Avoidance of Counseling: Psychological Factors That Inhibit Seeking Help

Knowledge, Beliefs, and Experiences With Mental Health Services and Help-Seeking in People With Aphasia and Care Partners

PURPOSE

Supporting psychological well-being in persons with aphasia (PWA) can improve social and health outcomes; however, PWA and their care partners (CPs) are often not receiving mental health support. Previous research explores this from the perspective of health care professionals.

AIMS

The aim of this study was to examine knowledge, beliefs, and experiences related to mental health services directly from PWA and CPs.

METHOD

The study included 11 PWA and 11 CPs. Participants completed a guided survey (virtual) with opportunities for elaboration related to the knowledge, beliefs, and experiences of mental health.

RESULTS

There was variability in personal preferences for referrals, types of coping strategies, and confidants for general thoughts and feelings and those specific to aphasia. PWA identified health care professionals as people to share thoughts and feelings, whereas CPs chose family and friends more often. Both CPs and PWA reported communication difficulty and finding a counselor as "sometimes" preventing access to services but cited fear and trust as "always" preventing access.

CONCLUSIONS

Knowledge, beliefs, and experience with help-seeking and mental health services are personal and variable. Assessing barriers unique to living with aphasia, such as communication challenges and locating a suitable counselor, must also be considered within more complex and personal barriers of fear and trust that are consistently reported in the general public. Health professionals across the continuum of aphasia care need to understand the communication challenges of living with aphasia in tandem with understanding individual differences to personalize approaches to mental health services and help-seeking.

Factors Associated with Professional Mental Help-Seeking Among U.S. Immigrants: A Systematic Review

Structural and cultural barriers have led to limited access to and use of mental health services among immigrants in the United States (U.S.). This study provided a systematic review of factors associated with help-seeking attitudes, intentions, and behaviors among immigrants who are living in the U.S. This systematic review was performed using Medline, CINAHL, APA PsycInfo, Global Health, and Web of Science. Qualitative and quantitative studies examining mental help-seeking among immigrants in the U.S. were included. 954 records were identified through a search of databases. After removing duplicates and screening by title and abstract, a total of 104 articles were eligible for full-text review and a total of 19 studies were included. Immigrants are more reluctant to seek help from professional mental health services due to barriers such as stigma, cultural beliefs, lack of English language proficiency, and lack of trust in health care providers.

Barriers to School-Based Mental Health Resource Utilization Among Black Adolescent Males

Black adolescent males use available mental health services at a disproportionately lower rate compared to males of other racial groups. This study examines barriers to school-based mental health resource (SBMHR) use among Black adolescent males, as a means of addressing reduced usage of available mental health resources and to improve these resources to better support their mental health needs. Secondary data for 165 Black adolescent males were used from a mental health needs assessment of two high schools in southeast Michigan. Logistic regression was employed to examine the predictive power of psychosocial (self-reliance, stigma, trust, and negative previous experience) and access barriers (no transportation, lack of time, lack of insurance, and parental restrictions) on SBMHR use, as well as the relationship between depression and SBMHR use. No access barriers were found to be significantly associated with SBMHR use. However, self-reliance and stigma were statistically significant predictors of SBMHR use. Participants who identified self-reliance in addressing their mental health symptoms were 77% less likely to use available mental health resources in their school. However, participants who reported stigma as a barrier to using SBMHR were nearly four times more likely to use available mental health resources; this suggests potential protective factors in schools that can be built into mental health resources to support Black adolescent males' use of SBMHRs. This study serves as an early step in exploring how SBMHRs can better serve the needs of Black adolescent males. It also speaks to potential protective factors that schools provide for Black adolescent males who have stigmatized views of mental health and mental health services. Future studies would benefit from a nationally representative sample allowing for more generalizable results regarding barriers and facilitators to Black adolescent males' use of school-based mental health resources.

The Mediating Role of Stigma, Internalized Shame, and Autonomous Motivation in the Relationship Between Depression, Anxiety, and Psychological Help-Seeking Attitudes in Multiple Sclerosis

BACKGROUND

Depression and anxiety are commonly experienced in individuals with multiple sclerosis (MS) yet little is known about factors associated with psychological help-seeking attitudes in those with MS.

METHOD

The current study investigated whether increased stigma related to chronic illness, internalized shame, and autonomous motivation mediated the relationship between depressive and anxiety symptoms and psychological help-seeking attitudes in individuals with MS. Two hundred fifty-four participants with MS completed an online questionnaire assessing depressive and anxiety symptoms, stigma related to chronic illness, internalized shame, autonomous motivation, and psychological help-seeking attitudes.

RESULTS

Stigma related to chronic illness, internalized shame, and autonomous motivation mediated the relationships between increased depressive symptoms and anxiety symptoms and psychological help-seeking attitudes. The study also found that higher levels of chronic illness-related stigma and internalized shame were associated with more negative psychological help-seeking attitudes and higher autonomous motivation was associated with more positive psychological help-seeking attitudes. There were no direct effects of depressive or anxiety symptoms on psychological help-seeking attitudes.

CONCLUSION

The significant mediating roles of stigma-related chronic illness, internalized shame, and autonomous motivation indicate that these factors may be useful to include in future depression and anxiety intervention studies targeting MS populations.

Counselling challenges associated with donor conception and surrogacy treatments - time for debate

Fertility counselling services have had to respond to significant developments in fertility treatments in recent years, prompting increasingly complex personal and professional ethical challenges. This Commentary focuses on those rising from donor conception and/or surrogacy. The profile of those seeking such treatments has changed to include growing numbers of same sex couples, single people, people who are transitioning or have done, people seeking posthumous use of gametes, and people using cross-border services. Alongside, awareness has grown of life-span implications, the impact of commercial DNA testing, and the need for 'later-life' support. Responses vary internationally and the time for debate is overdue. Who should provide fertility counselling and how? Should specialist qualifications, training, continuing professional development, and regulation be required? Should counsellors play a role in assessing suitability to parents? What aspects of different contractual arrangements and conflicts of interest need attention? Has the time come for counselling to be mandatory as part of pre-treatment pathways? What should be the relationship between fertility counsellors and multi-disciplinary clinic teams? How might fertility counsellors be represented nationally and internationally? What should be their relationship to 'later life' professional support? What place should professional knowledge hold in the evidence base?

Public perception of social workers as a source for providing help during the COVID-19 pandemic

Summary

The current study examined the contribution of select demographic and psychosocial variables, as well as prior experience with social workers (SWs), to explaining the likelihood of seeking their help by the general public in Israel during the COVID-19 pandemic. For the purpose of the study, an online questionnaire was administered to a sample of 582 respondents older than 20.

Findings

The findings show that the respondents reported a fairly low likelihood of seeking help from SWs. Women, those not in a significant relationship, people who had prior experience with SWs, and those reporting higher levels of loneliness, had a higher likelihood of seeking help from SWs. At the same time, no association was found between age, employment status, depression, and anxiety, and the likelihood of seeking help from SWs.

Applications

When dealing with the mental, health, and social consequences of the COVID-19 crisis, it is important to identify groups with a lower likelihood of seeking help from SWs and to actively offer them help. Furthermore, it is important to develop a policy aimed at promoting knowledge of SW roles and reducing barriers to seeking SW help, while attending to the unique needs of diverse population groups.

"Obligated to Keep Things Under Control": Sociocultural Barriers to Seeking Mental Health Services Among Veterinary Medical Students

Research reveals veterinary medical students and professionals are at increased risk for mental health problems such as depression, anxiety, and suicidality, yet many individuals in distress do not seek professional mental health services. Although some barriers to accessing services have been identified, other factors, including how professional culture influences service underutilization, are poorly understood. In this study, we used a mixed-methods approach to investigate 573 veterinary students' perceptions of barriers to seeking mental health services and potential mechanisms to lessen them. We identified four barrier themes: stigma, veterinary medical culture and identities, services, and personal factors. Participants' suggestions for reducing barriers to seeking help related to three themes: culture, services, and programmatic factors. We compared perceptions of barriers based on the severity of participants' self-reported symptoms of depression and anxiety and found that participants with severe depression, compared with participants with mild depression, were more likely to perceive barriers related to veterinary medical culture. The results of this study provide a deeper understanding of veterinary students' barriers to seeking mental health services and, in particular, how these barriers, as both individual and sociocultural phenomena, are often interrelated and mutually reinforcing.

Employment status and bereavement after parental suicide: a population representative cohort study

OBJECTIVES

To examine employment status among adults bereaved by parental suicide at the time of bereavement and 2 and 5 years after the loss and to explore the importance of the gender of the adult child and the deceased parent.

DESIGN

Population-based register study.

SETTING

Norwegian population-based registries linked using unique personal identifiers.

PARTICIPANTS

Norwegian residents aged 25-49 years in the period 2000-2014. Participants were divided into three groups: bereaved by parental suicide, bereaved by parental death of other causes and non-bereaved population controls.

MAIN OUTCOME MEASURES

ORs for the risk of non-employment at the time of bereavement and 2 and 5 years after the loss.

RESULTS

Those bereaved by parental suicide had a higher risk of non-employment already at the time of bereavement (OR 1.14, 95% CI 1.05 to 1.23). Stratified analyses showed that women accounted for this difference (OR 1.20, 95% CI 1.09 to 1.33), while no difference was found for men (OR 1.00, 95% CI 0.88 to 1.13). Looking at the gender of the parent, there was only a significant association of non-employment when losing a mother (OR 1.24, 95% CI 1.08 to 1.42), while not for losing a father (OR 1.09, 95% CI 0.99 to 1.20). Among those working at the time of bereavement, offspring bereaved by suicide were more likely to be non-employed at both 2 (OR 1.13, 95% CI 0.99 to 1.30) and 5 (OR 1.20, 95% CI 1.02 to 1.40) years after the loss compared with the general population.

CONCLUSIONS

Women bereaved by parental suicide and those losing a mother to suicide were found to have a weaker attachment to the labour market already before losing their parent. Those who were employed when bereaved by suicide were somewhat more likely to be non-employed 5 years after the event.

Barriers to Accessing Mental Health Services by Migrant Youth

The purpose of the study was to identify barriers to accessing mental health services by migrant youth in a middle-sized central Canadian city. We asked participants, "What would stop you from talking to someone about mental health stress?". We interviewed 30 youth aged 16 to 22 who migrated from 10 different countries and lived in Canada for an average of 29 months. The data was analyzed using group concept mapping. The participants identified five concepts: fear of being misunderstood or ignored, desire for confidentiality, lack of trust and understanding, talking about it as not appropriate, and fear of the disclosure process. We compare these results with the literature.

An Analysis of the Diversity and Inclusion Content Featured on Ophthalmology Residency Program Web Sites

Introduction Ophthalmology departments have been stated to be among the least diverse clinical departments at United States medical schools. Improvement requires recruiting a pipeline of diverse trainees. Residency program Web sites represent a potential diversity and inclusion recruitment tool. This study assesses how ophthalmology residency program Web sites demonstrate a commitment to diversity and inclusion.

Methods We analyzed the diversity and inclusion content of 116 ophthalmology residency program Web sites in April 2021. Main outcome measures were the presence of 12 diversity and inclusion elements on program Web sites, based on prior work and Accreditation Council for Graduate Medical Education guidelines: nondiscrimination statement, diversity and inclusion message, community resources, extended faculty or resident biographies (including hobbies, etc.), faculty photos, resident photos, additional financial resources for trainees, wellness resources, mental health resources, health disparities/community engagement, and diversity council. We used Mann–Whitney U and Kruskal–Wallis tests to assess whether residency program characteristics such as rank, size, university affiliation, and geographic location were associated with commitment to diversity and inclusion on affiliated residency Web sites.

Results Ophthalmology residency program Web sites included a mean of 4.4 ± 2.1 diversity elements. Sixteen percent of programs featured more than half (7 + ) of the evaluated diversity elements. The most featured common diversity elements included resident photos (85.3%), faculty photos (78.4%), and community resources (64.3%). Extended faculty biographies (2.6%), mental health resources (9.5%), and diversity council information (11.2%) were less commonly showcased. Top-ranked programs (7.6 ± 1.8, p < 0.0001) and university-based/-affiliated programs (4.7 ± 2.8, p = 0.0039) displayed more diversity elements than lower-ranked (4.1 ± 1.8) and community-based programs (2.8 ± 1.7).

Conclusion Most ophthalmology residency program Web sites feature less than half of the 12 diversity and inclusion elements included in this study, suggesting room for improvement. By drawing attention to program diversity and inclusion efforts, Web sites offer a potential tool for residency programs to consider in their recruitment efforts for diverse trainees. Incorporating the diversity and inclusion elements analyzed in this study represents a low-burden way to signal a greater commitment to diversity that could help programs recruit diverse applicants.

Feasibility of Predicting In-Season Mental Health Problems in College Student-Athletes From Pre-season Assessment

OBJECTIVE

To examine whether pre-season assessment using a validated assessment tool, the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF), could predict college student-athletes identified as experiencing in-season mental health (MH) problems.

DESIGN

A prospective study of athletes who completed a pre-season evaluation in August 2018.

SETTING AND PARTICIPANTS

A total of 195 National Collegiate Athletic Association Division 1 student-athletes from a large midwestern university in northeast Ohio.

INDEPENDENT VARIABLE

The MMPI-2-RF, a 338-item self-report measure of constructs relevant to the assessment of psychopathology and personality.

MAIN OUTCOME MEASURE

Mental health problems of student-athletes tracked throughout the competitive season (August 2018-May 2019) by a team of athletic department personnel who met weekly with a licensed clinical psychologist.

RESULTS

In pre-season assessment, 71.8% of athletes clinically elevated at least one MMPI-2-RF scale and underreporting was higher in student-athletes than normative controls. Pre-season levels of internalizing psychopathology, diffuse physical symptoms, and unusual thoughts predicted increased likelihood of experiencing MH problems during the competitive season.

CONCLUSIONS

The current findings suggest that the MMPI-2-RF may be a promising tool for identifying student-athletes at risk for MH concerns.

Short-Term Changes in Internalizing Symptoms and Help-Seeking Attitudes During the Coronavirus Pandemic

Introduction: Existing data suggest that American adults experience added emotional difficulties amid the coronavirus disease outbreak. Psychotherapy can help mitigate mental health concerns; still, many individuals with unmet mental health needs refrain from professional help-seeking. According to theory of reasoned action, negative help-seeking attitudes are key barriers to engagement with mental health services. Given that individuals with severe distress are more likely to seek therapy than individuals with mild psychopathology symptoms, greater initial and increasing levels of internalizing symptoms amid the coronavirus outbreak likely are linked to increasingly favorable attitudes toward professional help-seeking. Method: In the early months of the coronavirus pandemic, American community adults, N = 831 [49.0% Asian Americans], Mage = 46.78, 50.2% women, were recruited for a panel survey study conducted over the course of three weeks. At each time point, participants completed questionnaires to assess their internalizing symptoms associated with depression and anxiety as well as their openness to and perceived value/need in treatment seeking. Results: Very few participants—especially Asian Americans —were seeking counseling during the study period. Latent growth curve results showed a general decline in internalizing symptoms, and no changes in openness to and perceived need in professional help-seeking. Whereas there were no time-varying correlations between internalizing symptoms and help-seeking attitudes, individuals with greater baseline internalizing symptoms generally were more open to seeking professional help and perceived less value in mental health services. Sensitivity analyses showed patterns in the Asian American subsample similar to those in the overall sample. Discussion: Implications for research and clinical practice are discussed.

Knowledge and perceptions of the genetic counseling profession among a national cross-sectional sample of U.S. adults

Awareness of the genetic counseling (GC) profession may influence access to genetic services, yet awareness among the U.S. population is unknown. A survey of U.S. adults was conducted using age- and sex-based quotas. Participants were asked if they had heard of the GC profession and to describe what genetic counselors (GCs) do. After reading a brief description of what GCs do, participants were asked the likelihood they would request to see a genetic counselor if they were concerned about a genetic condition. We used descriptive statistics to characterize the population, logistic regression to determine factors related to awareness of the GC profession, and ordinary least squares regression to identify which factors correlated with likelihood of seeking GC services. Thematic analysis was used to code open-ended responses. Among the final sample of 543, the majority were White individuals (79.7%) with an average age of 46.5 and median income between $60,000 and $69,999. Although 20% indicated they had heard of the GC profession, further analysis of the qualitative follow-up question suggested only 13.4% understood the role of GCs (CI 10.6%-16.3%). Factors positively and significantly correlated with knowledge of the GC profession included identifying as White or female and having higher educational attainment or higher science knowledge after controlling for income, age, and political views. Approximately 45% of respondents indicated they would likely or very likely seek GC if concerned about a genetic condition. Biological sex, age, religious affiliation, science knowledge, and awareness of the GC profession were significantly correlated with likelihood of seeking GC services while controlling for race, income, educational attainment, and political views. Curiosity/interest, the perception of benefits, and trust in GCs were all major themes that emerged to explain reasons for seeking an appointment with GCs. Lack of awareness, lack of perceived benefit, and lack of trust in GCs or greater trust in other healthcare providers were reasons for not wanting a GC appointment. Despite the 50-year existence of the GC profession, awareness remains low and negative attitudes exist.

Factors Associated with Mental Health Help-Seeking Among Asian Americans: a Systematic Review

Objective

Asian Americans are underutilizing mental health services. The aim of the current systematic review was to identify protective and risk factors of mental health help-seeking patterns among the disaggregated Asian Americans and to classify types of help.

Methods

A systematic literature review was conducted using the PRISMA guidelines. The Health Belief Model served as the theoretical framework for this review. Thirty-four articles were reviewed, and the studies investigated one of the following Asian ethnic subgroups: Chinese, Filipino, Asian Indian, Korean, or Vietnamese. Data were extracted based on the study characteristics, sample characteristics, and protective and risk factors to mental health help-seeking patterns.

Results

Predisposing factors like female gender, higher levels of English proficiency, and history of mental illness increased the likelihood for help-seeking across several ethnic groups. Interestingly, cues to action and structural factors were under-examined. However, cues to action like having a positive social network did increase the likelihood of using formal support services among Chinese and Filipinx participants. Structural factors like lacking ethnic concordant providers and access to healthcare served as barriers for Korean and Vietnamese participants.

Discussion

The findings showed a need for ethnic tailored approaches when supporting mental health help-seeking patterns. Asian ethnic group’s immigration status, acculturation level, and psychological barriers to help-seeking should continue to be emphasized. Psychoeducational groups can be beneficial to expand the knowledge base surrounding mental illness and to link group members to culturally responsive resources.

Factors Contributing to Parents' Psychological and Medical Help Seeking During the COVID-19 Global Pandemic

The COVID-19 pandemic and related quarantine orders will impact the mental health of millions of individuals in the United States. Mental health difficulties, including depression, anxiety, traumatic stress, and other negative mental health sequelae are likely and likely to persist. These challenges will require response from the psychotherapeutic and medical community that addresses the mental health needs of the population. Using binary logistic regression (n = 322 at time 1, and n = 189 at time 2), researchers in the present study examined promotive factors related to having sought medical or behavioral health treatment during a 30-day period in the midst of the COVID-19 pandemic in the United States. Approximately 10% of the sample indicated having sought either type of help. Results from the binary logistic regressions indicated those who sought counseling or medical help were those who reported increased depression symptoms at time 1. The likelihood of help seeking was heightened for those who reported greater caregiving burden, highlighting the need to consider the availability of services for those caring for children during this community-wide crisis.

Psychometric properties of the social interaction anxiety scale and the social phobia scale in Hungarian adults and adolescents

BACKGROUND

Although social anxiety disorder is one of the most frequent disorders, it often remained unrecognized. Utilizing brief, yet reliable screening tools, such as the Social Interaction Anxiety Scale (SIAS-6) and the Social Phobia Scale (SPS-6) are helping to solve this problem in parts of Western Europe and the US. Still some countries, like Hungary, lag behind. For this purpose, previous studies call for further evidence on the applicability of the scales in various populations and cultures, as well as the elaborative validity of the short forms. Here, we aimed to provide a thorough analysis of the scales in five studies. We employed item response theory (IRT) to explore the psychometric properties of the SIAS-6 and the SPS-6 in Hungarian adults (n = 3213, age range:19-80) and adolescents (n = 292, age range:14-18).

RESULTS

In both samples, IRT analyses demonstrated that the items of SIAS-6 and SPS-6 had high discriminative power and cover a wide range of the latent trait. Using various subsamples, we showed that (1) the scales had excellent convergent and divergent validity in relation to domains of anxiety, depression, and cognitive emotion regulation in both samples. Further, that (2) the scales discriminated those with a history of fainting or avoidance from those without such history. Lastly, (3) the questionnaires can discriminate people diagnosed with social anxiety disorder (n = 30, age range:13-71) and controls.

CONCLUSIONS

These findings suggest that the questionnaires are suitable for screening for SAD in adults and adolescents. Although the confirmation of the two-factor structure may be indicative of the validity of the "performance only" specifier of SAD in DSM-V, the high correlation between the factors and the similar patter of convergent validity might indicate that it is not a discrete entity but rather a part of SAD; and that SAD is latently continuous.

How are psychotic symptoms and treatment factors affected by religion? A cross-sectional study about religious coping among ultra-Orthodox Jews

Religious coping is prevalent among individuals diagnosed with psychotic disorders, however its clinical relevance has been insufficiently studied. Thirty ultra-Orthodox Jewish patients experiencing current psychotic symptoms and receiving treatment in the inpatient and day-care units were administered measures assessing severity of psychotic symptoms, psychological distress/well-being, beliefs about treatment credibility/expectancy, and aspects of religious belief and coping. Among men, negative religious coping was associated with lower treatment credibility. Among women, positive religious coping was associated with increased treatment expectancy and greater quality of life; and trust in God was associated with reduced psychiatric symptoms and greater treatment expectancy. Study findings indicate that religious factors may promote treatment motivation and engagement, crucial factors for subpopulations facing culturally-based barriers to treatment, as well as boost more favorable outcomes. Sensitivity to religious factors in treatment appears to play an important role in the management of psychotic disorders and should be engaged when culturally appropriate in order to maximize treatment potential.

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

To date, little is known about the concurrent impact of structural and attitudinal factors on help-seeking behaviour for mental health problems. Therefore, this study investigated a longitudinal German community sample of adults with currently untreated mental health problems (N = 188, mean age = 50.34, 70.7% female) regarding perceived structural (e.g. accessibility) as well as attitudinal barriers (e.g. anticipated self-stigma) to help-seeking intentions and behaviour. Overall, perceived accessibility, spatial and temporal distance from mental health services predicted help-seeking. Among attitudinal factors, treatment efficacy beliefs were strongly connected to help-seeking. In addition, among people who knew where to find a psychologist or psychotherapist, anticipated self-stigma emerged as a significant barrier to help-seeking. Therefore, creating positive treatment expectancies and dismantling erroneous perceptions of structural aspects of mental health services hold promise to further close the gap in mental health care utilisation. However, the role of anticipated self-stigma within the help-seeking process requires further research.

Talking About Suicide: Trends in Christian and Socially Conservative Suicide Decedents

This study examined the relationship between religious affiliation, social policy beliefs, and whether individuals spoke with anyone about suicide prior to suicide death. Two hundred sixty-seven suicide loss survivors reported on characteristics of suicide decedents. Binary logistic regressions found those who identified as socially liberal were more likely to have discussed suicide with the loss survivor or to have told someone else they were thinking about attempting suicide than were those who identified as socially conservative. Follow-up analyses indicated Christian affiliation was only associated with a lower likelihood of having discussed suicide with the loss survivor among older men. Results indicated that specific worldviews may serve as obstacles to suicidal individuals discussing their suicidal thoughts prior to death. As such, the findings indicate that public health approaches to suicide prevention that do not rely on open reporting of suicidal ideation may be vital within such communities.

Factors that influence psychiatric help-seeking behavior in Japanese university students

We investigated the periods from symptom onset to the first visit to the psychiatric consultation and the factors that influence psychiatric help-seeking behavior in university students. Students who first visited the psychiatric department of university health care center were the study participants. We surveyed the elicited information such as age, sex, period from symptom onset to the first visit, main symptoms, General Health Questionnaire GHQ-12, and perception of stigma associated with receiving a psychiatric consultation. We analyzed the factors affecting the duration until a psychiatric consultation was made using logistic regression analysis, examining age, sex, contents of the problem, GHQ-12, and stigma as independent variables. Of the participants, 48.2 % did not consult with a psychiatrist for more than 6 months and 51 participants (36.7 %) took more than a year before a consultation. We divided the study participants into two groups: early examinees and delayed examinees. In order to investigate the factors affecting the two groups, logistic regression analysis was performed. Of the independent variables, one consultation content (physical symptoms; odds ratio (OR) = 9.21, 95 % CI (confidence interval) = 2.00-42.62, p = 0.004) and the GHQ-12 (OR = 1.17, 95 % CI = 1.05-1.31, p = 0.005) were significant factors. It became clear that physical symptoms significantly accelerated consultation with psychiatry. When various problems occurred, the decision to seek a psychiatry consultation required a long time. Health education focusing on the values of seeking an early consultation is required so that when students have mental health problems they will seek psychiatric services in a timely manner.

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.

Students' willingness to seek help from school staff when coping with parental maltreatment

BACKGROUND

Many children who suffer parental maltreatment are unknown to welfare authorities and do not receive any treatment or support. Schools, which serve as a key social resource for child protection and welfare enforcement, also fail to identify these students.

OBJECTIVE

The aim of the study was to examine children's willingness to seek help at school for dealing with parental maltreatment and to reveal those factors that enhance students' willingness to seek help at school.

PARTICIPANTS AND SETTING

A national random sample of 859 Israeli students (56 % girls) in 6th-12th grades participated in the study.

METHODS

Using a sequential mixed-methods research design including both surveys and interviews, the study investigated students' willingness to seek help from their homeroom teacher, school counselor, school teachers, and friends when dealing with neglect, abuse, corporal punishment, and psychological aggression.

RESULTS

About half of the students who suffer parental maltreatment never sought help in school. Of those who sought help, about 19 % sought from their friends, and 15 % sought help from the school staff in which school counselors (8.2 %) comprised the most common help resource. Three fundamental factors that explained students' willingness to seek help were revealed: An active helper, positive relationship with the helper, and the importance of confidentiality and trust.

CONCLUSIONS

The findings highlight the role of active efforts by school for enhancing students' willingness to seek help and the need to devote more attention to friends who serve as a strong help resource and as a possible bridge between peers and the educational team.

Attitudes Towards Seeking Psychological Help: An Integrative Model Based on Contact, Essentialist Beliefs About Mental Illness, and Stigma

Based on intergroup contact theory, a proposed comprehensive model of attitudes towards seeking professional psychological help was tested, including both potential barriers to mental health help-seeking (i.e., public stigma and self-stigma of seeking help, prejudicial and essentialist beliefs about mental illness, intergroup anxiety) and potential facilitators (i.e., direct and extended contact with persons with mental illness). Relevant measures were completed by 119 community-dwelling participants. Path analysis showed that direct (but not extended) contact with mental illness, by reducing intergroup anxiety, led to less negative beliefs about mental illness and weaker essentialist beliefs about mental illness (the latter being directly and positively associated with negative beliefs about mental illness). Moreover, less negative beliefs about mental illness, by reducing perceptions of self (but not public) stigma of seeking psychological help, were related to more positive attitudes towards help-seeking. Results are discussed in the context of the (unintentional) adverse effects of biogenetic (essentialist) explanations of mental disorders, and the clinical implications regarding interventions that aim at improving help-seeking attitudes.

Alexithymia and help-seeking attitudes in college-aged students

Aim

This epidemiological study focused on prevalence of the personality trait, alexithymia – the inability to recognize and describe one’s own emotions – among college-aged students.

Method

Levels of normative alexithymia (measured by the NMAS), clinical alexithymia (measured by the TAS), as well as attitudes towards help seeking behavior (measured by the ATSPPH) were assessed.

Results

A total of 547 participants were collected from over 48 colleges and universities, primarily in Western New York. Results indicated that 89.5% of college students displayed moderate to high levels of normative alexithymia and 48.7% displayed moderate to high levels of clinical alexithymia. Additionally, there were no significant differences between the scores of men and women on either alexithymia measure. Significant findings indicated that there was a positive relationship between clinical alexithymia scores and attitudes toward help-seeking.

Conclusion

These results call into question previous literature, which states that there is no correlation between alexithymia and help-seeking behavior (Berger et al., 2005, https://doi.org/10.1037/1524-9220.6.1.73). The results of this study suggest a shift in culture, as well as a need for more research regarding alexithymia.

Perfectionistic traits and self-presentation are associated with negative attitudes and concerns about seeking professional psychological help

Numerous factors influence whether an individual is able and willing to seek professional help for psychological difficulties. One of these may be perfectionism, a multidimensional personality construct that has been linked to poor psychological adjustment. The current study investigated whether perfectionism traits and self-presentational facets were associated with negative help-seeking attitudes and concerns about psychotherapy. Samples of university (N = 299) and community (N = 77) men and women completed the Multidimensional Perfectionism Scale, Perfectionistic Self-Presentation Scale, Attitudes Towards Seeking Professional Help Scale, and Thoughts About Psychotherapy Survey. Various components of perfectionism were associated with both negative help-seeking attitudes and concerns about psychotherapy. The findings suggest that perfectionistic behaviour may be an important dispositional factor that interferes with seeking and obtaining help for psychological difficulties. Theoretical and clinical implications are discussed.

Barriers in Seeking Psychological Help: Public Perception in Pakistan

Mental health services are globally less utilized because of several psychosocial barriers that vary from culture to culture. Regarding Pakistan, a serious knowledge gap existed in this regard. The current study was aimed at exploring the barriers for Pakistanis which stop them from seeking psychological help. The survey involved 3500 participants from 5 cities. The sample was sufficiently rich to be categorized based on gender, age, education, profession and income. Data was gathered through interviews and a self-report questionnaire. Lack of faith in psychological treatment, prior personal experience, religious fatalism, carelessness for mental disorders, social defame, personal shame, bad reputation of mental health practitioners, prohibition by family, and fear of treatment were found to be the barriers in seeking psychological help. To overcome these barriers, the participants of the current study suggested the mental health practitioners of the country to raise awareness on mental health and improve mental health services.

The Unmet Needs of Parents of Highly Dependent Children with Cerebral Palsy

The overall care for children with cerebral palsy (CP) is challenging to the family which causes significant impacts to their livelihood. There is limited qualitative research that reports the unmet needs of parents with physically disabled children, especially highly dependent CP. The aim of this study was to explore the unmet needs of parents of highly dependent children with CP. A qualitative study using semi-structured face to face interviews was carried out among nine parents of children with CP with gross motor classification function score (GMFCS) levels III, IV, and V. The interviews were tape-recorded and transcribed verbatim. Transcribed data was analysed using thematic analysis method. Several unmet needs were highlighted by the parents; namely the needs in receiving information regarding CP conditions, getting psychological and financial support and explaining the child's condition to strangers. In addition, parents expressed the need for better support from the social welfare department, as well as in effectively organising family functioning. The findings of this study indicate that there is a need for the healthcare professionals to develop suitable strategies to assist the parents of highly dependent children with CP in fulfilling their specific needs. The role of relevant agencies should be optimised in addressing this area of concern.

Help-seeking Behavior in Socially Conservative and Christian Suicide Decedents

OBJECTIVE

The purpose of this study was to examine the relationship between religious affiliation, political beliefs, and lifetime mental health help-seeking behavior in a sample of suicide decedents. We hypothesized that Christian decedents would be less likely to have sought help than non-Christians, and socially conservative individuals would be less likely to have sought help than socially liberal or moderate individuals.

METHOD

Smaller samples (N = 147 for political analyses, N = 218 for religion analyses) were drawn from a larger sample of 267 suicide decedents, for whom data were collected from loss survivors.

RESULTS

Logistic regression analyses showed that Christian and non-Christian individuals did not differ significantly in help-seeking behavior prior to death by suicide. Individuals who identified as socially liberal were significantly more likely to have sought mental health care than were individuals who identified as socially conservative.

CONCLUSIONS

This is the first study to examine the association between social conservatism and a lack of help-seeking behavior. These findings show the importance of implementing interventions to increase help-seeking behavior for suicidality within demographic groups that stigmatize help-seeking behavior, specifically socially conservative individuals. They also stress the importance of suicide prevention tactics that do not require disclosing suicidal intent within these groups.

Psychologists' Willingness to Provide Services to Individuals at Risk of Suicide

OBJECTIVE

This study examined psychologists' willingness to accept a new client into their private practice as a function of the client's clinical presentation (with or without overt suicidality). Psychologists' openness to working with a client at risk of suicide was evaluated in the context of potential barriers to treatment provision, such as practitioners' endorsement of stigmatizing attitudes, concerns over liability and inadequate training, and limited access to community resources.

METHOD

Eighty-six licensed psychologists practicing within the United States were surveyed via e-mail and randomly assigned to one of two conditions, consisting of exposure to a vignette describing either a client reporting current suicidal ideation and a history of attempts or a client without explicitly elevated suicide risk. All participants were asked to complete a questionnaire assessing their likelihood of accepting the hypothetical client into their practice and examining possible explanations for disinclination to provide treatment.

RESULTS

Psychologists were less willing to work with a client experiencing suicidality than an individual without elevated suicide risk. Those indicating a reluctance to provide services reported greater concerns over the adequacy of their suicide-related skills and training and fewer resources in the community.

CONCLUSIONS

Recommendations for improving the responsiveness of private practitioners are provided, with an emphasis on enhancing clinical training and increasing the availability and accessibility of mental health resources.

The Big Five Personality Traits as Predictors of Loneliness among Older Men in Israel

Loneliness may have complex implications for the mental and physical health of older people. It could have unique expressions among older men due to the social construction of gender, which raises an expectation that men should be strong, assertive, and capable of independently coping with their difficulties. As a result, older men suffering from loneliness may avoid talking about it and seeking help for this matter. The Big Five personality traits were found to be associated with many life domains, including loneliness, yet this issue has received limited research attention with regard to older adults in general and older men in particular. Therefore, the current study explores the contribution of the Big Five personality traits to understanding loneliness among older men in Israel, while controlling for several demographic factors. The data were collected through structured questionnaires administered to a sample of 392 older men. The results indicate that agreeableness, emotional stability, and openness to experiences were negatively associated with older men's loneliness. In addition, no association was found between extraversion and conscientiousness and respondents' loneliness, and no significant association was found between age and loneliness, and being employed and being in a relationship were associated with lower levels of loneliness. The conclusion is that it is important that professionals working with older men utilize the Big Five personality traits to understand loneliness and offer them interventions for reducing their loneliness. Furthermore, it is essential to promote social awareness of the importance of intimate relationships, as well as of employment, in the old age.

The Association between Sleep Duration and Dizziness in Korean Women: The Korea National Health and Nutrition Examination Survey

BACKGROUND

The aim of this study was to investigate the association between sleep duration and dizziness in a representative Korean population.

METHODS

We analyzed data from the Korea National Health and Nutrition Examination Surveys (2010-2012). A total of 12,499 adults who completed otolaryngologic examinations were evaluated.

RESULTS

Both men and women with severely short sleep duration (≤ 5 hours) and severely long sleep duration (≥ 9 hours) tended to have higher dizziness prevalence. However, the adjusted odds ratio (OR) for sleep duration was only significant in women with dizziness after adjusting for confounders. Compared to that in an optimal sleep group (6-8 hr/day), the OR (95% confidence interval) for dizziness prevalence after adjusting for age and health behaviors (body mass index, smoking habit, alcohol consumption, level of exercise, metabolic syndrome, and tinnitus) was 1.473 (1.194-1.818) for the severely short sleep group (≤ 5 hr/day) and 1.472 (1.078-2.009) for the severely long sleep group (≥ 9 hr/day) only in women.

CONCLUSION

In the Korean population, dizziness was associated with shorter or longer sleep durations only among women. Further epidemiologic and experimental studies are necessary to clarify the impact of dizziness on sleep disorders.

Understanding the factors influencing health professionals' online voluntary behaviors: Evidence from YiXinLi, a Chinese online health community for mental health

BACKGROUND

Normal users' voluntary behaviors (e.g., knowledge sharing) in virtual communities (VCs) has been well investigated; however, research on health professionals' voluntary behaviors in online health communities (OHCs) is limited.

OBJECTIVE

This paper focuses on OHCs for mental health and aims to explore how intrinsic and extrinsic motivations influence mental health service providers' voluntary behaviors.

METHODS

Based on motivation theory and prior studies, we incorporated technical competence as intrinsic motivation and online reputation and economic rewards as extrinsic motivations, and proposed five hypotheses. We crawled objective data from YiXinLi, a Chinese OHC for mental health, and tested the hypotheses based on the Poisson regression model. All hypotheses are supported.

RESULTS

1) Technical competence, online reputation, and economic rewards positively influence mental health service providers' voluntary behaviors; 2) the interaction effect between technical competence and online reputation negatively influences mental health service providers' voluntary behaviors; 3) the interaction effect between technical competence and economic rewards negatively influences mental health service providers' voluntary behaviors.

CONCLUSIONS

Both intrinsic motivations and extrinsic motivations positively influence mental health service providers' voluntary behaviors, and their interaction effects negatively influence mental health service providers' voluntary behaviors. This study first contributes to the literature on health professionals' voluntary behaviors in OHCs by verifying the positive effect of economic rewards. It then contributes to motivation theory by incorporating a situation where intrinsic motivations and extrinsic motivations could negatively interact.

Sociocultural Perceptions and Enablers to Seeking Mental Health Support Among Bhutanese Refugees in Western Massachusetts

This qualitative study aimed to identify cultural influences on seeking mental health support among Bhutanese refugees resettled in Western Massachusetts. Bhutanese refugees aged 18 years or older were recruited for eight focus group discussions, organized by age and gender ( N = 67, 49.3% female, mean age = 38, SD = 15.9). The PEN-3 cultural model was used as the theoretical framework to examine the roles of cultural perceptions that influence mental health-seeking behaviors. Focus group discussions were audio taped to facilitate the thematic-analysis. Younger participants (<35 years) reported experiencing stressors relating to economic hardships and difficulties in developing academic and social skills as they juggle breadwinner and care-giving responsibilities for their families. Older participants reported frustration with the difficulties in learning English and increased dependence on their children. Family members provided the initial frontline support to persons with mental health problems. If family support did not work, they consulted with their relatives and trustworthy community members for further assistance. Psychological factors such as fears of emotions, social norms, beliefs, and self-esteem associated with cultural norms and values influenced seeking mental health support. All participants expressed the need to have a culturally tailored intervention to develop acquired skills to improve their self-esteem and self-efficacy in order to integrate into their new social and cultural environment. Because family members make important decisions about seeking mental health support, involving family members in developing and delivering culturally appropriate skill development interventions could be a potential strategy to reduce their stress and increase resilience in this refugee community.

Self-Reported Likelihood of Seeking Social Worker Help Among Older Men in Israel

The current study assessed the association between demographic factors (age, relationship status, and education), psychosocial factors (self-rated health and self-reported loneliness), and factors related to attitudes and behaviors associated with seeking help (prior experience with social workers, attitudes towards social workers, and the stigma attached to seeking help from social workers, and the self-reported likelihood of seeking social workers' help among older men in Israel. The data were collected through structured questionnaires, administered to a sample of 256 older men. The findings indicated several avoidance factors which might discourage older men from seeking social worker help. Older men who are more educated, experience less loneliness, report lower self-rated health, have no prior experience with social workers, have less positive attitudes towards social workers and higher stigma attached to seeking social workers' help, are less likely to seek social workers' help. The research conclusion is that it is important to develop tools and interventions aimed at helping older men deal with such avoidance factors affecting their tendency to refrain from seeking social worker help, as well as to develop practices adapted to their unique needs.