Treatment-seeking Intentions Research Articles

Randomized Controlled Trial Evaluating the Effectiveness of a Direct-to-Consumer Marketing Video About Patients' Right to Evidence-Based Mental Health Care.

This study evaluated the impact of a direct-to-consumer (DTC) marketing video designed to educate the public about patients' rights to evidence-based mental health care (EBMHC). Participants ( N = 632) were randomly assigned to an active DTC video condition, a control video condition, or a control condition without a video. Participants who watched the DTC video ( vs . both control conditions) had significantly greater knowledge of patients' rights to EBMHC. Further, individuals who watched the DTC ( vs . control) video reported significantly greater comfort with accessing care and perceived their assigned video as significantly more culturally sensitive. However, participants who watched the DTC video were not significantly different from both control conditions on self-report measures of self-efficacy in working with a provider, likelihood of asking a provider about one's rights, treatment-seeking intentions, and self-stigma. Findings suggest the potential for a DTC video to promote knowledge of EBMHC, though its impact on help-seeking perceptions and intentions was less promising.

Prevalence, characteristics, and correlates of probable avoidant/restrictive food intake disorder among adult respondents to the National Eating Disorders Association online screen: a cross-sectional study

BackgroundAvoidant/restrictive food intake disorder (ARFID) is a serious, albeit under-researched, feeding or eating disorder. This exploratory study utilized data from adult respondents to the National Eating Disorders Association online eating disorder screen to validate items assessing the presence of ARFID and examine the prevalence, clinical characteristics, and correlates of a positive ARFID screen.MethodsAmong 50,082 adult screen respondents between January 2022 and January 2023, the prevalence of a positive ARFID screen was calculated. Chi-square tests and t-tests compared demographics, eating disorder attitudes and behaviors, suicidal ideation, current eating disorder treatment status, and eating disorder treatment-seeking intentions between respondents with possible ARFID and other eating disorder diagnostic and risk categories. Clinical characteristics of respondents with possible ARFID were also examined.Results2378 (4.7%) adult respondents screened positive for ARFID. Respondents with possible ARFID tended to be younger, male, and have lower household income, and were less likely to be White and more likely to be Hispanic/Latino than most other diagnostic/risk groups. They had lower weight/shape concerns and eating disorder behaviors than most other diagnoses and higher BMI than those with AN. 35% reported suicidal ideation, 47% reported intentions to seek treatment for an eating disorder, and 2% reported currently being in treatment. The most common clinical feature of ARFID was lack of interest in eating (80%), followed by food sensory avoidance (55%) and avoidance of food due to fear of aversive consequences (31%).ConclusionsFindings from this study indicated that ARFID was prevalent among adult screen respondents and more common among individuals who were younger, male, non-White, Hispanic, and lower income relative to those with other eating disorders, at risk for an eating disorder, or at low risk. Individuals with possible ARFID frequently reported suicidal ideation and were rarely in treatment for an eating disorder. Further research is urgently needed to improve advances in the assessment and treatment of ARFID and improve access to care in order to prevent prolonged illness duration.

The relation of food insecurity to eating disorder characteristics and treatment-seeking among adult respondents to the National Eating Disorders Association online screen

BackgroundFood insecurity (FI), characterized by limited or uncertain access to adequate food, has been associated with eating disorders (EDs). This study explored whether FI was associated with ED behaviors, ED diagnosis, current treatment status, and treatment-seeking intentions among adults who completed an online ED screen. MethodsRespondents to the National Eating Disorders Association online screening tool self-reported demographics, FI, height and weight, past 3-month ED behaviors, and current treatment status. Respondents were also asked an optional question about treatment-seeking intentions. Hierarchical regressions evaluated relations between FI and ED behaviors, treatment status, and treatment-seeking intentions. Logistic regressions explored differences in probable ED diagnosis by FI status. ResultsOf 8714 respondents, 25 % screened at risk for FI. FI was associated with greater binge eating (R2Change = 0.006), laxative use (R2Change = 0.001), and presence of dietary restriction (R2Change = 0.001, OR: 1.32) (ps < .05). Having FI was associated with greater odds of screening positive for a probable ED or as high risk for an ED (ps < .05). FI was not associated with current treatment status or treatment-seeking intentions (ps > .05). ConclusionsFindings add to existing literature supporting a relation between FI and EDs. Implications include a need to disseminate EDs screening and treatment resources to populations affected by FI and to tailor treatments to account for barriers caused by FI.

Alcohol and other drug use: A qualitative exploration of staff and patient's experiences of language use as a means of stigma communication in hospital and primary care settings

IntroductionHospital and primary care settings present opportunities to interact, initiate conversations, and instigate referrals for patients experiencing harm from their alcohol and other drug use. Using a stigma communication model, our qualitative study explored whether stigma communication materialized in staff's language in the hospital and primary care settings, and if so, whether this had any impact on staff's and patients' experiences. MethodThe study conducted thematic analysis on 39 semi-structured interviews comprising both male and female adults (n = 20) who had experienced or were currently experiencing problematic alcohol or other drug use; and staff (n = 19) from either alcohol and other drug specialist services, or other broader health care services. ResultsThe study identified three themes where language use materialized as a means of stigma communication: (i) language that positioned a patient as undeserving; (ii) language that separated a patient from other patients; and (iii) language that blamed a patient. Where language use materialized as a means of stigma communication, this appeared to influence staff's decision-making, or potential avoidance of staff's obligations related to health care. Where language use materialized as a means of stigma communication for patients, poor experiences occurred for both staff and patients, that potentially influenced health care provision or future treatment-seeking intentions. ConclusionsThe use of language as a means of stigma communication was present in staff/patient interactions. Although a number of targeted interventions exist that address language and stigma toward people who use alcohol and other drugs, our findings indicate that change may be inhibited if staff do not realize that their own use of language may contribute to the perpetuation of stigma. The findings also suggest that aspects of language that materialize as a means of stigma communication may impact the “no wrong door” approach, which intends that people, regardless of which service they attend, receive appropriate support.

Selfie Videos to Reduce Stigma and Increase Treatment Seeking Among Youths: Two Noninferiority Randomized Controlled Trials.

Confronting stigma early in life could enhance treatment seeking. In two randomized controlled trials (RCTs), one focused on psychosis and the other on adolescent depression, the efficacy and equivalence of brief social contact-based videos were evaluated and compared with a control condition. The outcomes of interest were changes in illness-related stigma and treatment-seeking intention. The hypotheses were that the intervention videos would show greater efficacy than control conditions and that traditional and selfie videos would demonstrate similar efficacy. Young adults (study 1, N=895) and adolescents (study 2, N=637) were randomly assigned to view intervention videos (in traditional or selfie styles) or to a control condition. In short videos (58-102 seconds), young presenters humanized their illness by emotionally describing their struggles and discussing themes of recovery and hope. Repeated-measures analyses of variance and paired t tests showed significant differences in stigma and treatment seeking between the intervention and control groups and similar efficacy of the traditional and selfie videos. Cohen's d effect sizes ranged from 0.31 to 0.76 for changes in stigma from baseline to 30-day follow-up in study 1 and from 0.13 to 0.47 for changes from baseline to postintervention in study 2. The RCTs demonstrated the efficacy of brief videos, both traditional and selfie, in reducing illness-related stigma among young adults and adolescents and in increasing treatment-seeking intention among adolescents. Future studies should explore the effects of brief videos presented by social media influencers on mental health stigma and treatment engagement.

“The peer workers, they get it” – how lived experience expertise strengthens therapeutic alliances and alcohol and other drug treatment-seeking in the hospital setting

Introduction and aims Despite a long history of the adoption of a peer workforce in alcohol and other drug treatment service provision, there is limited peer reviewed literature on the benefits of peer worker role integration in the hospital setting. Our qualitative study explored the perceptions of people with lived experience of problematic alcohol and other drugs use and their experiences of peer worker roles in the hospital setting. Design and methods Twenty semi-structured interviews with people who experienced problematic alcohol and other drug use. Transcripts were thematically analyzed and guided by a broad interest in a therapeutic alliance. Results We identified four themes related to how lived experience expertise within a peer worker role strengthened therapeutic alliances: (i) by building trust and credibility; (i) by building hope; (iii) the ability to approach informally; and (iv) in continuing to be accessible long term. Discussion and conclusion The results partly echo earlier literature, however highlight two innovative aspects that relate to lived experience expertise that maintain therapeutic alliances in the hospital setting being, firstly, the ability to approach informally, and secondly, an opportunity for longer-term engagement. In Australia at present there is a window of opportunity to better integrate peer workers into clinical care models, and as such our results have implications for how policy makers might better approach peer worker integration and configuration to improve treatment-seeking intentions both within and beyond the hospital setting.

Associations between heavy drinker’s alcohol-related social media exposures and personal beliefs and attitudes regarding alcohol treatment

ObjectiveSocial media use among American adults is ubiquitous. Alcohol-related social media posts often glamorize heavy drinking, with increased exposure to such content associated with greater alcohol use. Comparatively less is known, however, about how social media promotes alcohol-related health behavior change. Greater scientific knowledge in this area may enhance our understanding of the relationship between social media and alcohol behaviors, helping to inform clinical and public health recommendations. We examined the relationship between exposure to peer alcohol-related social media posts (pro-drinking, negative consequences, and pro-treatment/recovery) and treatment-seeking intentions among heavy drinkers, as well as potential mediators of the relationship (e.g., attitudes toward treatment effectiveness). MethodHazardous drinking adults (aged 18–55 years) who use social media (N = 499) completed an online questionnaire. Linear regression analysis examined the association between alcohol-related social media exposures and treatment-seeking intentions. Mediation was tested using structural equation modelling ResultsExposure to peer pro-drinking posts was negatively associated with intentions to seek treatment (β = -0.67, p < 0.01), whereas exposures to peer alcohol-related negative consequences posts and peer posts about positive experiences with treatment/recovery were positively associated with treatment-seeking intentions (β = 0.69, p < 0.01; β = 1.23, p < 0.001, respectively). Mediation analysis concluded the effect of exposures on intentions was explained partially by attitudes toward treatment effectiveness (25.5%) and alcohol treatment stigma (6.1%). Conclusions: Findings suggest peers’ alcohol-related social media posts may both promote and hinder health behavior change depending on the nature of the post. Future research that develops and tests social media-delivered interventions to promote treatment and recovery seeking is warranted.

Effect of a Brief Social Contact Video on Transphobia and Depression-Related Stigma Among Adolescents

Transphobia and stigma remain barriers to seeking mental health care for gender-diverse adolescents. To examine the utility of brief social contact-based video interventions of transgender protagonists with depression to reduce transphobia and depression-related stigma and increase treatment-seeking intentions among adolescents in the general population. During August 2021, a total of 1437 participants were recruited and randomly assigned to 1 of 4 video-based conditions in a 2:2:1:1 ratio: (1) transgender adolescent girls, (2) transgender adolescent boys, (3) cisgender adolescent girls, or (4) cisgender adolescent boys. In each of the approximately 110-second videos, an empowered presenter shared their personal story about coping with depression and reaching out for help. The primary outcome was the score on the Attitudes Toward Transgender Men and Women (ATTMW) scale. Secondary outcomes were (1) a "gender thermometer" rating for warmth in transgender perception, (2) the Depression Stigma Scale (DSS) score, and (3) the General Health-Seeking Questionnaire (GHSQ) score. Of the 1437 randomized participants, 1098 (76%) completed the postintervention assessment and passed all the validity tests (mean [SD] age, 16.9 [1.2] years; 481 [44%] male; 640 [58%] White). A significant change in attitudes toward transgender youth was found within the intervention group only (mean [SD] ATTMW scores: intervention group, 34.6 [23.1] at baseline to 32.8 [24.2] after intervention; P < .001; control group, 33.5 [23.4] at baseline to 32.4 [24.1] after intervention; P = .01). The mean (SD) total DSS scores decreased significantly across study groups (intervention: 1.3 [3.3]; control: 1.7 [3.3]; P < .001). A significant increase in intention to seek help from a parent was found in the intervention (mean [SD] GHSQ score, 0.2 [1.1]) and control (mean [SD] GHSQ score, 0.3 [1.2]) groups (P < .001), as was a decrease in those not wanting to seek help from anyone (mean [SD] GHSQ score: intervention, 0.2 [1.6], P = .009; control, 0.3 [1.2], P < .001) Secondary analyses revealed significant differences in baseline ATTMW scores and intervention effects between transgender and gender-diverse and cisgender participants and between lesbian, gay, bisexual, or queer (LGBQ) and straight participants (F = 36.7, P < .001) and heterosexual participants (F = 37.0, P < .001). A significant difference was also found in mean (SD) transgender warmth scores from baseline to after intervention between groups (2.6° [13.1°] in the intervention group vs 0.4° [8.3°] in the control group; P < .001). In this randomized clinical trial, brief social contact-based videos proved efficacious in reducing transphobia and depression-related stigma and in increasing treatment-seeking intentions among adolescents in the general population. By personifying, individualizing, and providing face and voice to the experience of transgender youth, other adolescents, especially those who are cisgender and/or of a heterosexual orientation, can gain empathetic insights into the lives of their often marginalized and stigmatized fellow youth. ClinicalTrials.gov Identifier: NCT04969003.

Seeking treatment for mental illness and substance abuse: A cross-sectional study on attitudes, beliefs, and needs of military personnel with and without mental illness

BackgroundOften, military personnel do not seek treatment for mental illness or wait until they reach a crisis point. Effective, selective, and indicated prevention is best achieved by seeking treatment early. AimsWe aimed to examine military personnel's attitudes, beliefs, and needs around seeking treatment for mental illness. We compared those who sought treatment to those who did not and those with and without the intention to seek treatment. Finally, we examined factors associated with intentions of not seeking treatment. MethodWe conducted a cross-sectional questionnaire study of military personnel with (N = 324) and without (N = 554) mental illness. Descriptive and regression analyses (logistic and ordinal) were performed. ResultsThe majority of the personnel believed treatment was effective (91.6%); however, most preferred to solve their own problems (66.0%). For personnel with mental illness, compared to those who sought treatment, those who did not had a higher preference for self-management and found advice from others less important. For those without mental illness, those with no intention to seek treatment indicated a higher preference for self-management, stigma-related concerns, denial of symptoms, lower belief in treatment effectiveness and found it less important to be an example, compared to those with treatment-seeking intentions. A clear indication of where to seek help was the most reported need (95.7%). Regression analyses indicated that not seeking treatment was most strongly related to preference for self-management (OR(95%CI) = 4.36(2.02–9.39); no intention to seek treatment was most strongly related to a lower belief that treatment is effective (OR(95%CI) = .41(0.28–0.59) and with not having had positive earlier experiences with treatment seeking (OR(95%CI) = .34(0.22–0.52). ConclusionsTo facilitate (early) treatment seeking, interventions should align with a high preference for self-management, mental illness stigma should be targeted, and a clear indication of where to seek treatment is needed.

Chinese Parents' Perceptions, Attitudes, and Treatment-Seeking Intentions Toward Congenital Heart Disease with Charitable Assistance: A Cross-Sectional Study in a Congenital Heart Center in Southern China.

ObjectiveTo investigate the perceptions, attitudes and treatment-seeking intentions of Chinese parents toward charitable assistance for congenital heart disease (CHD).MethodsThis was a cross-sectional study, and different questionnaires were used. Data on Chinese parents’ perceptions, attitudes, and treatment-seeking intentions toward charitable assistance for CHD were collected and analyzed.ResultsA total of 220 parents of children with CHD were included in the survey, and 201 completed the survey. The results showed that the perception rate of charity assistance for CHD was only 44.8%, and the channels of understanding were narrow. The majority of participants (98.0%) approved of charitable assistance. A total of 79.1% of the parents thought that charity assistance would improve their treatment-seeking intentions, and 62.7% of the parents answered that it would affect their medical institutions’ choice. The results also showed that higher treatment-seeking intention was significantly correlated with higher income and charitable assistance but not with the parents’ education level. Correlation analysis found that parents with different monthly incomes and charitable assistance had statistically significant treatment-seeking intentions. Analyzing the factors of surgical treatment in our hospital, it was found that charitable assistance was an essential factor influencing them to choose treatment.ConclusionMany Chinese parents of patients with CHD did not know about charity assistance, but most of them approved the project. Charitable assistance could improve parents’ treatment-seeking intentions.

The Influence of Web-Based Tools on Maternal and Neonatal Outcomes in Pregnant Adolescents or Adolescent Mothers: Mixed Methods Systematic Review.

BackgroundPregnant adolescent women increasingly seek support during pregnancy and the puerperium through digital platforms instead of the traditional support system of family, friends, and the community. However, it is uncertain whether digital, web-based tools are reliable and effective in providing information to the user on a variety of topics such as fetal development, pregnancy outcomes, delivery, and breastfeeding to improve maternal and infant outcomes.ObjectiveWe aimed to identify web-based tools designed to promote knowledge, attitudes, and skills of pregnant adolescents or adolescent mothers and determine the efficacy of such web-based tools compared with conventional resources in promoting good pregnancy and infant outcomes.MethodsA systematic search was conducted using Medline, Scopus, CINAHL, and PsycINFO for articles published from January 2004 to November 2020 to identify randomized trials and observational studies that evaluated digital, web-based platforms to deliver resources to pregnant adolescents. All articles written in the author’s languages were included. Two authors independently reviewed abstracts and full-text articles for inclusion and assessed study quality. Risk of bias in each study was assessed using appropriate tools recommended by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) and the Joanna Briggs Institute. We adopted a qualitative synthesis and presented the results in a narrative format due to the heterogenous nature of the studies.ResultsSeven articles met the inclusion criteria and were analyzed. The majority of the studies were graded to be of low to moderate risk for bias. The research methodologies represented were varied, ranging from randomized (n=1) and nonrandomized controlled trials (n=1) and prospective cohort studies (n=1) to mixed methods studies (n=1) and longitudinal surveys (n=3). Four studies included active web-based interventions, and 3 described exposure to web-based tools, including the use of social media and/or other internet content. Web-based tools positively influenced treatment-seeking intentions (intervention 17.1%, control 11.5%, P=.003) and actual treatment-seeking behavior for depression among postpartum adolescents (intervention 14.1%, control 6.5%, P<.001). In contrast, readily available information on the internet may leave adolescents with increased anxiety. The critical difference lies in information curated by health care professionals specifically to address targeted concerns versus self-acquired data sourced from various websites.ConclusionsDespite almost universal web use, few studies have used this platform for health promotion and disease prevention. Social media interventions or web-based tools have the potential to positively influence both maternal and infant outcomes in adolescent pregnancy, but there is a need for more well-conducted studies to demonstrate the effectiveness of these support programs. The vastness of the information available on the web limits the ability of health care professionals to monitor or control sources of information sought by patients. Thus, it is important to create professionally curated platforms to prevent or limit exposure to potentially misleading or harmful information on the internet while imparting useful knowledge to the user.Trial RegistrationPROSPERO International Prospective Register of Systematic Reviews CRD42020195854; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=195854

Video intervention to increase treatment-seeking by healthcare workers during the COVID-19 pandemic: randomised controlled trial

BackgroundMany healthcare workers do not seek help, despite their enormous stress and greater risk for anxiety, depression and post-traumatic stress disorder (PTSD).AimsThis study screened for psychopathology and evaluated the efficacy of a brief, social contact-based video intervention in increasing treatment-seeking intentions among healthcare workers (trial registration: NCT04497415). We anticipated finding high rates of psychopathology and greater treatment-seeking intentions post-intervention.MethodHealthcare workers (n= 350) were randomised to (a) a brief video-based intervention at day 1, coupled with a booster video at day 14; (b) the video at day 1 only; or (c) a non-intervention control. In the 3 min video, a female nurse described difficulty coping with stress, her anxieties and depression, barriers to care and how therapy helped her. Assessments were conducted pre- and post-intervention and at 14- and 30-day follow-ups.ResultsOf the 350 healthcare workers, 281 (80%) reported probable anxiety, depression and/or PTSD. Participants were principally nurses (n= 237; 68%), physicians (n= 52; 15%) and emergency medical technicians (n= 30; 9%). The brief video-based intervention yielded greater increases in treatment-seeking intentions than the control condition, particularly among participants in the repeat-video group. Exploratory analysis revealed that in both video groups, we found greater effect among nurses than non-nurses.ConclusionsA brief video-based intervention increased treatment-seeking intention, possibly through identification and emotional engagement with the video protagonist. A booster video magnified that effect. This easily disseminated intervention could increase the likelihood of seeking care and offer employers a proactive approach to encourage employees to search for help if needed.

The role of institutional trust in preventive practices and treatment-seeking intention during the coronavirus disease 2019 outbreak among residents in Hubei, China.

BackgroundWe aimed to investigate the association between institution trust and public responses to the coronavirus disease 2019 (COVID-19) outbreak.MethodsAn Internet-based, cross-sectional survey was administered on 29 January 2020. A total of 4393 adults ≥18 y of age and residing or working in the province of Hubei, central China were included in the study.ResultsThe majority of the participants expressed a great degree of trust in the information and preventive instructions provided by the central government compared with the local government. Being under quarantine (adjusted odds ratio [OR] 2.35 [95% confidence interval {CI} 1.80 to 3.08]) and having a high institutional trust score (OR 2.23 [95% CI 1.96 to 2.53]) were both strong and significant determinants of higher preventive practices scores. The majority of study participants (n=3640 [85.7%]) reported that they would seek hospital treatment if they suspected themselves to have been infected with COVID-19. Few of the participants from Wuhan (n=475 [16.6%]) and those participants who were under quarantine (n=550 [13.8%]) expressed an unwillingness to seek hospital treatment.ConclusionsInstitutional trust is an important factor influencing adequate preventive behaviour and seeking formal medical care during an outbreak.

Reducing depression-related stigma and increasing treatment seeking among adolescents: randomized controlled trial of a brief video intervention.

Confronting stigma early in life could enhance receptivity to seeking treatment. We evaluated the efficacy of social contact interventions to reduce stigma toward depression and to enhance treatment-seeking intentions among adolescents. We hypothesized that the brief video-based interventions would be more effective than their matched controls. Using crowdsourcing, we recruited and randomly assigned 1,183 participants aged 14-18 to one of four video-based stimuli on a 4:4:1:1 ratio: (a) adolescent girl with depression; (b) adolescent boy with depression; (c) same girl, without depression; or (d) same boy, without depression. In each of the ~100-second-long videos, two simulated patients (SPs) depicted empowered presenters sharing their personal stories. In the depression conditions, SPs described how social support from family, friends, and professionals helped them overcome their symptoms and recover. We found a significant effect for the Depression Stigma Scale (DSS) between active and control groups (F = 27.4, p < .001). We found a significant increase in treatment-seeking intentions, as measured by the General Help-Seeking Questionnaire (GHSQ; p < .001). Secondary analyses revealed that racial (but not gender) congruence between protagonists and participants resulted in greater stigma reduction and treatment seeking, as compared to racially incongruent pairings (t = 2.9, p = .004). A brief video-based intervention effectively reduced stigma toward depression and increased treatment seeking among adolescents. Favorable changes were greater when race (but not gender) was congruent between protagonists and participants. Future studies should explore how to optimize brief contact-based interventions according to adolescents' race and ethnicity and how to scale such interventions to novel online platforms of dissemination.

Increasing treatment-seeking intentions of US veterans in the Covid-19 era: A randomized controlled trial.

BackgroundVeterans have higher rates of anxiety, depression, and posttraumatic stress disorder (PTSD), and may be vulnerable to mental health consequences of the Covid‐19 pandemic. More than half of veterans who meet mental illness criteria do not seek help. This study screened for clinical symptoms and evaluated the efficacy of a brief, online social‐contact‐based video intervention in increasing treatment‐seeking intentions among veterans. We hypothesized that the video‐based intervention would increase treatment‐seeking intentions more than written vignette and control conditions.MethodsOne hundred seventy‐two veterans were randomized to either a (a) brief video‐based intervention; (b) written vignette intervention, or (c) nonintervention control group. In the 3‐min video, a veteran previously diagnosed with PTSD described his symptom reactivation by Covid‐19, his barriers to care, and how therapy helped him to cope. Assessments were conducted at baseline, postintervention, and at 14‐ and 30‐day follow‐ups.ResultsA total of 91 (53%) veterans reported high levels of clinical symptoms, especially those self‐reporting Covid‐19 exposure. The brief video‐based intervention yielded greater increase in treatment‐seeking intentions among veterans. Within the video group, women showed an increase in treatment‐seeking intentions from baseline to postintervention only, whereas men showed a more sustained effect, from baseline to Day 14.ConclusionsSurveyed veterans reported high symptoms levels. A brief video intervention increased treatment‐seeking intention, likely through identification and emotional engagement with the video protagonist. This easily disseminable video‐based intervention has the potential to increase likelihood of seeking care. Future research should examine longer term sustainability and changes in help‐seeking behavior.

Destigmatizing Mental Health Treatment and Increasing Treatment-Seeking Intentions Among US Essential Workers: Randomized Controlled Trial of Brief-Video Interventions

Destigmatizing Mental Health Treatment and Increasing Treatment-Seeking Intentions Among US Essential Workers: Randomized Controlled Trial of Brief-Video Interventions

Understanding barriers to treatment and treatment delivery preferences for individuals with symptoms of hoarding disorder: A preliminary study

Hoarding Disorder (HD) is a common and debilitating mental health condition that is characterized by low treatment uptake and high drop-out rates. The aim of the present study was to 1) provide a preliminary evaluation of the barriers to psychological help-seeking and 2) understand psychological treatment preferences of individuals with clinically significant symptoms of HD. Fifty participants (82% female; M age = 47.82, SD = 12.92) completed the study. The most frequently cited barriers to treatment were related to cost (66%), self-reliance (58%), and lack of knowledge about treatment options (42%). Likelihood of seeking treatment for HD symptoms was low and past-treatment predicted treatment-seeking intention, while symptom severity, depression, and internalized stigma were non-significant predictors (F(4, 44) = 9.40, p < .001; R2 = 0.49). Participants indicated a preference for individually-administered treatment (41.3%) or remote low intensity treatments (30.4%), over accelerated or group therapy approaches. The study highlights that individuals with HD experience significant barriers to accessing psychological treatment for HD and providing a variety of low cost, evidence-based treatment approaches may enhance treatment uptake for this population.

Psychological distance reduces the effect of internalized stigma on mental health treatment decisions.

Although stigma is a major barrier to treatment for those with mental health concerns, it is poorly understood when stigma is more or less influential in mental health treatment decisions. In the current work, we examined whether psychological distance - the removal of an event from direct experience - reduced the influence of internalized stigma on willingness to seek treatment. Specifically, we tested the hypothesis that psychological distance versus proximity (e.g., seeking treatment in three months vs. in two days, respectively) decreases the negative influence of stigma on willingness to seek treatment. We focused on a population for whom mental health treatment decisions are personally-relevant: individuals who had previously sought mental health treatment. Experiment 1 showed that the extent to which these individuals internalized (i.e., personally endorsed) stigma about mental illness predicted lower intentions to make an appointment with a mental health care provider for themselves (but not another person). Experiment 2 replicated this result using a different measure of psychological distance (temporal distance) and extended this finding to behavior (time spent reading mental health resources). Overall, this research demonstrated that internalized stigma disrupts mental health treatment-seeking intentions and behaviors when they are psychologically proximal, but not when they are distant. Potential applications of these results are discussed.

The Impact of Indigenous Identity and Treatment Seeking Intention on the Stigmatization of Substance Use

Substance use disorders are one of the most stigmatized mental health issues. There is a disproportionate burden of substance use disorders (SUDs) and related harms on Indigenous peoples in Canada. The current study examined the public stigma associated with substance use and how that stigma intersects with Indigenous identity and treatment seeking intention. Participants (N = 711) were randomly assigned to read one of four vignettes depicting a person living with a SUD and then complete an online survey. Vignettes differed on the character’s ethnicity (Caucasian vs. First Nations) and their treatment seeking intention (seeking treatment vs. not seeking treatment). Participants then completed a series of questionnaires to assess stigma, including measures of perceived unpredictability and incompetence, desired social distance, and emotional response. Significant main effects of both ethnicity and treatment seeking were found on all three outcome measures of stigma. Specifically, participants assigned a vignette depicting a First Nations person responded with more stigmatizing attitudes than participants assigned a vignette of a Caucasian person. Additionally, participants assigned a vignette of a person not seeking treatment responded with more stigmatizing attitudes than participants assigned a vignette of a person who sought treatment. These findings highlight the need for future anti-stigma interventions and educational programming for substance use in general and within an Indigenous context. Furthermore, documenting and addressing prejudice towards Indigenous populations is a crucial step in working towards reconciliation.

Reach Out and Recover: Intentions to seek treatment in individuals using online support for eating disorders

The aim of this study was to explore characteristics and treatment-seeking intentions of consumers accessing an online resource for eating disorders support, Reach Out and Recover (ROAR). Factors associated with treatment-seeking intent among visitors to ROAR were also examined. Participants were 200 visitors to the website aged 18 to 60 plus. The majority of participants (93.5%) identified as women. Responses to self-report questions assessing treatment-seeking intention, eating disorder symptoms and their impact on health, and attitudes to treatment were collected. Participants experienced a range of eating disorder symptoms, yet the majority (86.0%) was not receiving treatment. Importantly, of those not in treatment, the majority (82.6%) indicated that they planned to get treatment. In addition, more than half of participants (52.9%) downloaded a report to present to their health practitioner to facilitate communication with a health professional. Intention to seek treatment and download of the report were positively associated with motivation to change, confidence to achieve change, greater frequency of binge eating, and greater recognition of the impact of eating disorder symptoms on relationships and well-being but not with stigma or ambivalence. Study findings indicated that the ROAR website was accessed by individuals for whom it was designed, namely those experiencing eating disorder symptoms who are not receiving treatment. Encouragingly, participants had strong intentions to seek treatment, and the majority downloaded a report that could be used to facilitate the first step toward treatment. Greater focus on enhancing motivation and confidence to change may further promote treatment-seeking.