Factors associated with help-seeking behaviour among individuals with major depression: A systematic review

Abstract

Psychological models can help to understand why many people suffering from major depression do not seek help. Using the ‘Behavioral Model of Health Services Use’, this study systematically reviewed the literature on the characteristics associated with help-seeking behaviour in adults with major depression. Articles were identified by systematically searching the MEDLINE, EMBASE and PsycInfo databases and relevant reference lists. Observational studies investigating the associations between individual or contextual characteristics and professional help-seeking behaviour for emotional problems in adults formally diagnosed with major depression were included. The quality of the included studies was assessed, and factors associated with help-seeking behaviour were qualitatively synthesized. In total, 40 studies based on 26 datasets were included. Several studies investigated predisposing (age (N = 17), gender (N = 16), ethnicity (N = 9), education (N = 11), marital status (N = 12)), enabling (income (N = 12)), need (severity (N = 14), duration (N = 9), number of depressive episodes (N = 6), psychiatric comorbidity (N = 10)) and contextual factors (area (N = 8)). Socio-demographic and need factors appeared to influence help-seeking behaviour. Although existing studies provide insight into the characteristics associated with help seeking for major depression, cohort studies and research on beliefs about, barriers to and perceived need for treatment are lacking. Based on this review, interventions to increase help-seeking behaviour can be designed.

Health care use and treatment-seeking for depression symptoms in rural India: A descriptive cross-sectional analysis

“…Intriguingly, the gender differences often reported in studies from high-income countries were not replicated in this setting, and we found the opposite association between marital status and treatment-seeking that which is typically reported elsewhere (6,7,64). This demonstrates the importance of local data in identifying vulnerable groups for service planning, and provides suggestive evidence that processes believed to inhibit treatment-seeking in other cultural contextssuch as masculine ideals of self-sufficiency (65, 66) -may not apply in the same way to Indian populations.…”

Deliberate self‐harm in older adults: A national analysis of US emergency department visits and follow‐up care

“…Based on 30 days before the emergency department visit.b For mental disorder variables, the reference group consists of treatment episodes without the disorder.Any mental diagnosis recognized during index emergency department visit for deliberate self-harm. Moreover, the only variable associated with lower likelihood of follow-up mental health care was male gender (ARR = 0.82, 99% CI = 0.71-0.94), which is consistent with research demonstrating lower help-seeking behavior in men 66,67. Prior US research shows that roughly 50% of younger ED patients discharged to the community following self-harm proceed to followup on referrals to outpatient mental health services 26,28,62.…”

“…65 Moreover, the only variable associated with lower likelihood of follow-up mental health care was male gender (ARR = 0.82, 99% CI = 0.71-0.94), which is consistent with research demonstrating lower help-seeking behavior in men. 66,67 Because active contact and mental health care following self-harm events reduce repeated selfharm 68,69 and suicide mortality, 10,11 guidelines in the management of self-harm emphasize the importance of rapid referral and outreach to ensure receipt of mental health care. 33,34,[70][71][72] This study has several potential limitations.…”

Positive Emotion Infusions: Can Savoring Increase Help‐Seeking Intentions among People with Depression?

“…For example, Gulliver, Griffiths, and Christensen (2010) conducted a systematic review on barriers to mental health help-seeking and found that among adolescents, factors inhibiting help-seeking included, though are not limited to, perceived stigma, low mental health literacy, and embarrassment. Magaard et al (2017) found that feeling uncomfortable asking for help is associated with lower likelihood for seeking assistance. In addition to these contextual factors, scholars have underscored the importance of considering the cognitive processes of individuals with elevated depressive symptomatology (e.g.…”

“…Although depression is treatable, there is a disparity between the number of individuals who need treatment and the number of individuals who seek treatment; only 20 per cent of individuals with moderate, and 35 per cent of those with severe, depressive symptomatology sought professional help for their symptoms in the year prior to being surveyed (Pratt & Brody, 2014). In addition, men, young adults, elderly persons, and those with lower education status are among the least likely to seek help (Magaard, Seeralan, Schulz, & Br€ utt, 2017). Research that focuses on bridging this gap and identifying additional risk factors is important, as failing to take action and subsequently allowing symptoms to remain untreated for extended periods of time may worsen depressive symptomatology and ultimately result in suicide (WHO, 2016).…”