatized, which is then associated with help seeking and, to some degree, with interference with work. Rejection can lead to feeling stigmatized and to increased alcohol consumption, but the data show that patients may drink without conscious awareness of their feelings. When patients experience psoriasis-related rejection, they may feel stigmatized and suffer further adverse effects on their emotional and occupational life. It is urgent that ways of helping people deal with the impact of psoriasis, its stigmatizing potential, and the consequences of psoriasis-induced rejection be emphasized.

The role of marital intimacy in psychiatric help-seeking.

Epidemiological studies have shown that most people with diagnosable psychiatric illnesses do not seek professional help. Symptoms of non-psychotic emotional illness, interpersonal relationship quality and personality traits have demonstrable associations. The influence of these factors on help-seeking was examined by comparing 57 psychiatric outpatients with a community sample of 90 symptomatic individuals on self-report measures of marital intimacy, life events, and personality, while controlling for symptomatology. Compared to non-patients, outpatients reported less intimacy in their marriages across a variety of relationship dimensions on the Waring Intimacy Questionnaire, and scored higher on the Psychoticism scale of the Eysenck Personality Questionnaire. Marital Intimacy level proved to be the best single predictor of patient and non-patient status, suggesting that help-seeking behaviour may be partly motivated by unsatisfactory marriages. The detection of low marital intimacy in these help-seekers might be an indication for prescribing marital therapy.

Intimacy and emotional illness in the general population.

Ninety married couples in the general population received a structured interview to assess their level of intimacy. The couples also completed self-report questionnaires to assess non-psychotic emotional illness and marital adjustment. High levels of intimacy were associated with martial adjustment. Low ratings of marital intimacy were significantly associated with non-psychotic emotional illness and psychiatric help-seeking. These findings are discussed in relationship to recent studies which explore the role of lack of marital intimacy as a vulnerability factor in the development of non-psychotic emotional illness. Implications for treatment of non-psychotic emotional illness in married individuals is briefly discussed.

Family, kin, and friend networks in psychiatric help-seeking

Family, kin, and friend networks in psychiatric help-seeking

Family, kin, and friend networks in psychiatric help-seeking

Data regarding the help-seeking efforts in the community of 120 patients at a community mental health center are used to examine the following processes: (1) the role of different types of nuclear family structures in the response to mental disorder; (2) the relationship of family interaction patterns to the extent and type of help-seeking from kinship and friendship networks; and (3) the different types of assistance provided by different sectors of the social network to individuals with psychiatric problems. The major findings are that: (1) the type of husband-wife relationship is significantly related to help-seeking efforts; (2) friends and close kin are the most common sources of assistance; and (3) kin and friends provide certain specialized forms of assistance to help-seekers. Some speculative implications of these findings for the study of social networks are also discussed.

Social Networks and Pathways to Psychiatric Treatment

Cultural interpretations have dominated the study of class differences in entering psychiatric treatment. This study compares the power of cultural variables and structural variables to predict the entry into psychiatric treatment. The concept of the social network is used to show that structural relationships, in addition to the culture of the different social classes, are important predictors of psychiatric labels and referrals, severity of symptoms, and duration of symptoms in the community. Interviews with 120 outpatients and short-term inpatients at a community mental health center provide the data for the study. The findings support the hypothesis that structural variables are important determinants of the pathways into psychiatric treatment and point to the need to link the structure of social networks to the content of networks. Studies of psychiatric help-seeking have emphasized the cultural forces predisposing individuals to enter psychiatric treatment. Sociologists have paid particular attention to the attitudes, knowledge, and verbal skills of persons of various social class backgrounds (Dohrenwend and Chin-Song; Gove and Howell; Hollingshead and Redlich; Myers and Roberts). For example, middle-class persons have more favorable attitudes toward psychiatry and greater knowledge to correctly identify psychiatric disorders than lower-class people, leading them to enter psychiatric treatment with less severe problems and in shorter periods of time (Gove and Howell). In addition, the greater intellectual sophistication of the middle and upper classes makes them more likely to initiate hospitalization themselves while the lack of such sophistication among the lower classes makes social control agents more likely to initiate hospitalization (Gove and Howell). The primary causal factor in these studies has been different cultural attitudes -how they lead to different behavior patterns in psychiatric help-seeking. Recently, researchers have questioned this preoccupation with cultural forces and have used structural patterns of interaction to predict