An examination of help-seeking preferences via best-worst scaling

A Reasoned Action Approach to Social Connection and Mental Health: Racial Group Differences and Similarities in Attitudes, Norms, and Intentions

This study employed a Reasoned Action Approach to investigate two communication behaviors that were being built into a statewide behavioral health campaign: initiating a conversation about one's own mental health struggles, and starting a conversation to discuss someone else's mental health difficulties. We examined whether the extent of attitudes, perceived norms, and perceived behavioral control regarding intent to perform these behaviors varied by racial identity. Using original survey data from Texans (N = 2,033), we conducted regression analyses for the two communication behaviors and found that intention to seek help was primarily explained by instrumental attitude, injunctive norm, descriptive norm, and perceived capacity; and intention to start a conversation to help someone else was primarily explained by instrumental attitude, injunctive norm, and perceived capacity. Additionally, we identified important common and distinct determinants of the two behaviors across different racial groups. Implications for health communication campaign message development and audience segmentation are discussed.

Help-Seeking Preferences and Influencing Factors Among Chinese Nurses Exposed to COVID-19: A Person-Centered Approach

PURPOSE

This study aimed to explore help-seeking preference categories and crucial influencing factors among community nurses exposed to COVID-19 in China using a new person-centered approach.

DESIGN

A cross-sectional design including an online self-reported questionnaire survey was used.

METHODS

A total of 667 nurses who participated in COVID-19 prevention and control work were recruited. Latent class analysis and logistic regression were used to analyze the data using Mplus and SPSS.

FINDINGS

Two latent classes of help-seeking preferences were identified: high help-seeking preferences (33.58%) and low help-seeking preferences (66.42%). Most sampled nurses had relatively low help-seeking preferences when facing psychological threats during COVID-19. Logistic regression showed that career duration, perceived social support, online help-seeking intention, and social media exposure negatively affected low help-seeking preferences.

CONCLUSIONS

Career duration, perceived social support, online help-seeking intention, and social media exposure could be key factors influencing help-seeking preferences among Chinese nurses exposed to public emergencies. It is necessary to implement relevant intervention measures, such as focusing on nurses whose career durations are shorter, improving nurses' perceived social support, strengthening positive media publicity, and developing comprehensive online mental health services that promote nurses' help-seeking preferences and behaviors to reduce mental illness during public health emergencies.

CLINICAL EVIDENCE

Help-seeking preferences are relatively low among Chinese nurses during public emergencies. Based on the major influencing factors of help-seeking preferences, including social support and social media exposure, more interventions must be developed for prompting psychological help-seeking intentions among Chinese nurses.

Chinese university students' help-seeking behaviors when faced with mental health challenges

BACKGROUND

Mental illnesses and mental health challenges have become increasingly pervasive among Chinese university students. However, the utilization rate of mental health services is low among students.

AIMS

We aimed to explore Chinese university students' help-seeking behaviors to understand how they deal with mental health challenges and use the results to inform the development of effective mental health promotion initiatives.

METHODS

In this study, we conducted 13 focus group interviews with students in six universities in Jinan, China, including 91 (62%) female students and 56 (38%) male students. We drew on the Theory of Planned Behaviors to guide our thematic analysis to gain a contextual understanding of participants' accounts on help-seeking.

RESULTS

Our results have depicted the help-seeking patterns of Chinese university students and show that there are four major behaviors which are self-reliance, seeking support from peers and families, seeking professional support, and accessing virtual mental health care.

CONCLUSION

Results from this study can be used to inform the development of mental health literacy programming for students in universities that share similar contexts, and the study has also opened up a new space for using qualitative approaches to study mental health needs and access to care in diverse populations.

Measuring Mental Health Service Preferences Amongst Illinois Dairy Producers

OBJECTIVES

To mitigate mental health concerns of farmers, research is needed to investigate strategies that encourage help-seeking behavior in this population. This study attempts to identify those help-seeking strategies. Six mental health service options were examined.

METHODS

A survey, implementing a best-worst scaling choice experiment, was disseminated to members of the Illinois Milk Producers Association. Two methods of analysis were conducted. The first, a count-based method, employs a simple count-based approach to measure the relative preferences for the six mental health service options in question. The second is more complex and employs a latent-class logit regression model to measure individual preferences.

RESULTS

The mental-health service options, ranked in order from most preferred to least preferred were: 1) speak to family and friends, 2) keep it to myself, 3) utilize programs offered by agricultural organizations, 4) search online for self-help resources, 5) talk to a mental health professional, and 6) use "tele-health" support services.

CONCLUSION

This study examined an important gap in the literature concerning help-seeking preferences of dairy farmers. It is the first to utilize a choice experiment approach to assess help-seeking preferences among this understudied population. Results provide important empirical evidence to support distinct categories of farmers who may be weighing options regarding how to best address their mental health concerns.

Beliefs and Attitudes Held Toward Sex Therapy and Sex Therapists

There is a growing recognition that sexual problems can adversely impact health, well-being, and quality of life. Sex therapy provides individuals with an effective means of understanding, improving, and resolving their sexual difficulties. Yet, few individuals access a sex therapist when experiencing sexual difficulties and research on perceptions toward this service remains limited. The current study aimed to explore attitudes and beliefs held by a sample with a current or previous history of sexual problems toward sex therapy and therapists. A total of 27 individuals aged 19-53 participated in unmoderated structured interviews that were analyzed using reflexive thematic analysis. The results were organized into five categories, (1) overall perceptions of sex therapy, (2) when and for whom is sex therapy, (3) expectations, (4) beliefs about sex therapists, and (5) sources of beliefs. While the results indicated that participants held positive attitudes toward the service and about others seeking sex therapy, none had accessed sex therapy for their previous or current sexual problems. Numerous barriers relating to stigma, cost, and accessibility appeared to hinder the utilization of the service. The inaccurate and unrealistic beliefs about sex therapy and sex therapists highlight the need for increased education regarding the profession, which could reduce barriers and increase accessibility.

Efficacy of contact intervention videos on college students' intentions toward mental health help-seeking

ObjectiveUntreated mental health (MH) concerns have significant implications for college students. This study examined the efficacy of a video contact intervention targeting students' intentions to seek counseling. Participants: One-hundred and sixty-three college students (M^age = 21.05, SD = 2.20) from a Mid-Atlantic university participated. The sample was predominantly female (74%). Method: Students were randomly assigned to view a student-targeted contact video (ie, clips from college students who share their mental health experiences), a MH comparison contact video, or a non-MH comparison video. Intentions to seek counseling and psychological distress were measured pretest and post-test. Results: Intentions to seek counseling significantly increased from pretest to post-test in the student-targeted contact video condition (F[1, 156] = 22.75, p < .001, partial η² = .13), but not in the comparison conditions. Further, this effect was only observed among participants who reported preexisting psychological distress (F[1, 153] = 28.00, p < .001, partial η² = .16). Conclusions: This study provides initial support for the utility of a student-targeted contact intervention video for increasing help-seeking intentions among those reporting current psychological distress.

Peer-Presented Versus Mental Health Service Provider-Presented Mental Health Outreach Programs for University Students: Randomized Controlled Trial

BACKGROUND

University students are reporting concerning levels of mental health distress and challenges. University mental health service provider initiatives have been shown to be effective in supporting students' mental health, but these services are often resource-intensive. Consequently, new approaches to service delivery, such as web-based and peer support initiatives, have emerged as cost-effective and efficient approaches to support university students. However, these approaches have not been sufficiently evaluated for effectiveness or acceptability in university student populations.

OBJECTIVE

Thus, the overarching goal of this study was to evaluate a mental health service provider-presented versus peer-presented web-based mental health resilience-building video outreach program against a wait-list comparison group.

METHODS

Participants were 217 undergraduate students (mean age 20.44, SD 1.98 years; 171/217, 78.8% women) who were randomly assigned to one of the intervention groups (mental health service provider-presented: 69/217, 31.8%; peer-presented: 73/217, 33.6%) or the wait-list comparison group (75/217, 34.6%). Participants in the intervention groups were asked to watch 3 brief skill-building videos addressing strategies for building mental health resilience, whereas the comparison group was wait-listed. The mental health service provider-presented and peer-presented video series were identical in content, with presenters using a script to ensure consistency across delivery methods, but the videos differed in that they were either presented by mental health service providers or university students (peers). All participants were asked to complete web-based self-report measures of stress, coping self-efficacy, social support, social connectedness, mindfulness, and quality of life at baseline (time 1), 6 weeks later (time 2, after the intervention), and 1-month follow-up (time 3).

RESULTS

Results from a series of 2-way ANOVAs found no significant differences in outcomes among any of the 3 groups. Surprisingly, a main effect of time revealed that all students improved on several well-being outcomes. In addition, results for program satisfaction revealed that both the mental health service provider-presented and peer-presented programs were rated very highly and at comparable levels.

CONCLUSIONS

Thus, findings suggest that a web-based mental health resilience-building video outreach program may be acceptable for university students regardless of it being mental health service provider-presented or peer-presented. Furthermore, the overall increases in well-being across groups, which coincided with the onset and early weeks of the COVID-19 pandemic, suggest an unexpected pattern of response among university students to the early period of the pandemic. Limitations and barriers as well as research implications are discussed.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05454592; https://clinicaltrials.gov/ct2/show/NCT05454592.

Influence of Adult Attachment on COVID-19 Vaccination Intention: The Mediating Roles of Help-Seeking Style and Professional Help-Seeking Behavior

Vaccination against COVID-19 is regarded as one of the most promising interventions to control the pandemic. This study aimed to examine whether adult attachment affects an individual’s COVID-19 vaccination intention and whether this relationship is mediated by help-seeking style and professional help-seeking behavior. A total of 401 Chinese adults participated in this online cross-sectional survey. The questionnaires for adult attachment (Depend, Close, and Anxiety), help-seeking style (dependency, autonomy, and avoidance), professional help-seeking behavior, and COVID-19 vaccination intention were rated on five-point or seven-point Likert scales, with satisfactory reliability (Cronbach’s α values were all >0.80). Structural equation modelling was used to construct path models based on the above elements. Higher scores in the Depend (Effect = 0.047, SE = 0.018, 95% CI = [0.019, 0.093]) and Close dimensions of attachment (Effect = 0.028, SE = 0.014, 95% CI = [0.007, 0.065]) predicted a stronger dependency-oriented help-seeking style, which thus predicted greater vaccination intention. Higher scores in the Close dimension (Effect = 0.007, SE = 0.004, 95% CI = [0.001, 0.018]) and lower scores in the Anxiety dimension of attachment (Effect = −0.003, SE = 0.002, 95% CI = [−0.008, −0.001]) predicted a stronger autonomy-oriented help-seeking style and further predicted more professional help-seeking behaviors, which promoted greater COVID-19 vaccination intention. The results of this study indicate that help-seeking moderates the relationship between adult attachment and COVID-19 vaccination intention. Guiding help-seeking behavior for individuals with different attachment styles may be an entry point for improving COVID-19 vaccination intention.

Self-Reported Preferences for Help-Seeking and Barriers to Using Mental Health Supports Among Internal Medicine Residents: Exploratory Use of an Econometric Best-Worst Scaling Framework for Gathering Physician Wellness Preferences

BACKGROUND

Burnout interventions are limited by low use. Understanding resident physician preferences for burnout interventions may increase utilization and improve the assessment of these interventions.

OBJECTIVE

This study aims to use an econometric best-worst scaling (BWS) framework to survey internal medicine resident physicians to establish help-seeking preferences for burnout and barriers to using wellness supports by quantifying selections for 7 wellness support options and 7 barriers.

METHODS

Internal medicine resident physicians at our institution completed an anonymous web-based BWS survey during the 2020-2021 academic year. This cross-sectional study was analyzed with multinomial logistic regression and latent class modeling to determine the relative rank ordering of factors for seeking support for burnout and barriers to using wellness supports. Analysis of variance with Tukey honest significant difference posthoc test was used to analyze differences in mean utility scores representing choice for barriers and support options.

RESULTS

Of the 163 invited residents, 77 (47.2% response rate) completed the survey. Top-ranking factors for seeking wellness supports included seeking informal peer support (best: 71%; worst: 0.6%) and support from friends and family (best: 70%; worst: 1.6%). Top-ranking barriers to seeking counseling included time (best: 75%; worst: 5%) and money (best: 35%; worst: 21%).

CONCLUSIONS

Overall, our findings suggest that low utilization of formal mental health support is reflective of resident preferences to seek help informally and that increasing utilization will require addressing pragmatic barriers of time and cost. Assessing physician preferences for wellness-related initiatives may contribute to understanding the low utilization of formal mental health services among physicians, which can be determined using a BWS framework.

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.