Labels used by young people to describe mental disorders: which ones predict effective help-seeking choices?

Depression Literacy and Self-Reported Help-Giving Behaviour in Adolescents in Ireland

This questionnaire-based study aimed to explore depression literacy (DL) and help-giving experiences in 12-18-year-old adolescents (N = 535, Mage = 14.9 years, 51.8% male) in Ireland. In response to a vignette depicting a character displaying symptoms of depression, 46.7% labelled these symptoms 'depression', with increasing age and empathy associated with increased likelihood of labelling as such. Almost all (92.1%) believed the character needed help, but the perceived helpfulness of potential responses varied. Over one-third (38.2%) indicated they knew someone who had displayed similar symptoms in the past year, with 85.2% of these reporting having helped this person. Reported help-giving responses included comforting the person, encouraging professional help-seeking, and informing an adult. The findings suggest adolescent DL can be best supported by developmentally-sensitive interventions that encourage empathy and the importance of engaging adults' assistance.

The effect of appearance and functionality concerns, and weight status, on negative body image mental health literacy in women

Few studies have investigated community knowledge and beliefs about negative body image. Yet, low rates of recognition and help-seeking for body image concerns have been reported. Given the prevalence of body image problems and associated mental health risks in women, the current online study investigated negative body image mental health literacy in 260 women aged 18 to 64 years recruited via Prolific. The mental health literacy paradigm was employed in a 2 × 2 experimental design in which the effect of a target's domain of body image concern (appearance versus body functionality) and weight status ("normal weight" versus "overweight") was assessed on problem recognition, beliefs, and help-seeking recommendations. Overall, low symptom recognition was observed, and ratings for beliefs and help-seeking suggested low levels of stigma. However, significantly greater sympathy and lifestyle support recommendations were observed in the overweight compared to normal weight condition, and a domain × weight interaction suggested significantly fewer negative emotional reactions in the appearance overweight condition compared to appearance normal weight, and functionality overweight, conditions. The findings suggest a need for education about body image independent of weight status in women. Future research would benefit from examining diverse samples, broader functionality concerns, and stigma.

The Impact of Video-Based Microinterventions on Attitudes Toward Mental Health and Help Seeking in Youth: Web-Based Randomized Controlled Trial

BACKGROUND

Mental health (MH) problems in youth are prevalent, burdening, and frequently persistent. Despite the existence of effective treatment, the uptake of professional help is low, particularly due to attitudinal barriers.

OBJECTIVE

This study evaluated the effectiveness and acceptability of 2 video-based microinterventions aimed at reducing barriers to MH treatment and increasing the likelihood of seeking professional help in young people.

METHODS

This study was entirely web based and open access. The interventions addressed 5 MH problems: generalized anxiety disorder, depression, bulimia, nonsuicidal self-injury, and problematic alcohol use. Intervention 1 aimed to destigmatize and improve MH literacy, whereas intervention 2 aimed to induce positive outcome expectancies regarding professional help seeking. Of the 2435 participants who commenced the study, a final sample of 1394 (57.25%) participants aged 14 to 29 years with complete data and sufficient durations of stay on the video pages were randomized in a fully automated manner to 1 of the 5 MH problems and 1 of 3 conditions (control, intervention 1, and intervention 2) in a permuted block design. After the presentation of a video vignette, no further videos were shown to the control group, whereas a second, short intervention video was presented to the intervention 1 and 2 groups. Intervention effects on self-reported potential professional help seeking (primary outcome), stigma, and attitudes toward help seeking were examined using analyses of covariance across and within the 5 MH problems. Furthermore, we assessed video acceptability.

RESULTS

No significant group effects on potential professional help seeking were found in the total sample (F2,1385=0.99; P=.37). However, the groups differed significantly with regard to stigma outcomes and the likelihood of seeking informal help (F2,1385=3.75; P=.02). Furthermore, separate analyses indicated substantial differences in intervention effects among the 5 MH problems.

CONCLUSIONS

Interventions to promote help seeking for MH problems may require disorder-specific approaches. The study results can inform future research and public health campaigns addressing adolescents and young adults.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00023110; https://drks.de/search/de/trial/DRKS00023110.

Causal beliefs about mental illness: A scoping review

Research on causal beliefs about mental illness-the beliefs people hold about what causes a particular mental illness, or mental illnesses in general-is split across a number of theories and disciplines. Although research on this subject has provided a number of insights and practical applications, the diversity of theories, terminology, and keywords makes it challenging for a new reader to gain a comprehensive understanding. We sought to address this by conducting a systematic scoping review of research on causal beliefs. This review included English-language articles from any year that mentioned causal beliefs for mental illness in their title or abstract. We identified articles in two stages. In the first stage, we used a narrow set of search terms referring specifically to causal beliefs (1227 records identified, 417 included). In the second stage, we used a comprehensive set of terms relevant to research on causal beliefs (10,418 records identified, 3838 included). We analyzed articles qualitatively, organizing them into one of five theories or categories: the common-sense model of self-regulation, explanatory models, mental health literacy, biogenetic causal beliefs, and other research on causal beliefs. We provide a comprehensive summary of these literatures in terms of their history, typical research questions and study design, findings, and practical applications. These theories differ in their theoretical orientation towards causal beliefs, research methods, findings, and applications. However, they broadly share a view of causal beliefs as multifaceted, culturally determined, and relevant for additional psychosocial variables such as mental illness stigma and help-seeking. We conclude by making recommendations for researchers, clinicians, public health messaging, and for individuals with mental illness.

Adolescents' beliefs about what symptoms constitute depression: Are more expansive definitions helpful or harmful?

Purpose

What symptoms do people think constitute "depression"? In a mental health literacy framework, knowing more of depression's nine core symptoms (per formal psychiatric diagnostic criteria) is thought to help people identify and seek help for depression. However, the common-sense model of self-regulation suggests that more expansive beliefs about what symptoms constitute an illness may be maladaptive, whereby viewing more symptoms as characterizing a disorder predicts greater functional impairment.

Methods

We collected data from N = 281 U.S. adolescents experiencing elevated depression symptoms, recruited via social media. Symptom beliefs were assessed descriptively and with a latent profile analysis to test associations with other variables.

Results

Adolescents' beliefs about what symptoms constitute depression varied widely, and only 49% endorsed all DSM-5 depression symptoms as characterizing the disorder. Adolescents who identified more symptoms as belonging to depression had more severe depression symptoms (p = .004), reported more hopelessness (p = .021), and were more pessimistic about the permanence of depression (p = .007); they were also more likely to rate medication as potentially helpful (p = .001).

Conclusion

These findings simultaneously support and challenge elements of both the common-sense model and the mental health literacy framework. Future research on mental health literacy may examine why adolescents with more psychiatrically-accurate understandings of depression experience worse clinical outcomes. Likewise, future research on the common sense model should explore whether more expansive depression symptom beliefs may be adaptive as well as maladaptive.

Predictors of help-seeking behavior in mothers of preschoolers

Mental health difficulties in the preschool years require early intervention, but preschool children are underserved in mental healthcare. One explanation might be that parents do not seek services because their problem recognition, or labeling, ability is lacking. While previous research demonstrates that labeling is positively associated with help-seeking, interventions aimed at improving help-seeking by improving labeling are not always successful. Parental perceptions of severity, impairment, and stress also predict help-seeking, but have not been examined alongside labeling. Thus, it is unclear how much they add to the parental help-seeking process. The present study simultaneously examined labeling and parental perceptions of severity, impairment, and stress on help-seeking. Participants (82 adult mothers of children ages 3-5 years) read vignettes describing preschool-aged children with symptoms of depression, anxiety, and ADHD, and answered a series of questions to assess their labeling and likelihood of help-seeking for each of the problems presented. Help-seeking was found to be positively associated with labeling (r = .73; r = .60), severity (r = .66), impairment (r = .31), and stress (r = .25). Furthermore, severity, impairment, and stress predicted endorsements of help-seeking above and beyond what was predicted by labeling alone (R2 change = .12; χ2 (3) = 20.03, p < .01). These results underscore the importance of parental perceptions of children's behavior to the help-seeking process.

A perspective on mental health literacy and mental health issues among Australian youth: Cultural, social, and environmental evidence!

Mental health literacy (MHL) helps improve mental health outcomes and reduce the impacts of mental illness. This study aims to reflect on scientific evidence on MHL levels, barriers to MHL, their impacts on mental health among Australian youth and interventions to overcome these barriers. The factors explored in the Perspective included; influence of social determinants, culturally and linguistically diverse (CALD) communities, help-seeking attitudes and behaviors. MHL intervention programs and MHL for improving mental health outcomes due to the recent COVID-19 pandemic were also explored. Adequate levels of youth MHL significantly improved one's ability to recognize own mental health status as well as provide peer support. Practical considerations such as designing more gender and culturally specific youth MHL programs are proposed.

Help-seeking attitudes and intentions for generalised anxiety disorder in adolescents: the role of anxiety literacy and stigma

Help seeking for anxiety tends to be low in adolescents. Identifying modifiable factors that may facilitate help seeking is important. The aim of the current study is to test the effects of generalized anxiety disorder (GAD) literacy and stigma (personal and perceived) on attitudes and intentions toward seeking help from professionals and key adult sources. 1767 adolescents aged 12-18 years participated in the current study and completed measures of GAD literacy, GAD stigma, professional help-seeking attitudes, and intentions to seek help from a range of sources. The results of the study found that participants had limited GAD literacy and up to 20% personally agreed with stigmatising statements about GAD. Participants reported greater intentions to seek help from parents than from formal sources. More positive attitudes toward seeking help were associated with higher levels of GAD literacy (p < 0.001) and lower personal GAD stigma (p < 0.001). Lower perceived GAD stigma was associated with increased intentions to seek help from their mothers (p < 0.05) or fathers (p < 0.01), while lower personal GAD stigma was also associated with help-seeking intentions from their mothers (p < 0.05). Higher perceived GAD stigma was associated with intentions to seek help from nobody (p < 0.001). Overall, the current study highlights the important role that parents can play in the help-seeking process for adolescents, with parents often the most accessible source of help. Improving parent and adolescent knowledge and attitudes towards GAD may help to improve early help seeking in young people.

Self-Reported Cognitive Functions Predict the Trajectory of Paranoid Ideation Over a 15-Year Prospective Follow-Up

Background

This study investigated whether self-reported cognitive functions (i.e. task orientation, distractibility, persistence, flexibility, and perseverance) predict the trajectory of paranoid ideation over a 15-year prospective follow-up in adulthood.

Methods

The participants came from the population-based Young Finns study (N = 1210‒1213). Paranoid ideation was assessed with the Paranoid Ideation Scale of the Symptom Checklist-90 Revised (SCL-90R) in 1997, 2001, 2007, and 2012. Self-reported cognitive functions were evaluated in 1997 with the Task orientation, Distractibility, Persistence, and Flexibility scales of the DOTS-R (the Revised Dimensions of Temperament Survey) and the Perseverance scale of the FCB-TI (the Formal Characteristics of Behaviour – Temperament Inventory). The data was analyzed using growth curve models that were adjusted for age, sex, and socioeconomic factors in childhood and adulthood.

Results

Low self-reported task orientation, low persistence, high distractibility, low flexibility, and high perseverance predicted higher level of paranoid ideation over the 15-year follow-up.

Conclusions

Self-reported cognitive functions seem to predict paranoid ideation over a long-term follow-up. Promoting cognitive functions in early interventions may have long-term protective influences against the development of paranoid ideation in non-clinical populations.

Immigration, acculturation, and preferred help-seeking sources for depression: comparison of five ethnic groups

Background

Immigrants are more likely than the majority population to have unmet needs for public mental health services. This study aims to understand potential ethnic differences in preferred help-seeking sources for depression in Norway, and how such preferences relate to acculturation orientation.

Methods

A convenience sample of immigrants from Russia (n = 164), Poland (n = 127), Pakistan (n = 128), and Somalia (n = 114), and Norwegian students (n = 250) completed a survey. The sample was recruited from social media platforms, emails, and direct contact. The survey consisted of a vignette describing a moderately depressed person. Respondents were asked to provide advice to the person by completing a modified version of the General Help-Seeking Questionnaire. The immigrant sample also responded to questions about acculturation orientation using the Vancouver Index of Acculturation Scale.

Results

Significant differences were found in the endorsement of traditional (e.g., religious leader), informal (e.g., family), and semiformal (e.g., internet forum) help-sources between immigrant groups, and between immigrant groups and the Norwegian respondent group. Immigrants from Pakistan and Somalia endorsed traditional help sources to a greater extent than immigrants from Russia and Poland, and the Norwegian student sample. There were no ethnic differences in endorsement of formal mental help sources (e.g., a medical doctor). Maintenance of the culture of origin as the acculturation orientation was associated with preferences for traditional and informal help sources, while the adoption of mainstream culture was associated with semiformal and formal help-seeking sources.

Conclusion

Ethnic differences in help-seeking sources need to be considered when designing and implementing mental health services.

Teen Mental Health First Aid for years 7-9: a description of the program and an initial evaluation

BACKGROUND

A teen Mental Health First Aid training course for high school students in years 10-12 (tMHFA 10-12) has previously been evaluated in uncontrolled and randomized controlled trials and found to improve Mental Health First Aid intentions, mental health literacy and to reduce stigma. This 3 × 75-min course has more recently been adapted for younger students in years 7-9 (tMHFA 7-9). The present study reports an initial uncontrolled trial of this new training course which aimed to assess feasibility and acceptability of the course and test effects on knowledge, attitudes and behaviour.

METHODS

An uncontrolled trial was carried out in five schools with measures taken at pre-test, post-test and 3-month follow-up. The outcomes measured were: quality of first aid intentions to help peers, confidence in helping, stigmatising attitudes, recognition of anxiety disorder, number of adults thought to be helpful, help-seeking intentions, quality of support provided to a peer, quality of support received, and psychological distress. Questions were also asked about satisfaction with the course.

RESULTS

There were 475 students (mean age 13.86 years) who provided data at baseline, with 76% of these providing data at post-test and 75% at follow-up. Sustained changes at follow-up were found for: number of adults thought to be helpful, some components of stigma, recognition of anxiety disorder, and quality of support provided to a peer. However, there was an unexpected decline in willingness to tell others about a mental health problem. Most students found the information presented to be new, easy to understand, and useful.

CONCLUSIONS

The tMHFA 7-9 training course produced some positive changes that were sustained over 3 months. However, the changes were not as strong as previously found for older high school students, suggesting the need for further refinement of the course.

Cross-sectional survey of mental health literacy among undergraduate students of the University of Nigeria

OBJECTIVE

This study sought to assess knowledge of schizophrenia and help-seeking behaviour among undergraduate students of a Nigerian university. Sociodemographic predictors of correct recognition were also explored.

DESIGN

The study was a cross-sectional descriptive survey.

SETTING

The study was carried out at the University of Nigeria, a pioneer university located in Southeastern Nigeria.

PARTICIPANTS

Undergraduate students of the University of Nigeria.

METHODS

All consenting male and female students of three purposively selected faculties were recruited for the study. Self-administered vignette-based questionnaires were distributed to students of the selected faculties between September and November 2018. Data were analysed using the IBM Statistical Product and Services Solution for Windows V.21.0.

RESULTS

Out of the 400 questionnaires that were distributed, 389 were completed and returned (97.3% response rate). Respondents were mainly female (64.9%, n=252) and were between the ages of 18 and 24 years (75.8%, n=294). One in eight respondents (12.1%, n=47) correctly identified and labelled the schizophrenia vignette. Hallucination was the most identified symptom of distress for schizophrenia (47.9%, n=186). The most common alternative label for schizophrenia was 'mental illness' (24.7%, n=96). Schizophrenia was also mislabelled as depression (11.6%, n=45). More than a 10th of the respondents used stigmatising labels such as 'crazy' and 'mad' (11.1%, n=43). Psychiatrists were the most recommended source of help for the vignette character (36.3%, n=141). There was a strong association between the faculty of study and the ability to correctly identify and label the schizophrenia vignette (χ²=44.557, p<0.001).

CONCLUSION

Mental health literacy among students of the University of Nigeria was poor. Research on culturally sensitive interventions to improve mental health literacy should be embarked on.

What Adolescent Girls Know about Mental Health: Findings from a Mental Health Literacy Survey from an Urban Slum Setting in India

BACKGROUND

Youth in vulnerable situations are known to have high rates of mental disorders but low help-seeking. Help-seeking is known to be influenced by mental health literacy (MHL), a key concept that is important for the recognition of mental disorders and planning intervention.

AIMS

To explore MHL and help-seeking patterns in a group of young women in an urban slum setting in India.

MATERIALS AND METHODS

A total of 337 young women between 16 and 19 years of age belonging to urban slum settings formed the study sample. Two vignettes on depression and self-harm were used to assess: (a) recognition of the disorder, (b) help-seeking, and (c) knowledge of treatments available.

RESULTS

Only 8% of women were able to label the condition as depression in the first vignette. Though suicidality was identified correctly by the majority of participants 73 (63%), they did not think it needed urgent intervention. Only a few considered mental health professionals as possible sources of help (19.3% for depression and 2.4% for self-harm). Majority of the young women felt friends and parents were sources of help, and that stigma and lack of awareness were the reasons for not considering professional help.

CONCLUSION

MHL regarding depression and suicidality is low among young women from low-income areas. It is a critical and urgent need to encourage early and appropriate help-seeking for mental health problems in this vulnerable population.

Association between recognition and help-seeking preferences and stigma towards people with mental illness

AIMS

The ability to recognise a mental illness has important implications as it can aid in timely and appropriate help-seeking, and ultimately improve outcomes for people with mental illness. This study aims to explore the association between recognition and help-seeking preferences and stigmatising attitudes, for alcohol abuse, dementia, depression, obsessive-compulsive disorder (OCD) and schizophrenia, using a vignette-based approach.

METHODS

This was a population-based, cross-sectional survey conducted among Singapore Residents (n = 3006) aged 18-65 years. All respondents were asked what they think is wrong with the person in the vignette and who they should seek help from. Respondents were also administered the Personal and Perceived sub scales of the Depression Stigma Scale and the Social Distance Scale. Weighted frequencies and percentages were calculated for categorical variables. A series of multiple logistic and linear regression models were performed separately by vignette to generate odd ratios and 95% confidence intervals for the relationship between help-seeking preference, and recognition and beta coefficients and 95% confidence intervals for the relationship between stigma and recognition.

RESULTS

Correct recognition was associated with less preference to seek help from family and friends for depression and schizophrenia. Recognition was also associated with increased odds of endorsing seeking help from a psychiatric hospital for dementia, depression and schizophrenia, while there was also an increased preference to seek help from a psychologist and psychiatrist for depression. Recognition was associated with less personal and perceived stigma for OCD and less personal stigma for schizophrenia, however, increased odds of social distancing for dementia.

CONCLUSION

The ability to correctly recognise a mental illness was associated with less preference to seek help from informal sources, whilst increased preference to seek help from mental health professionals and services and less personal and perceived stigma. These findings re-emphasise the need to improve mental health literacy and reinforce the potential benefits recognition can have to individuals and the wider community in Singapore.

The Recognition of Mental Illness, Schizophrenia Identification, and Help-Seeking from Friends in Late Adolescence

Objective

The recognition of mental illness without anticipating stigma might encourage adolescents’ help-seeking behavior. We aimed to identify the relationship between mental illness identification and adolescents’ intention to seek help if faced with mental illness.

Method

We examined the relationships between help-seeking intentions and recognition of mental illness (RMI) without correctly identifying the disease name, as well as correct labelling of schizophrenia (LSC) using a vignette about a person with schizophrenia in a cross-sectional survey of 9,484 Japanese high-school students aged 15–18 years.

Results

When compared with adolescents who were unable to recognize the mental illness (UMI) in the vignette, those in the RMI group reported they were significantly more likely to seek help from friends (odds ratio [OR] = 1.29; 95% confidence interval [CI] = 1.17–1.41; P < 0.001) and expressed an increased likelihood to seek help from professionals (all P < .05). Those in the LSC group reported they were significantly less likely to exhibit help-seeking behavior (OR = 0.77, 95% CI = 0.65–0.92, P = 0.003) and expressed an increased likelihood of help-seeking from health professionals than the UMI group (all P < .05).

Conclusion

The ability to recognize mental illness without identifying the disease may increase help-seeking from friends, while the ability to identify the disease as schizophrenia might decrease late adolescents’ help-seeking. To promote help-seeking behavior among adolescents, improving their ability to recognize mental illness generally is recommended.

'teen Mental Health First Aid': a description of the program and an initial evaluation

BACKGROUND

Many adolescents have poor mental health literacy, stigmatising attitudes towards people with mental illness, and lack skills in providing optimal Mental Health First Aid to peers. These could be improved with training to facilitate better social support and increase appropriate help-seeking among adolescents with emerging mental health problems. teen Mental Health First Aid (teen MHFA), a new initiative of Mental Health First Aid International, is a 3 × 75 min classroom based training program for students aged 15-18 years.

METHODS

An uncontrolled pilot of the teen MHFA course was undertaken to examine the feasibility of providing the program in Australian secondary schools, to test relevant measures of student knowledge, attitudes and behaviours, and to provide initial evidence of program effects.

RESULTS

Across four schools, 988 students received the teen MHFA program. 520 students with a mean age of 16 years completed the baseline questionnaire, 345 completed the post-test and 241 completed the three-month follow-up. Statistically significant improvements were found in mental health literacy, confidence in providing Mental Health First Aid to a peer, help-seeking intentions and student mental health, while stigmatising attitudes significantly reduced.

CONCLUSIONS

teen MHFA appears to be an effective and feasible program for training high school students in Mental Health First Aid techniques. Further research is required with a randomized controlled design to elucidate the causal role of the program in the changes observed.

Is the use of accurate psychiatric labels associated with intentions and beliefs about responses to mental illness in a friend? Findings from two national surveys of Australian youth

Aims. An inherent prerequisite to mental health first-aid (MHFA) is the ability to identify that there is a mental health problem, but little is known about the association between psychiatric labelling and MHFA. This study examined this association using data from two national surveys of Australian young people. Methods. This study involved a national telephonic survey of 3746 Australian youth aged 12-25 years in 2006, and a similar survey in 2011 with 3021 youth aged 15-25 years. In both surveys, respondents were presented with a vignette portraying depression, psychosis or social phobia in a young person. The 2011 survey also included depression with suicidal thoughts and post-traumatic stress disorder. Respondents were asked what they thought was wrong with the person, and reported on their first-aid intentions and beliefs, which were scored for quality of the responses. Results. Accurate labelling of the mental disorder was associated with more helpful first-aid intentions and beliefs across vignettes, except for the intention to listen non-judgementally in the psychosis vignette. Conclusions. Findings suggest that community education programmes that improve accurate psychiatric label use may have the potential to improve the first-aid responses young people provide to their peers, although caution is required in the case of psychosis.

The associations between psychiatric label use and young people's help-seeking preferences: results from an Australian national survey

Aims. Emerging evidence suggests that psychiatric labels may facilitate help seeking in young people. This study examined whether young people's use of accurate labels for five disorders would predict their help-seeking preferences. Methods. Young people's help-seeking intentions were assessed by a national telephone survey of 3021 Australian youths aged 15-25. Respondents were presented with a vignette of a young person portraying depression, depression with suicidal thoughts, psychosis, social phobia or post-traumatic stress disorder (PTSD). They were then asked what they thought was wrong with the person, and where they would go for help if they had a similar problem. Results. Accurate psychiatric label use was associated with a preference to seek help from a general practitioner or mental health specialist. Accurately labelling the psychosis vignette was also associated with a preference to not seek help from family or friends. Conclusions. Findings add to the emerging evidence that accurate psychiatric labelling may facilitate help seeking for various mental disorders in young people, and support the promise of community awareness campaigns designed to improve young people's ability to accurately identify mental disorders.

Increasing knowledge about depression in adolescents: effects of an information booklet

PURPOSE

This study evaluates a newly developed information booklet about depression among adolescents. The aim was to examine the enhancement of knowledge through the booklet with the objective of reducing stigma and facilitating awareness of own treatment needs.

METHODS

628 German ninth graders were enrolled in a pre-post-follow-up study using study-specific questionnaires to investigate knowledge enhancement in seven depression-related topics. Exploratively, knowledge enhancement was calculated with respect to education level and gender. Additionally, the students assessed the booklet's layout, content and utility. Knowledge enhancement was analyzed using repeated measures ANOVA for index values of the booklet's topics. The effect size partial eta square (η²) was computed.

RESULTS

The pre-post-follow-up comparison yielded significant knowledge enhancement for all seven index values (p < 0.001). The associated effect sizes were medium to large. The strongest effects were achieved for the categories "Antidepressants" (η² = 0.56), "Symptoms" (η² = 0.45) and "Treatment" (η² = 0.17) of depression as well as for "Suicidality" (η² = 0.36). Although baseline knowledge was high in all students, knowledge enhancement was greater in better educated than in less educated students. Overall assessment of the booklet was good (mean = 2.15 on a rating scale from "very good" (1) to "fail" (6)).

CONCLUSIONS

The information booklet as a low-threshold educational approach can significantly enhance depression-specific knowledge in students. Hence, it helps adolescents to acknowledge their own symptoms and treatment needs as well as to recognize these specific mental health problems in their peers. Thus, the booklet can contribute to the reduction of stigma and treatment barriers in adolescents.

Attitudes towards help-seeking and stigma among young people at risk for psychosis

The role of self-labeling as 'mentally ill' and of stigma-related stress for help-seeking among young people at risk for psychosis is unknown. Stronger self-labeling and less stigma stress predicted better attitudes towards psychiatric medication and psychotherapy, controlling for clinical and sociodemographic variables. Interventions could target stigma-related stress to increase help-seeking.

Media representation of depression in young people: a corpus-based analysis of Irish newspaper coverage

Objectives

Newspaper media are an important source of information regarding mental health and have a significant influence on people’s awareness of, and decision making around, mental health issues. Depression in young people has seen increasing media attention in recent years, but few studies have examined media representation of mental health, specifically in young people. The current study used a quantitative approach to examine the words used in reports concerning depression in young people, in Irish broadsheets, published between 2007 and 2011.

Method

A sample of 269 texts, containing 176 223 words, was collected from three Irish broadsheet newspapers, using the search terms ‘depression’ or ‘depressed’ or ‘mental health’ and ‘youth’ or ‘young people’. A corpus-based approach was used to examine word frequencies, clusters and keywords.

Results

The analysis identified textual patterns, suggesting recurring associations between youth depression and suicide, and, to a lesser extent, alcohol use and bullying. Keywords relating to emotional distress and symptoms of depression were less frequent and sometimes associated with constructions inferring lack of agency (such as ‘suffering from’). A focus on the role of the parents was also evident. Of the professions mentioned, psychiatrists were referred to most often.

Conclusions

The analysis suggests that media coverage of depression in young people accurately reflects concerns reported in surveys by young people, but provides less information that might help in recognising depression in a young person.

Medicalizing versus psychologizing mental illness: what are the implications for help seeking and stigma? A general population study

PURPOSE

This study contrasts the medicalized conceptualization of mental illness with psychologizing mental illness and examines what the consequences are of adhering to one model versus the other for help seeking and stigma.

METHODS

The survey "Stigma in a Global Context-Belgian Mental Health Study" (2009) conducted face-to-face interviews among a representative sample of the general Belgian population using the vignette technique to depict schizophrenia (N = 381). Causal attributions, labeling processes, and the disease view are addressed. Help seeking refers to open-ended help-seeking suggestions (general practitioner, psychiatrist, psychologist, family, friends, and self-care options). Stigma refers to social exclusion after treatment. The data are analyzed by means of logistic and linear regression models in SPSS Statistics 19.

RESULTS

People who adhere to the biopsychosocial (versus psychosocial) model are more likely to recommend general medical care and people who apply the disease view are more likely to recommend specialized medical care. Regarding informal help, those who prefer the biopsychosocial model are less likely to recommend consulting friends than those who adhere to the psychosocial model. Respondents who apply a medical compared to a non-medical label are less inclined to recommend self-care. As concerns treatment stigma, respondents who apply a medical instead of a non-medical label are more likely to socially exclude someone who has been in psychiatric treatment.

CONCLUSIONS

Medicalizing mental illness involves a package deal: biopsychosocial causal attributions and applying the disease view facilitate medical treatment recommendations, while labeling seems to trigger stigmatizing attitudes.

The Australian public's beliefs about the causes of depression: associated factors and changes over 16 years

BACKGROUND

Biological conceptualisations of depression are increasingly prevalent. The current study aimed to investigate the current prevalence of causal beliefs about depression in the Australian public, the factors associated with these beliefs, and changes over time.

METHOD

A nationally representative sample of Australian adults was surveyed as part of the 2011 National Mental Health Literacy and Stigma Survey. Beliefs about the causes of depression were assessed based on responses to vignettes depicting a person with either depression (n=893) or depression with suicidal thoughts (n=903). Socio-demographic characteristics, personal and professional experience with depression, and correct recognition of depression were investigated as predictors of causal beliefs about depression using binary logistic regression. Comparisons were made between the Australian public's current causal beliefs and data obtained in national surveys conducted in 1995 and 2003/4.

RESULTS

Over 80% of the Australian public attributed depression to day to day problems, death of a close friend or relative, a recent traumatic event, childhood problems, and a chemical imbalance in the brain. People who correctly labelled the disorder in the vignettes were more likely to attribute depression to psychosocial reasons and less likely to attribute it to an allergic reaction, a virus, or an infection. Belief in psychosocial and genetic causes has increased over time, whereas belief in infection, allergy and weakness of character has decreased.

LIMITATIONS

Comparisons between the 1995, 2003/4 and 2011 surveys were limited by the differences in the survey methodology at each time point, and by low response rates to the 2003/4 and 2011 surveys. The survey design prevented insight into the reasoning underlying individuals' responses, and lacked sufficient power to explore the beliefs of Australians from cultural minorities.

CONCLUSIONS

The majority of the Australian public believe that both psychosocial and biological factors cause depression.

Iranian adolescents' ability to recognize depression and beliefs about preventative strategies, treatments and causes of depression

BACKGROUND

Since depression often has its onset during adolescence, knowledge about adolescents' ability to recognize depression and their beliefs about preventative strategies, treatments, and causes of depression are of importance.

METHODS

A total of 1984 adolescents, aged 12-17 years, participated in this study. They were recruited from 16 urban and suburban schools in Ahvaz City, Iran by cluster sampling. Participants were presented with a vignette depicting depression that was developed by Jorm and colleagues.

RESULTS

About half of the adolescents were able to correctly recognize depression. In terms of dealing with the depression depicted by the character in the vignette, older compared to younger participants, thought it best to ignore the individual or keep him/her busy. Younger adolescents were more likely to believe that depression was the result of god's will and a physical illness, whereas older adolescents tended to consider depression as resulting from the way in which people were raised, and from the normal ups and downs of life. Older, compared to younger adolescents, tended to endorse the preventative value of "not using marijuana" and "never drinking alcohol in excess".

LIMITATIONS

Since a hypothetical vignette was used, the findings may not truly reflect the real life experience of depression. The sample was drawn from a single region in Iran.

CONCLUSIONS

Given adolescents' relatively limited knowledge about depression and their beliefs about the causes and preventative strategies, there is fertile ground for health promotion in Iran.

"There are too many steps before you get to where you need to be": help-seeking by patients with first-episode psychosis

BACKGROUND

There has been substantial research on pathways to care in first-episode psychosis (FEP); however, few studies have used a qualitative research paradigm or have been done from the perspective of the person experiencing the psychotic episode.

OBJECTIVE

We sought to describe the experiences of patients with FEP on their pathway to care and to identify factors that help or hinder help-seeking efforts.

METHODS

Using a qualitative descriptive approach, we conducted semi-structured interviews with 16 patients recruited from an early intervention program. Data were analyzed using content analysis to organize the findings into themes.

FINDINGS

Self-stigma and a pervasive lack of knowledge regarding the symptoms of psychosis and availability of services were barriers to help-seeking. Participants highlighted the crucial role of significant others in initiating the help-seeking process. Participants typically described a complex series of contacts along the pathway to care which resulted in feelings of being misunderstood and losing control, but many individuals identified unexpected benefits of their experience.

CONCLUSIONS

Our findings suggest a shift in the philosophy and orientation of service delivery towards the creation of services that address these concerns and are relevant to the young people who utilize them.