Gender-related patterns and determinants of recent help-seeking for past-year affective, anxiety and substance use disorders: findings from a national epidemiological survey

Aims.To examine: (1) gender-specific determinants of help-seeking for mental health, including health professional consultation and the use of non-clinical support services and self-management strategies (SS/SM) and; (2) gender differences among individuals with unmet perceived need for care.Method.Analyses focused on 689 males and 1075 females aged 16–85 years who met ICD-10 criteria for a past-year affective, anxiety or substance use disorder in an Australian community-representative survey. Two classifications of help-seeking for mental health in the previous year were created: (1) no health professional consultation or SS/SM, or health professional consultation, or SS/SM only, and; (2) no general practitioner (GP) or mental health professional consultation, or GP only consultation, or mental health professional consultation. Between- and within-gender help-seeking patterns were explored using multinomial logistic regression models. Characteristics of males and females with unmet perceived need for care were compared using chi-square tests.Results.Males with mental or substance use disorders had relatively lower odds than females of any health professional consultation (adjusted odds ratio [AOR] = 0.46), use of SS/SM only (AOR = 0.59), and GP only consultation (AOR = 0.29). Notably, males with severe disorders had substantially lower odds than females of any health professional consultation (AOR = 0.29) and GP only consultation (AOR = 0.14). Most correlates of help-seeking were need-related. Many applied to both genders (e.g., severity, disability, psychiatric comorbidity), although some were male-specific (e.g., past-year reaction to a traumatic event) or female-specific (e.g., past-year affective disorder). Certain enabling and predisposing factors increased the probability of health professional consultation for both genders (age 30+ years) or for males (unmarried, single parenthood, reliance on government pension). Males with unmet perceived need for care were more likely to have experienced a substance use disorder and to want medicine or tablets or social intervention, whereas their females peers were more likely to have experienced an anxiety disorder and to want counselling or talking therapy. For both genders, attitudinal/knowledge barriers to receiving the types of help wanted (e.g., not knowing where to get help) were more commonly reported than structural barriers (e.g., cost).Conclusions.Findings suggest a need to address barriers to help-seeking in males with severe disorders, and promote GP consultation. Exploring gender-specific attitudinal/knowledge barriers to receiving help, and the types of help wanted, may assist in designing interventions to increase consultation. Mental health promotion/education efforts could incorporate information about the content and benefits of evidence-based treatments and encourage males to participate in other potentially beneficial actions (e.g., physical activity).

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Enhancing help-seeking behaviour among men who have sex with men at risk for sexually transmitted infections: the syn.bas.in randomised controlled trial

Sexually Transmitted Infections ◽

10.1136/sextrans-2020-054438 ◽

2020 ◽

pp. sextrans-2020-054438 ◽

Cited By ~ 1

Author(s):

Roeland Christiaan Alfons Achterbergh ◽

Martijn S van Rooijen ◽

Wim van den Brink ◽

Anders Boyd ◽

Henry John Christiaan de Vries

Keyword(s):

Mental Health ◽

Substance Use ◽

Randomised Controlled Trial ◽

Help Seeking ◽

Controlled Trial ◽

Risk Behaviour ◽

Control Group ◽

Help Seeking Behaviour ◽

Sex With Men ◽

Randomised Controlled

ObjectivesMen who have sex with men (MSM) are at increased risk for STIs and mental disorders. Syndemic theory holds that psychosocial issues co-occur and interact, and thus increase sexual risk behaviour. Psychosocial issue identification, referral and management might reduce risk behaviour.MethodsIn the syndemic-based intervention study, an open-label randomised controlled trial, MSM were enrolled at the STI outpatient clinic of the Public Health Service of Amsterdam. We screened participants using validated questionnaires on the following problem domains: alcohol and substance use, sexual compulsivity, anxiety, depression, attention deficit hyperactivity disorder, alexithymia, intimate partner violence and childhood sexual abuse. Individuals were randomly assigned (1:1) to receive either tailored, face-to-face feedback and help-seeking advice on mental health screening, or no feedback and no help-seeking advice. Participants were followed trimonthly for a year. The primary outcomes were self-reported and confirmed help-seeking behaviour.ResultsWe included 155 MSM: 76 in the intervention group and 79 in the control group. At inclusion, 128 participants (83.1%) scored positive in at least one problem domain. We found no significant differences in self-reported or confirmed help-seeking behaviour between the intervention and the control group: 41% vs 29% (p=0.14) and 28% vs 22% (p=0.44), respectively. There were also no differences in STI incidence and condomless anal sex acts between the two groups.ConclusionScreening showed high prevalence of problems related to mental health and substance use, while tailored feedback, advice and referral did not significantly increase help-seeking behaviour. Other interventions are needed to tackle the high burden of mental disorders among MSM.Trial registration numberNCT02859935.

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Individuals with currently untreated mental illness: causal beliefs and readiness to seek help

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796017000828 ◽

2018 ◽

Vol 28 (04) ◽

pp. 446-457 ◽

Cited By ~ 11

Author(s):

S. Stolzenburg ◽

S. Freitag ◽

S. Evans-Lacko ◽

S. Speerforck ◽

S. Schmidt ◽

...

Keyword(s):

Mental Health ◽

Mental Illness ◽

Childhood Trauma ◽

Mental Health Treatment ◽

Help Seeking ◽

Causal Beliefs ◽

Professional Help ◽

Health Treatment ◽

Causal Explanations ◽

Perceived Need

Aims.Many people with mental illness do not seek professional help. Beliefs about the causes of their current health problem seem relevant for initiating treatment. Our aim was to find out to what extent the perceived causes of current untreated mental health problems determine whether a person considers herself/himself as having a mental illness, perceives need for professional help and plans to seek help in the near future.Methods.In a cross-sectional study, we examined 207 untreated persons with a depressive syndrome, all fulfilling criteria for a current mental illness as confirmed with a structured diagnostic interview (Mini International Neuropsychiatric Interview). The sample was recruited in the community using adverts, flyers and social media. We elicited causal explanations for the present problem, depression literacy, self-identification as having a mental illness, perceived need for professional help, help-seeking intentions, severity of depressive symptoms (Patient Health Questionnaire – Depression), and whether respondents had previously sought mental healthcare.Results.Most participants fulfilled diagnostic criteria for a mood disorder (n = 181, 87.4%) and/or neurotic, stress-related and somatoform disorders (n = 120, 58.0%) according to the ICD-10. N = 94 (45.4%) participants had never received mental health treatment previously. Exploratory factor analysis of a list of 25 different causal explanations resulted in five factors: biomedical causes, person-related causes, childhood trauma, current stress and unhealthy behaviour. Attributing the present problem to biomedical causes, person-related causes, childhood trauma and stress were all associated with stronger self-identification as having a mental illness. In persons who had never received mental health treatment previously, attribution to biomedical causes was related to greater perceived need and stronger help-seeking intentions. In those with treatment experience, lower attribution to person-related causes and stress were related to greater perceived need for professional help.Conclusions.While several causal explanations are associated with self-identification as having a mental illness, only biomedical attributions seem to be related to increase perceived need and help-seeking intentions, especially in individuals with no treatment experiences. Longitudinal studies investigating causal beliefs and help-seeking are needed to find out how causal attributions guide help-seeking behaviour. From this study it seems possible that portraying professional mental health treatment as not being restricted to biomedical problems would contribute to closing the treatment gap for mental disorders.

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Depression, Substance Use and Suicidality in Help-Seeking Adolescents: A Survey of Prevalence

Australian Journal of Guidance and Counselling ◽

10.1017/s1037291100002478 ◽

2004 ◽

Vol 14 (2) ◽

pp. 162-175 ◽

Cited By ~ 5

Author(s):

Elizabeth Cosgrave ◽

Eóin Killackey ◽

Alison Yung ◽

Joe Buckby ◽

Katherine Godfrey ◽

...

Keyword(s):

Mental Health ◽

Substance Use ◽

Depressive Symptoms ◽

Substance Use Disorders ◽

Psychiatric Diagnosis ◽

Help Seeking ◽

Mental Health Problems ◽

Common Mental Disorders ◽

School Setting ◽

Public Mental Health

AbstractMental health problems affect a sizeable minority of Australian adolescents. Depression and substance use disorders are common mental disorders reported in this age group. Difficulties of this nature that manifest in adolescence will often continue into adulthood. This report describes a sample of adolescents referred to a public mental health service with respect to their psychiatric diagnoses, depressive symptoms, patterns of substance use and level of suicidality. Mood disorders and substance-use disorders were both prevalent in the sample of participants, with sizeable comorbidity reflected in the number ol participants meeting criteria for both of these diagnoses. Data revealed participants with a psychiatric diagnosis were significantly more likely to have made a suicide attempt than those with no diagnosis. High levels of depressive symptoms were associated with suicidality, illicit substance use, and the likelihood of having a psychiatric diagnosis. Heavy use of alcohol was prevalent in this group, but unrelated to the other variables of interest to the study. These results are discussed with respect to the importance of early detection of vulnerable students in a school setting.

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Help Seeking and Perceived Need for Mental Health Care Among Individuals in Canada With Suicidal Behaviors

Psychiatric Services ◽

10.1176/ps.2009.60.7.943 ◽

2009 ◽

Vol 60 (7) ◽

pp. 943-949 ◽

Cited By ~ 41

Author(s):

Jina Pagura ◽

Sarah Fotti ◽

Laurence Y. Katz ◽

Jitender Sareen

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Help Seeking ◽

Suicidal Behaviors ◽

Perceived Need

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Differences between the Canadian military’s Regular and Reserve Forces in perceived need for care, mental health services use and perceived sufficiency of care: a cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2018-028849 ◽

2019 ◽

Vol 9 (9) ◽

pp. e028849

Author(s):

David Boulos ◽

Deniz Fikretoglu

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Armed Forces ◽

Need For Care ◽

Health Services Use ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Perceived Need ◽

Service Category

ObjectiveThe primary objective was to explore differences in perceived need for care (PNC), mental health services use (MHSU) and perceived sufficiency of care (PSC) between Canadian Armed Forces Regular Force (RegF) and Reserve Force (ResF) personnel with an objective need for mental health services.DesignData came from the 2013 Canadian Armed Forces Mental Health Survey, a cross-sectional survey of serving personnel (n=72 629). Analyses were among those with an Afghanistan deployment and an identified mental disorder (population n=6160; sampled n=868). Logistic regression compared PNC, MHSU and PSC between RegF and ResF. Covariate-adjusted marginal prevalence difference estimates were computed.Primary outcome measureThe primary outcomes were PNC, MHSU and PSC. Each had three service categories, including an aggregate ‘any’ of the three: (1) information about problems, treatments or services; (2) medication and (3) counselling.ResultsResF had an 10.5% (95% CI −16.7% to −4.4%) lower perceived need for medication services but PNC differences were not significant for other service categories. MHSU tended to be lower for ResF; 9.1% (95%CI −15.5% to −2.6%) lower for medication, 5.4% (95% CI −11.5% to 0.7%) lower, with marginal significance, for counselling and 11.3% (95% CI −17.3% to −5.2%) lower for the ‘any’ service category. Additionally, ResF tended to have a lower fully met need for care; 13.4% (95% CI −22.1% to −4.6%) lower for information, 15.3% (95% CI −22.9% to −7.6%) lower for counselling and 14.6% (95% CI −22.4% to −6.8%) lower for the ‘any’ service category.ConclusionsOur findings suggest MHSU and PSC differences between Canadian RegF and ResF personnel that are not fully accounted for by PNC differences. Deficits in ResF members’ perceptions of the sufficiency of information services and counselling services suggest perceived, or experienced, barriers to care beyond any PNC barriers. Additional research assessing barriers to mental healthcare is warranted.

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An Examination of the Roles of Mental Health Literacy, Treatment-Seeking Stigma, and Perceived Need for Care in Female Veterans’ Service Use

Psychiatric Services ◽

10.1176/appi.ps.201800405 ◽

2020 ◽

Vol 71 (2) ◽

pp. 144-150 ◽

Cited By ~ 1

Author(s):

Sarah Krill Williston ◽

Emily A. Bramande ◽

Dawne S. Vogt ◽

Katherine M. Iverson ◽

Annie B. Fox

Keyword(s):

Mental Health ◽

Health Literacy ◽

Mental Health Literacy ◽

Service Use ◽

Treatment Seeking ◽

Female Veterans ◽

Need For Care ◽

Perceived Need

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Perceived Need for Mental Health Treatment in a Nationally Representative Canadian Sample

The Canadian Journal of Psychiatry ◽

10.1177/070674370505001011 ◽

2005 ◽

Vol 50 (10) ◽

pp. 643-651 ◽

Cited By ~ 41

Author(s):

Jitender Sareen ◽

Brian J Cox ◽

Tracie O Afifi ◽

Ian Clara ◽

Bo Nancy Yu

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Mental Health Treatment ◽

Help Seeking ◽

Social Supports ◽

Health Treatment ◽

Perceived Need ◽

The Past ◽

Dsm Iv

Objective: The optimal method of determining how many people in the general population need help for emotional problems remains unclear. This study aimed to examine the prevalence and correlates of self-perceived need for mental health services (that is, help seeking and perceived need) in a large, population-based sample. Methods: Data came from the Canadian Community Health Survey 1.2 ( n = 36 816, respondent age 15 years and over, and response rate 77%). Respondents were asked whether they had sought help in the past year from any professional for emotional problems and whether they felt they needed help for emotional symptoms but had not sought treatment. The Composite International Diagnostic Interview (CIDI) was used to make DSM-IV mental disorder diagnoses. Results: The past-year prevalences of help seeking and perceived need were 8.7% and 2.9%, respectively. After adjusting for the presence of DSM-IV disorders assessed in the survey, sociodemographic factors, illness severity, social supports, and the presence of physical health conditions were associated with help seeking and perceived need. Independent of DSM diagnoses, sociodemographics, and social supports, perceived need and help seeking were associated with increased levels of distress, disability, and suicidal ideation and attempts. Conclusions: This study illustrates that, in addition to the presence of a DSM diagnosis, the respondent's self-perceived need for mental health treatment is important in the assessment of need for mental health services in the community.

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