Seeking Mental Health Services Research Articles

Heterogeneous Patient Graph Embedding in Readmission Prediction

The number of youth seeking mental health services has been increasing in the past decade. Accurate prediction of hospital readmission is a contributing factor in addressing youth mental health problem and healthcare service utilization. Medical records are an important source of information for readmission prediction, however utilizing such records in the context of mental care, requires overcoming two impeding challenges: the diversity of service utilization (e.g., using psychiatric vs. overdose vs. trauma clinics all for the same underlying mental health reason) and the heterogeneity of data associated with each service. Graph Neural Network (GNN) is shown to be promising in performing classification or regression tasks when input data bears a complex structure. In this research, we propose using graph embedding to first generate patient graph that captures episodic emergency department visits and the complex service utilizations of the patient. We then use GNN for readmission prediction. For embedding and training purposes, we utilize more than 4,000 unique mental health patients data over 19 years. To evaluate our approach we systematically compare a variety of of GNN models with four RNN models, namely LSTM, Bi-LSTM, GRU, and Bi-GRU. Our experimental evaluation demonstrates that encoding the complex interrelationship between features of a patient using graph embedding and GNN improves the performance of the predictive model compared to RNN counterparts.

Barriers to mental health services utilization among outpatient clinic attendees at Mathari National teaching and referral hospital, Nairobi City, Kenya

Background: World health organization defines mental health as a state where people realize and recognize their capacities, cope with life stressors, and contribute positively to the society. A gap exists between the need or demand for mental health services and their utilization due to a set of barriers that limit access. The prevalence of mental illnesses is approximately 10%. The study sought to investigate barriers to utilization of mental health services.Methods: The study used mixed-method research approach that is cross-sectional descriptive and qualitative study design. The study was conducted at Mathari national teaching and referral hospital outpatient clinic. Structured questionnaires and key informant interviews were used to collect data. Study participants comprised 216 caregivers of mentally ill patients and 6 key informants.Results: Costs of seeking mental health services is a barrier to accessing these services at the MNTRH outpatient clinic. More than half of the participants missed their clinics due to cost of medication, 56% (n=120), consultation costs 55% (n=118), and transport=54% (n=116). Caregivers sought other types of mental health services such as spiritual healing before taking their mentally ill relative for formal care. People with mental illness experienced social stigma 59.3% (n=128).Conclusions: The cost of mental health service access and stigma are the outstanding barriers to access and utilization of mental health services.

Addressing barriers to mental health services: evaluation of a psychoeducational short film for forcibly displaced people

ABSTRACT Background: Despite the high prevalence of mental illness in forcibly displaced people, their utilization of mental health services is low. Major barriers to seeking mental health services include mental health self-stigma. To address this issue, the psychoeducational short film ‘Coping with Flight and Trauma’ was developed as a brief online intervention. Objective: The present study aims to evaluate the feasibility and acceptance of the newly developed 10 min film, and to assess changes in self-stigma and help seeking. Method: The evaluation of the film was conducted using a mixed-methods design with an online survey including the Self-Stigma of Mental Illness Scale, help seeking, and mental health variables at baseline, postintervention, and 3 month follow-up, in addition to telephone interviews postintervention with a randomly selected volunteer subsample. Results: A total of 134 participants with a forced displacement history within the past 8 years took part in the study, of whom 66% scored as having probable post-traumatic stress disorder (PTSD), depression, and/or anxiety. The results revealed emotional, cognitive, and behavioural changes postintervention. Directly after watching the film, participants reported reduced self-stigma and increased openness towards accessing mental health services. At follow-up, precisely 3.8 months later, these changes were no longer significant, yet 11% of participants reported having started psychotherapy since watching the film. Probable PTSD was associated with higher self-stigma at all three time-points. The majority (90%) would recommend watching the film to other forcibly displaced people. Conclusions: Self-stigma was shown to be a robust and persistent issue, which tends to be underestimated by individuals not affected by mental illness. Low-threshold psychoeducational online interventions may be a promising tool to reduce barriers to accessing mental health services for forcibly displaced people, e.g. by being implemented in stepped-care models. HIGHLIGHTS Mental health self-stigma was shown to be a persistent and underestimated burden in forcibly displaced people. Psychoeducational online interventions are promising for addressing the burden of self-stigma and reducing barriers to seeking mental health services.

Asian Indians in the United States and Posttraumatic Stress Disorder Interventions: A Narrative Literature Review

Topic. Limited research has examined trauma and posttraumatic stress disorder (PTSD) among Asian Indians in the U.S. Thus, we (1) synthesize literature on trauma, PTSD, disparities in treatment for PTSD, the burden of untreated PTSD, and culturally-adapted (CA) PTSD interventions; and (2) discuss recommendations for clinicians/researchers working with this population. Method. We searched two databases using keywords related to Asian Indians, PTSD, and interventions. Of 238 identified articles, we used content from 26 articles to inform our review. Findings. Asian Indians report traumatic experiences before, during, or after immigration to the U.S. and consequential PTSD symptoms. Further, Asian Indians in the U.S. are disproportionately impacted by socio-cultural and economic determinants of poor mental health (e.g., shame/stigma associated with seeking mental health services, few culturally-responsive services), which may contribute to the under-reporting of PTSD and (interpersonal) traumas and less willingness to seek treatment. Additionally, CA PTSD interventions tailored to Asian Indians in the U.S. have not been developed. Socio-cultural considerations that can inform CA PTSD interventions for Asian Indians include: causal conditions (e.g., culturally-rooted beliefs about trauma/PTSD), intervening conditions/barriers (e.g., emotional inhibition), and mitigating/coping strategies (e.g., religious/spiritual practices, cultural idioms of distress). These considerations influence clinician/treatment preferences (e.g., solution-oriented and structured therapy, less emotional exposure). Lastly, we outline recommendations for clinicians/researchers: (1) need for national studies on trauma, PTSD, treatment utilization, and the burden of untreated PTSD; (2) consideration of immigration-related experiences influencing PTSD; (3) consideration of socio-cultural elements for CA PTSD interventions; and (4) need for culturally-valid PTSD assessments.

Help-Seeking Preferences and Factors Associated with Attitudes Toward Seeking Mental Health Services Among First-Year Undergraduates

Many first-year university students experience stressors that impact their adjustment and well-being. Their help-seeking attitudes and preferred sources of support may be associated with various factors. The purpose of the present study was to (1) examine help-seeking preferences amongst first-year university students, (2) explore factors associated with students’ attitudes toward seeking mental health services, and (3) identify perceived barriers associated with accessing formal sources of support. First-year students at a Canadian university (N = 167) completed a survey assessing help-seeking attitudes and preferences, as well as challenges associated with seeking support. Participants also provided information about their perceived levels of social support, personality characteristics, and their tendency to experience positive and negative affect. Findings suggest that social support and negative affect were significantly associated with positive attitudes toward seeking mental health services. However, students were more inclined to rely on informal sources of support, such as family members and friends, compared to formal sources of support available through on- or off-campus mental health services. For thosestudents who are inclined to access formal mental health support, barriers may impede access to care. Perceived barriers include cost and concerns about the availability of services and their overall effectiveness. These findings call for the creation of more opportunities for on-campus informal support in addition to better access to on-campus mental health services.

Disentangling the heterogeneity of emotional dysregulation in referred youth using the Child Behavior Checklist attending to age and sex effects

PurposeTo assess the utility of the Child Behavior Checklist (CBCL) to identify meaningful subtypes of emotional dysregulation in an outpatient pediatric psychiatry clinic. MethodsThe sample consisted of 417 newly referred youth 6–18 years of age. Parents completed the CBCL and rating scales measuring executive function deficits, social functioning, and quality of life. Patients were stratified into subtypes of emotional dysregulation and compared on clinical correlates based on the A-A-A profile consisting of the CBCL Anxious/Depressed, Aggressive Behavior, and Attention Problems (A-A-A) scales. Results67% of youth had emotional dysregulation (CBCL A-A-A T-score ≥ 180) and of these, 39% had a positive CBCL-Bipolar (BP) profile (A-A-A T-score ≥ 210), 24% had depression without the BP profile (CBCL Anxious/Depressed and/or Withdrawn/Depressed T-scores ≥70 and A-A-A T-score ≥ 180 and 〈210), and 37% had emotional impulsivity (A-A-A T-score ≥ 180 and <210) with normal CBCL Anxious/Depressed and Withdrawn/Depressed T-scores. Patients with the CBCL-BP profile were significantly more impaired on all measures of social and executive functioning compared to the other two groups. LimitationsSince our findings relied on the CBCL, other instruments may have led to different results. Because we included youth from a single clinic, largely Caucasian and referred, our findings may not generalize to other ethnic groups or settings. ConclusionsThe CBCL can aid in the identification of subtypes of emotional dysregulation affecting youth seeking mental health services.

Community Mental Health Clinicians' Perspectives on Telehealth During the COVID-19 Pandemic: Mixed Methods Study.

BackgroundIn March 2020, a rapid shift to telehealth occurred in community mental health settings in response to the need for physical distancing to decrease transmission of the virus causing COVID-19. Whereas treatment delivered over telehealth was previously utilized sparingly in community settings, it quickly became the primary mode of treatment delivery for the vast majority of clinicians, many of whom had little time to prepare for this shift and limited to no experience using telehealth. Little is known about community mental health clinicians’ experiences using telehealth. Although telehealth may make mental health treatment more accessible for some clients, it may create additional barriers for others given the high rates of poverty among individuals seeking treatment from community mental health centers.ObjectiveWe examined community mental health clinicians’ perspectives on using telehealth to deliver trauma-focused cognitive behavioral therapy to youth. We sought to better understand the acceptability of using telehealth, as well as barriers and facilitators to usage.MethodsWe surveyed 45 clinicians across 15 community clinics in Philadelphia. Clinicians rated their satisfaction with telehealth using a quantitative scale and shared their perspectives on telehealth in response to open-ended questions. Therapists’ responses were coded using an open-coding approach wherein coders generated domains, themes, and subthemes.ResultsClinicians rated telehealth relatively positively on the quantitative survey, expressing overall satisfaction with their current use of telehealth during the pandemic, and endorsing telehealth as a helpful mode of connecting with clients. Responses to open-ended questions fell into five domains. Clinicians noted that (1) telehealth affects the content (ie, what is discussed) and process (ie, how it is discussed) of therapy; (2) telehealth alters engagement, retention, and attendance; (3) technology is a crucial component of utilizing telehealth; (4) training, resources, and support are needed to facilitate telehealth usage; and (5) the barriers, facilitators, and level of acceptability of telehealth differ across individual clinicians and clients.ConclusionsFirst, telehealth is likely a better fit for some clients and clinicians than others, and attention should be given to better understanding who is most likely to succeed using this modality. Second, although telehealth increased convenience and accessibility of treatment, clinicians noted that across the board, it was difficult to engage clients (eg, young clients were easily distracted), and further work is needed to identify better telehealth engagement strategies. Third, for many clients, the telehealth modality may actually create an additional barrier to care, as children from families living in poverty may not have the requisite devices or quality broadband connection to make telehealth workable. Better strategies to address disparities in access to and quality of digital technologies are needed to render telehealth an equitable option for all youth seeking mental health services.

Mental Health Status and Its Influencing Factors among College Students during the Epidemic of Coronavirus Disease 2019:A Multi-center Cross-sectional Study

Objective To measure the prevalence of mental health symptoms and identify the associated factors among college students at the beginning of coronavirus disease 2019(COVID-19)outbreak in China. Methods We carried out a multi-center cross-sectional study via snowball sampling and convenience sampling of the college students in different areas of China.The rates of self-reported depression,anxiety,and stress and post-traumatic stress disorder(PTSD)were assessed via the 21-item Depression-Anxiety-Stress Scale(DASS-21)and the 6-item Impact of Event Scale-Revised(IES-6),respectively.Covariates included sociodemographic characteristics,health-related data,and information of the social environment.Data pertaining to mental health service seeking were also collected.Multivariate Logistic regression analyses were performed to identify the risk factors. Results A total of 3641 valid questionnaires were collected from college students.At the beginning of the COVID-19 outbreak,535(14.69%)students had negative emotions,among which 402(11.04%),381(10.49%),and 171(4.90%)students had the symptoms of depression,anxiety,and stress,respectively.Meanwhile,1245(34.19%)college students had PTSD.Among the risk factors identified,male gender was associated with a lower likelihood of reporting depression symptoms(AOR=0.755,P=0.037],and medical students were at higher risk of depression and stress symptoms than liberal arts students(AOR=1.497,P=0.003;AOR=1.494,P=0.045).Family support was associated with lower risks of negative emotions and PTSD in college students(AOR=0.918,P<0.001;AOR=0.913,P<0.001;AOR=0.899,P<0.001;AOR=0.971,P=0.021). Conclusions College students were more sensitive to public health emergencies,and the incidence of negative emotions and PTSD was significantly higher than that before the outbreak of COVID-19.More attention should be paid to female college students who were more likely to develop negative emotions.We should strengthen positive and proper propaganda via mass media and help college students understand the situation and impact of COVID-19.Furthermore,we should enhance family support for college students.The government and relevant agencies need to provide appropriate mental health services to the students under similar circumstances to avoid the deterioration of their mental well-being.

Systemic and Individual Factors That Shape Mental Health Service Usage Among Visible Minority Immigrants and Refugees in Canada: A Scoping Review.

There exists considerable research which reports that mental health disparities persist among visible minority immigrants and refugees within Canada. Accessing mental health care services becomes a concern which contributes to this, as visible minority migrants are regarded as an at-risk group that are clinically underserved. Thus, the purpose of this review is to explore the following research question: "what are the barriers and facilitators for accessing mental health care services among visible immigrants and refugees in Canada?". A scoping review following guidelines proposed by Arksey and O'Malley (International Journal of Social Research Methodology 8(1): 19-32, 2005) was conducted. A total of 45 articles published from 2000 to 2020 were selected through the review process, and data from the retrieved articles was thematically analyzed. Wide range of barriers and facilitators were identified at both the systemic and individual levels. Unique differences rooted within landing and legal statuses were also highlighted within the findings to provide nuance amongst immigrants and refugees. With the main layered identity of being a considered a visible minority, this yielded unique challenges patterned by other identities and statuses. The interplay of structural issues rooted in Canadian health policies and immigration laws coupled with individual factors produce complex barriers and facilitators when seeking mental health services. Through employing a combined and multifaceted approach which address the identified factors, the findings also provide suggestions for mental health care providers, resettlement agencies, policy recommendations, and future directions for research are discussed as actionable points of departure.

Help-Seeking and Services Utilization Among African American Emerging Adults: A Qualitative Study

This qualitative phenomenological study explored the mental health services utilization experiences of African American emerging adults and investigated the barriers and encumbrances interviewees experienced while seeking mental health support. An inductive thematic analysis revealed six themes: (a) hesitancy-acceptance conflict, (b) positive encounters with mental health services utilization, (c) intersectional barriers to seeking mental health services, (d) resource awareness and navigation, (e) help-seeking motivators, and (f) pastoral guidance and counseling. Interviewees emphasized financial factors, services affordability, and resource knowledgeability as prominent barriers to mental health services utilization, denoting familial, peer, and culturally driven faith influences as double-edged motivators and hindrances to help-seeking. Initial implications for community and college human services providers recommend mental health advocacy promotion through increased on-campus services visibility, off-campus resource accessibility, and culturally attuned collaborations.

Loneliness and Isolation as Barriers to Mental Health Services in a Rural Community

As America grapples with COVID-19, issues regarding mental health have been of rising concern, particularly among those who are isolated. According to the May 2021 American Perspectives Survey, “Americans report having fewer close friendships than they once did, talking to their friends less often, and relying less on their friends for personal support1.” Additionally, 49% have three or fewer close friends in 2021, compared to 27% in 1990. 17% have no friends in their core social network. Loneliness has been associated with physical and mental health risks. We sought to explore whether loneliness was also a barrier to seeking mental health services. 90 surveys were collected from rural New York. Respondents were aged 51 to 90, Caucasian (96.6%), and female (73.3% vs, 26.7%). Overall, 34.8% said they lived alone. 29.2% would seek mental health services for feelings of loneliness, while 75.4% would do so if isolated from family. Those who felt detached or isolated from others were significantly less likely to seek help from a counselor (r = - 0.25) or MD (r = - 0.37). Isolation also negatively related to measures on the resiliency scale (Purpose: - 0.22, Perseverance: - 0.33, being ok alone: - 0.32), and positively related to depression (r = .65). Those scoring higher on the “okay with being alone” scale had an increased likelihood of seeking counseling (r = 0.22). Thus, isolation and loneliness are complex topics. Intervention ought to be based on perceptions of being alone. Further research is needed.

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.

"Obligated to Keep Things Under Control": Sociocultural Barriers to Seeking Mental Health Services Among Veterinary Medical Students.

Research reveals veterinary medical students and professionals are at increased risk for mental health problems such as depression, anxiety, and suicidality, yet many individuals in distress do not seek professional mental health services. Although some barriers to accessing services have been identified, other factors, including how professional culture influences service underutilization, are poorly understood. In this study, we used a mixed-methods approach to investigate 573 veterinary students' perceptions of barriers to seeking mental health services and potential mechanisms to lessen them. We identified four barrier themes: stigma, veterinary medical culture and identities, services, and personal factors. Participants' suggestions for reducing barriers to seeking help related to three themes: culture, services, and programmatic factors. We compared perceptions of barriers based on the severity of participants' self-reported symptoms of depression and anxiety and found that participants with severe depression, compared with participants with mild depression, were more likely to perceive barriers related to veterinary medical culture. The results of this study provide a deeper understanding of veterinary students' barriers to seeking mental health services and, in particular, how these barriers, as both individual and sociocultural phenomena, are often interrelated and mutually reinforcing.

Barriers and facilitators to mental health care: A systematic review in Pakistan

It is well documented that there is a shortage of mental health care providers, mental health literacy, and underutilization of mental health services in Pakistan. This systematic review aimed to assess the available evidence on factors hindering and/or facilitating access to care among people with mental health issues, health care providers, carers, or any other population group (e.g., students, teachers) in Pakistan. Thirteen published studies of barriers and facilitators in Pakistan were identified through nine electronic databases: Ovid MEDLINE, Ovid Embase, Ovid Emcare, CINAHL plus, Proquest Central, PsycInfo, Scopus, Pubmed, and ScienceDirect. Thematic analysis revealed that factors facilitating access to mental health services were trust in the effectiveness of mental health services and acknowledging the seriousness of the problem. However, factors hindering the access were financial issues/constraints, personal issues/other priorities, stigma, low mental health knowledge, side-effects/dissatisfaction from previous treatments, time and distance constraints, reliance on traditional/religious healers, and lack of social (i.e., family and peers) support/encouragement. Findings suggest the need for reducing barriers to and enhancing facilitators of seeking mental health services. To improve help-seeking, the focus of strategies should be on enhancing mental health literacy, lowering stigma, and increasing trust in mental health services' effectiveness. Implications of rehabilitation What is known about this topic? There is a scarcity of empirical evidence on mental health and its correlates in Pakistan-a developing country and mental health services are restricted to psychiatry departments of teaching hospitals or in privately run clinics. There is a scarcity of psychiatrists in rural areas having 60% population and there is a need for recognizing facilitators and reducing barriers to reasonable mental health care is crucial. What the paper adds: Factors facilitating access to mental health services were trust in the effectiveness of mental health services and acknowledging the seriousness of the problem. Factors hindering the access were financial issues/constraints, personal issues/other priorities, stigma, low mental health knowledge, side-effects/dissatisfaction from previous treatments, time and distance constraints, reliance on traditional/religious healers, and lack of social (i.e., family and peers) support/encouragement. This recognition can help to design adequate programs and policies for people with mental health issues. There is a need to raise public awareness of the importance of seeking mental health services as well as for designing, testing, and executing strategies to reduce self and social stigma related to mental health problems.

Conversations on Mental Wellness in Vietnamese American Community

Stigma is one of the major barriers to seeking mental health services among Vietnamese Americans. This barrier is even more prominent spanning different cultures and different generations. The present study examines the following hypothesis: when first-generation, immigrant parents are willing to talk about mental health to their second-generation, US-born children, their children are more open to seeking mental health services as adults. An online survey consisting of quantitative and qualitative questions was administered to 63 people. The results suggest that students are more likely to talk to their peers about mental health issues compared to their families. The results indicate that there should be an increase in accessible services for students and educational workshops for parents and faculty to promote understanding and destigmatize mental health and mental illnesses.

Mental health care among marginalized populations in the United States

Mental health care among marginalized populations in the United States

Needs and Experiences of Users of Digital Navigation Tools for Mental Health Treatment and Supportive Services: Survey Study.

BackgroundDespite a recent proliferation in web-based and digital resources that are designed to assist users in finding appropriate mental health treatment and supportive services, it can be overwhelming, confusing, and difficult for an individual or family member to access and use an appropriate navigation tool. As digital resources are increasingly sought after, there is an urgent need for a clearer understanding of digital navigation tools in order to help link individuals with the tool that is best suited to their needs.ObjectiveThe objective of this study was to determine the needs of individuals seeking mental health treatment and supportive services and to quantify their experiences and satisfaction with available digital navigation tools.MethodsA survey was offered via an email newsletter and social media posting throughout the extended membership of the National Alliance on Mental Illness, which includes both individuals with a mental health condition and their family members and support networks. A 13-item anonymous survey, which consisted of multiple-choice and open response options, was developed to measure participants’ past use of and experiences with web-based, mobile, and phone-based navigation tools. The survey was available from April 9 through May 21, 2020.ResultsA total of 478 respondents completed the survey; the majority of respondents were female (397/478, 83.1%) and aged ≥35 years (411/478, 86%). Younger respondents were more likely to report seeking mental health services for themselves, while older respondents were more likely to be searching for such services on behalf of a family member. The majority of respondents seeking such services on behalf of a family member (113/194, 58.2%) required a combination of mental health treatment and supportive services. Furthermore, two-thirds of respondents (322/478, 67.4%) used a navigation tool to find treatment or services. The majority of respondents who provided feedback about their experiences with navigation tools (224/280, 80%) reported difficulties, with data availability and accuracy being the most commonly reported issues.ConclusionsThe survey results suggest that issues with data availability and accuracy in available navigation tools remain a major barrier for locating timely and appropriate mental health treatment and supportive services within the population of individuals seeking such services. Particularly for individuals seeking care on behalf of a family member, improving the accuracy of and users’ experiences with navigation tools could have a major impact on effectively connecting people to treatment and support services.

Military Spouses’ Perceptions of Suicide in the Military Spouse Community

Newly released data from the U.S. Department of Defense shows military spouse suicide to be an imminent concern for the U.S. military. Currently, there is an absence of research in the counseling profession related to suicide prevention and intervention for this population. Therefore, this qualitative phenomenological study explored the perceptions of military spouses regarding suicide within their community. Ten military spouses were interviewed twice and were asked to provide written responses to follow-up questions. Six main themes emerged: (a) loss of control, (b) loss of identity, (c) fear of seeking mental health services, (d) difficulty accessing mental health services, (e) the military spouse community as a protective factor, and (f) desire for better communication about available mental health resources. Implications for practicing counselors and military leadership in helping to prevent military spouse suicide as well as recommendations for future research regarding ways to support military spouse mental health and prevent suicide in this community are included.

The influence of contact with mental health services on carers’ help-seeking attitudes: contribution of stigma and affective state

Background Carers who experience stigma and aversion to help-seeking could have a detrimental impact on consumers of mental health services (MHS). Aim This study aimed to investigate the relationship between carers’ experiences with MHS, stigma, affective state and help-seeking attitudes. Methods Fifty-seven carers of people with a mental illness completed an online survey including demographics about the carer and consumer, carers’ experience with MHS, Days’ mental illness stigma scale, the inventory of attitudes towards seeking mental health services and the depression–happiness scale. Results Carer responses evenly reflected positive and negative experiences with MHS. There were significant correlations between experiences of MHS and stigma, attitudes towards help-seeking, and affective state. Carers who reported negative experiences of MHS demonstrated reduced help-seeking attitudes. Both stigma and affective state independently reduced the association between positive experiences of MHS and more positive help-seeking attitudes. When all three variables were included in the regression model, stigma was the only significant predictor of reduced help-seeking attitudes. Conclusions MHS must establish positive engagement with carers, as this is associated with positive help-seeking attitudes. Negative experiences of MHS exacerbate carer stigma. Positive interactions between MHS and carers likely facilitate better access to care for consumers and improve clinical outcomes.

Mental health literacy: A systematic review of knowledge and beliefs about mental disorders in Malaysia

AbstractBackgroundMental health problems in Malaysia are on a rise. This study aimed at performing a systematic review of mental health literacy (MHL) in Malaysia.MethodsMedline, Embase, ERIC/Proquest, ScienceDirect, Pubmed, PsycINFO, CINAHL, Scopus, EBM Reviews ‐ Cochrane Central Register of Controlled Trials, Ovid Emcare and reference lists of included studies were searched in February 2020. Studies that evaluated at least one of the main components of MHL, including (1) knowledge related to mental health issues, and (2) stigma, were included irrespective of study design. As secondary findings, the review also synthesized results related to facilitators and barriers to seeking mental health services. Depending on the research design, the quality of each study was assessed through checklists.ResultsForty six studies published between 1995 to 2019 were included. Most studies used cross‐sectional designs to investigate MHL. Findings indicate that most Malaysians have stigmatizing attitudes towards mental health problems. Participants in the included studies endorsed multifactorial explanations of mental health issues with a dominance of supernatural and religious aetiologies. Likewise, the commonest barrier was considering sources other than professional sources of mental‐health services. Presence of adequate knowledge and considering providers as competent facilitated help‐seeking. Additionally, there was considerable heterogeneity in studies and a lack of standardized measures assessing MHL.ConclusionsThere is an increase in studies on MHL in Malaysia. A few of these studies, based on experimental design, have shown positive effects. Researchers, practitioners, and policymakers should develop standardized measures and interventional studies based on all the components of MHL.