Mental disorder is common amongst young adults and is associated with many adverse outcomes. Data, however, indicate that young adults are particularly unlikely to seek help for such distress. This paper describes a qualitative study of 23 young adults (aged 16 to 24 years) with mental distress. Interviewing was used to obtain detailed narratives of illness behaviour and to explore reasons for non-help-seeking. Help-seekers and non-help-seekers were interviewed. The findings allowed development of an explanatory model -the cycle of avoidance (COA) -which contributes towards attempts to provide a dynamic understanding of help-seeking behaviour. Dominant approaches tend to be deterministic and static and to account for non-help-seeking in terms of 'barriers' to care, which although easily translated into targets for policy intervention, are superficial representations of complex issues. The COA conceptualises helpseeking as a circular process and offers a model of 'non-help-seeking' in which lay conceptions of mental distress, the social meanings attached to 'help-seeking' and treatment, and the purposeful action of individuals, assume central importance. Although derived in the context of young adulthood and mental distress, this model may have wider applicability as a theoretical template for explaining non-help-seeking in other age groups and conditions, and other illness behaviours.

Recentreports of suicide by young people have highlighted the possible influence of internet sites. Lucy Biddle and colleagues investigate what a web search is likely to find

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The need for schools to support children and young people's mental and emotional health is increasingly emphasised in policy initiatives, yet the role of teachers in this has been under explored. This paper reports findings from qualitative, semi‐structured interviews with 14 school staff at eight secondary schools in England, examining emotional health and well‐being (EHWB) activities in which they were involved. Three emergent themes are discussed: (1) a strongly held belief that teaching and EHWB are inevitably linked; (2) a perception that many colleagues outside the study sample are reluctant to engage in EHWB work; and (3) a concern that teachers’ own emotional health needs are neglected, leaving them unable or unwilling to consider those of pupils. The findings endorse whole‐school approaches to emotional health, with a focus on teachers’ training and support needs and clearer aims, including consideration of how such work fits with the broader goals of schools.

Patients with cancer have a high prevalence of distress. Needs assessment can be performed quickly and inexpensively. However, the DT&PL was not cost effective in improving patient mood states. It is important to explore the reasons for this so that oncology units can design better services to support patients.