A Prospective Study on Structural and Attitudinal Barriers to Professional Help-Seeking for Currently Untreated Mental Health Problems in the Community

Tomczyk, Samuel; Schmidt, Silke; Muehlan, Holger; Stolzenburg, Susanne; Schomerus, Georg

doi:10.1007/s11414-019-09662-8

Cited by 34 publications

(49 citation statements)

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“…Our unique longitudinal study examined the complex associations of various types of stigma (personal, perceived and anticipated), help-seeking intentions, functional deficit and health care utilization in a community sample of persons with mental health problems using structural equation modelling. Contrary to the longitudinal studies with 3- and 6-month follow-ups [ 8 , 26 , 27 ], our follow-up period of 3 years, was sufficiently long to allow for the new emergence of mental health problems and related help-seeking. While in comparison to a study with 11-year follow up of persons with and without mental health problems [ 23 ], our study was still short enough to rule out significant recall bias and significant change in attitudes and did not confuse the interpretation of non-help-seeking by mixing persons with and without mental health problems.…”

Section: Discussionmentioning

confidence: 98%

“…With regard to age, the reported association of older age with help-seeking [ 6 , 7 , 9 ] was not supported by our study, in which the contrary effect, an association with younger age, was found. Other direct effects on help-seeking reported from cross-sectional studies could not be replicated longitudinally, such as the help-seeking reducing effect of perceived and personal stigma [ 3 , 13 , 22 ], which also did not show on the level of bivariate correlations, or the help-seeking increasing effect of earlier help-seeking intentions [ 13 , 23 , 24 ], and of female sex [ 6 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…friends) [ 5 ]. HSmental is predicted by different sociodemographic factors, such as older age [ 6 , 7 ], female sex [ 6 , 8 ], and lack of a current partner [ 9 ]. In addition, former positive help-seeking experiences [ 10 ], and more severe functional impairments [ 9 ], were positively correlated with HSmental.…”

Section: Introductionmentioning

confidence: 99%

“…Most studies on HSmental were conducted only cross-sectionally [ 9 , 12 , 25 ] and frequently investigated only help-seeking intentions rather than actual help-seeking behaviour [ 6 ]. The longitudinal studies on HSmental, and stigma and attitudes have only a short follow-up of 6 months [ 8 , 26 , 27 ], small sample sizes [ 26 ], selected samples [ 28 , 29 ], or, at a large follow-up of 11 years, focussed only on the impact of attitudes toward mental health help-seeking and beliefs about the effectiveness of treatment but not of personal and perceived stigma and low functioning [ 23 ]. Thus, longitudinal studies of sufficient sample size of the impact of stigma and attitudes, and their interaction on actual HSmental are clearly needed.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of help-seeking behaviour in people with mental health problems: a 3-year prospective community study

et al. 2021

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Background The majority of people with mental illness do not seek help at all or only with significant delay. To reduce help-seeking barriers for people with mental illness, it is therefore important to understand factors predicting help-seeking. Thus, we prospectively examined potential predictors of help-seeking behaviour among people with mental health problems (N = 307) over 3 years. Methods Of the participants of a 3-year follow-up of a larger community study (response rate: 66.4%), data of 307 (56.6%) persons with any mental health problems (age-at-baseline: 16–40 years) entered a structural equation model of the influence of help-seeking, stigma, help-seeking attitudes, functional impairments, age and sex at baseline on subsequent help-seeking for mental health problems. Results Functional impairment at baseline was the strongest predictor of follow-up help-seeking in the model. Help-seeking at baseline was the second-strongest predictor of subsequent help-seeking, which was less likely when help-seeking for mental health problems was assumed to be embarrassing. Personal and perceived stigma, and help-seeking intentions had no direct effect on help-seeking. Conclusions With only 22.5% of persons with mental health problems seeking any help for these, there was a clear treatment gap. Functional deficits were the strongest mediator of help-seeking, indicating that help is only sought when mental health problems have become more severe. Earlier help-seeking seemed to be mostly impeded by anticipated stigma towards help-seeking for mental health problems. Thus, factors or beliefs conveying such anticipated stigma should be studied longitudinally in more detail to be able to establish low-threshold services in future.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Predictors of help-seeking behaviour in people with mental health problems: a 3-year prospective community study

et al. 2021

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“…Tomczyk et al. [ 4 ] zeigten in ihrer Studie, dass das Wissen um lokale Versorgungsangebote die vierte Stufe, das tatsächliche Hilfesuchverhalten der Betroffenen, positiv beeinflussen kann. In ihrer Studie gab jedoch lediglich um die Hälfte der Befragten an, zu wissen, wo sie einen professionellen Behandler für psychische Erkrankungen finden können.…”

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Info-Telefon Depression – eine explorative Analyse von Anruferdaten eines bundesweiten Informationsangebots zu depressiven Erkrankungen

et al. 2020

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Service intensity of community mental health outreach among people with untreated mental health problems in Japan: A retrospective cohort study

Iwanaga,

Yamaguchi,

Sato

et al. 2023

PCN Reports

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AimThis study aimed to clarify the association between treatment status (untreated or treated) at the start of community mental health outreach services and service intensity.MethodsThis retrospective cohort study was conducted using the Tokorozawa City mental health outreach service users' data. Treatment status at the start of service (exposure variable) and the service intensity (outcome variables) were taken from clinical records. Poisson regression and linear regression analyses were conducted. The frequency of medical or social service use 12 months after service initiation was also calculated. This study was approved by the Research Ethics Committee at the National Center of Neurology and Psychiatry (No. A2020‐081).ResultsOf 89 people, 37 (42%) were untreated. Family members in the untreated group were more likely to be targets or recipients of services than in the treated group (b = 0.707, p < 0.001, Bonferroni‐adjusted p < 0.001). Compared to the treated group, the untreated group received fewer services themselves (b = −0.290, p = 0.005), and also fewer services by telephone (b = −0.252, p = 0.012); by contrast, they received more services at the health center (b = 0.478, p = 0.031) and for family support (b = 0.720, p = 0.024), but these significant differences disappeared after Bonferroni adjustment. At least 11% of people in the untreated group were hospitalized and 35% were outpatients 12 months after service initiation.ConclusionFamily involvement may be a key service component for untreated people. The service intensity with and without treatment may vary by service location.

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A Prospective Study on Structural and Attitudinal Barriers to Professional Help-Seeking for Currently Untreated Mental Health Problems in the Community

Cited by 34 publications

References 50 publications

Predictors of help-seeking behaviour in people with mental health problems: a 3-year prospective community study

Predictors of help-seeking behaviour in people with mental health problems: a 3-year prospective community study

Info-Telefon Depression – eine explorative Analyse von Anruferdaten eines bundesweiten Informationsangebots zu depressiven Erkrankungen

Service intensity of community mental health outreach among people with untreated mental health problems in Japan: A retrospective cohort study

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