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O'Neill A, Stapley E, Rehman I, Humphrey N. Adolescent help-seeking: an exploration of associations with perceived cause of emotional distress. Front Public Health 2023; 11:1183092. [PMID: 37849721 PMCID: PMC10578439 DOI: 10.3389/fpubh.2023.1183092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 08/31/2023] [Indexed: 10/19/2023] Open
Abstract
Background Help-seeking is intrinsic to efforts to manage the onset, maintenance, or escalation of mental health difficulties during adolescence. However, our understanding of adolescent help-seeking remains somewhat nebulous. A greater comprehension of help-seeking behavior from the perspective of adolescents is needed. It is also prudent to explore help-seeking behavior in the context of perceived cause for emotional distress, particularly as causal beliefs have been found to influence help-seeking behavior in adults. Objectives The present study sought to categorize adolescents' experiences of help-seeking, and to examine the extent to which these categories (or "types") of help-seeking behavior are associated with their perceptions of causal factors for emotional distress. Methods The data for this study were drawn from interviews conducted as part of the HeadStart Learning Programme. The sample comprised of 32 young people aged 11-12 years. Ideal-type analysis, a qualitative form of person-centered analysis, was used to construct a typology of adolescent help-seeking. Participants' help-seeking "type" was then compared with their perceived cause for emotional distress "type." Findings We developed four distinct categories of help-seeking: (1) guided by others who have taken notice; (2) skeptical with unmet needs; (3) motivated and solution focused; and (4) preference for self-regulation. Simultaneously, we identified principal associations between perceived cause of emotional distress-(1) perceived lack of control; (2) unfair treatment; (3) others: their actions and judgements as the catalyst; (4) concern for self and others; and (5) self as cause-and help-seeking approaches. "Perceived lack of control" was most likely to be associated with "others who have taken notice"; "Unfair treatment" with "skeptical with unmet needs"; "others: their actions and judgements as the catalyst" with "motivated and solution focused"; "concern for self and others' with 'guided by others who have taken notice"; finally, "self as cause" was most likely to be associated with "preference for self-regulation." Conclusions This study demonstrates meaningful and distinct categories of adolescent help-seeking and offers empirical evidence to support the assertion that perceived cause for emotional distress may influence the help-seeking approaches of adolescents.
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Affiliation(s)
- Alisha O'Neill
- Manchester Institute of Education, The University of Manchester, Manchester, United Kingdom
| | - Emily Stapley
- Evidence Based Practice Unit (EBPU), Anna Freud National Centre for Children and Families and University College London (UCL), London, United Kingdom
| | - Ishba Rehman
- Manchester Institute of Education, The University of Manchester, Manchester, United Kingdom
| | - Neil Humphrey
- Manchester Institute of Education, The University of Manchester, Manchester, United Kingdom
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Amsalem D, Jankowski SE, Pagdon S, Valeri L, Yang LH, Markowitz JC, Neria Y, Pescosolido BA, Dixon LB, Martin A. Selfie Videos to Reduce Stigma and Increase Treatment Seeking Among Youths: Two Noninferiority Randomized Controlled Trials. Psychiatr Serv 2023; 74:229-236. [PMID: 36254455 DOI: 10.1176/appi.ps.20220168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Confronting stigma early in life could enhance treatment seeking. In two randomized controlled trials (RCTs), one focused on psychosis and the other on adolescent depression, the efficacy and equivalence of brief social contact-based videos were evaluated and compared with a control condition. The outcomes of interest were changes in illness-related stigma and treatment-seeking intention. The hypotheses were that the intervention videos would show greater efficacy than control conditions and that traditional and selfie videos would demonstrate similar efficacy. METHODS Young adults (study 1, N=895) and adolescents (study 2, N=637) were randomly assigned to view intervention videos (in traditional or selfie styles) or to a control condition. In short videos (58-102 seconds), young presenters humanized their illness by emotionally describing their struggles and discussing themes of recovery and hope. RESULTS Repeated-measures analyses of variance and paired t tests showed significant differences in stigma and treatment seeking between the intervention and control groups and similar efficacy of the traditional and selfie videos. Cohen's d effect sizes ranged from 0.31 to 0.76 for changes in stigma from baseline to 30-day follow-up in study 1 and from 0.13 to 0.47 for changes from baseline to postintervention in study 2. CONCLUSIONS The RCTs demonstrated the efficacy of brief videos, both traditional and selfie, in reducing illness-related stigma among young adults and adolescents and in increasing treatment-seeking intention among adolescents. Future studies should explore the effects of brief videos presented by social media influencers on mental health stigma and treatment engagement.
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Affiliation(s)
- Doron Amsalem
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Samantha E Jankowski
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Shannon Pagdon
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Linda Valeri
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Lawrence H Yang
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - John C Markowitz
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Yuval Neria
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Bernice A Pescosolido
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Lisa B Dixon
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Andrés Martin
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Neria, Dixon); Department of Biostatistics (Valeri) and Department of Epidemiology (Yang), Columbia University Mailman School of Public Health, New York City; Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York City (Yang); Department of Sociology, Indiana University, Bloomington (Pescosolido); Child Study Center and Simulated Participant Program, Yale School of Medicine, New Haven, Connecticut (Martin)
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Hayes D, Mansfield R, Mason C, Santos J, Moore A, Boehnke J, Ashworth E, Moltrecht B, Humphrey N, Stallard P, Patalay P, Deighton J. The impact of universal, school based, interventions on help seeking in children and young people: a systematic literature review. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-022-02135-y. [PMID: 36637482 PMCID: PMC9837763 DOI: 10.1007/s00787-022-02135-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 12/21/2022] [Indexed: 01/14/2023]
Abstract
Reviews into universal interventions to improve help seeking in young people focus on specific concepts, such as behaviour, do not differentiate between interpersonal and intrapersonal help seeking, and often report on statistical significance, rather than effect size. The aim of this review was to address the gaps highlighted above, to investigate the impact of universal, school-based interventions on help-seeking in children and young people, as well as to explore longer term impact. Four databases were searched. Data were extracted on country of origin, design, participant, school, and intervention characteristics, the help-seeking concept measured (e.g. knowledge, attitude/intention, behaviour), the duration between baseline and each follow-up (if applicable) and effect sizes at each follow-up. Quality assessment of the studies was undertaken using the Effective Public Health Practice Project (EPHPP) quality assessment tool. Overall, 14 different interventions met inclusion criteria. The majority of the studies were rated low in the quality assessment. Three constructs were most frequently reported a) intrapersonal attitudes towards help-seeking, b) interpersonal attitudes towards help-seeking and c) intrapersonal intended help-seeking. Findings around intervention effect were mixed. There was tentative evidence that interventions impacting interpersonal attitudes produced small effect sizes when measured between 3 and 6 months post intervention and that when effect sizes were initially observed intrapersonal attitudes, this remained at 3-6 month follow-up. Further work should pay attention to implementation factors, understanding the core ingredients needed to deliver effective interventions and whether embedding mental health education could help sustain or top up effect sizes from help-seeking interventions.
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Affiliation(s)
- Daniel Hayes
- Evidence Based Practice Unit, Anna Freud National Centre for Children, and Families, London, UK.
- Social Biobehavioural Research Group, Department of Behavioural Science and Health, University College London, London, UK.
| | - Rosie Mansfield
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
| | - Carla Mason
- Manchester Institute of Education, University of Manchester, Manchester, UK
| | - Joao Santos
- Manchester Institute of Education, University of Manchester, Manchester, UK
| | - Anna Moore
- Evidence Based Practice Unit, Anna Freud National Centre for Children, and Families, London, UK
| | - Jan Boehnke
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Emma Ashworth
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Bettina Moltrecht
- Evidence Based Practice Unit, Anna Freud National Centre for Children, and Families, London, UK
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
| | - Neil Humphrey
- Manchester Institute of Education, University of Manchester, Manchester, UK
| | | | - Praveetha Patalay
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
- Population Science and Experimental Medicine, MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Jessica Deighton
- Evidence Based Practice Unit, Anna Freud National Centre for Children, and Families, London, UK
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Mitchell RJ, McMaugh A, Schniering C, Cameron CM, Lystad RP, Badgery-Parker T, Nielssen O. Mental disorders and their impact on school performance and high school completion by gender in Australia: A matched population-based cohort study. Aust N Z J Psychiatry 2022; 56:1602-1616. [PMID: 34875885 DOI: 10.1177/00048674211061684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Young people with a mental disorder often perform poorly at school and can fail to complete high school. This study aims to compare scholastic performance and high school completion of young people hospitalised with a mental disorder compared to young people not hospitalised for a mental disorder health condition by gender. METHOD A population-based matched case-comparison cohort study of young people aged ⩽18 years hospitalised for a mental disorder during 2005-2018 in New South Wales, Australia using linked birth, health, education and mortality records. The comparison cohort was matched on age, gender and residential postcode. Generalised linear mixed modelling examined risk of school performance below the national minimum standard and generalised linear regression examined risk of not completing high school for young people with a mental disorder compared to matched peers. RESULTS Young males with a mental disorder had over a 1.7 times higher risk of not achieving the national minimum standard for numeracy (adjusted relative risk: 1.71; 95% confidence interval: [1.35, 2.15]) and reading (adjusted relative risk: 1.99; 95% confidence interval: [1.80, 2.20]) compared to matched peers. Young females with a mental disorder had around 1.5 times higher risk of not achieving the national minimum standard for numeracy (adjusted relative risk: 1.50; 95% confidence interval: [1.14, 1.96]) compared to matched peers. Both young males and females with a disorder had around a three times higher risk of not completing high school compared to peers. Young males with multiple disorders had up to a sixfold increased risk and young females with multiple disorders had up to an eightfold increased risk of not completing high school compared to peers. CONCLUSION Early recognition and support could improve school performance and educational outcomes for young people who were hospitalised with a mental disorder. This support should be provided in conjunction with access to mental health services and school involvement and assistance.
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Affiliation(s)
- Rebecca J Mitchell
- Australian Institute of Health Innovation (AIHI), Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Anne McMaugh
- The Macquarie School of Education, Macquarie University, Sydney, NSW, Australia
| | - Carolyn Schniering
- Centre for Emotional Health, Department of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Cate M Cameron
- Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Brisbane, QLD, Australia.,Queensland University of Technology (QUT), Centre for Healthcare Transformation, Australian Centre for Health Services Innovation (AusHSI), Brisbane, QLD, Australia
| | - Reidar P Lystad
- Australian Institute of Health Innovation (AIHI), Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Tim Badgery-Parker
- Australian Institute of Health Innovation (AIHI), Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Olav Nielssen
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
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Mitchell RJ, McMaugh A, Lystad RP, Cameron CM, Nielssen O. Health service use for young males and females with a mental disorder is higher than their peers in a population-level matched cohort. BMC Health Serv Res 2022; 22:1359. [DOI: 10.1186/s12913-022-08789-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/04/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
To inform healthcare planning and resourcing, population-level information is required on the use of health services among young people with a mental disorder. This study aims to identify the health service use associated with mental disorders among young people using a population-level matched cohort.
Method
A population-based matched case-comparison retrospective cohort study of young people aged ≤ 18 years hospitalised for a mental disorder during 2005–2018 in New South Wales, Australia was conducted using linked birth, health, and mortality records. The comparison cohort was matched on age, sex and residential postcode. Adjusted rate ratios (ARR) were calculated for key demographics and mental disorder type by sex.
Results
Emergency department visits, hospital admissions and ambulatory mental health service contacts were all higher for males and females with a mental disorder than matched peers. Further hospitalisation risk was over 10-fold higher for males with psychotic (ARR 13.69; 95%CI 8.95–20.94) and anxiety (ARR 11.44; 95%CI 8.70-15.04) disorders, and for both males and females with cognitive and behavioural delays (ARR 10.79; 95%CI 9.30-12.53 and ARR 14.62; 95%CI 11.20-19.08, respectively), intellectual disability (ARR 10.47; 95%CI 8.04–13.64 and ARR 11.35; 95%CI 7.83–16.45, respectively), and mood disorders (ARR 10.23; 95%CI 8.17–12.80 and ARR 10.12; 95%CI 8.58–11.93, respectively) compared to peers.
Conclusion
The high healthcare utilisation of young people with mental disorder supports the need for the development of community and hospital-based services that both prevent unnecessary hospital admissions in childhood and adolescence that can potentially reduce the burden and loss arising from mental disorders in adult life.
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Martin A, Calhoun A, Páez J, Amsalem D. Destigmatizing perceptions about Black adolescent depression: randomized controlled trial of brief social contact-based video interventions. J Child Psychol Psychiatry 2022; 63:1270-1278. [PMID: 35066880 PMCID: PMC9307690 DOI: 10.1111/jcpp.13570] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/10/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To test the utility of brief social contact-based video interventions of a Black adolescent girl to reduce stigmatized attitudes and increase help-seeking intentions around adolescent depression. METHODS We conducted a randomized controlled trial (RCT) with 14- to18-year-old healthy volunteers drawn from the general US population. We enrolled participants through a crowdsourcing platform (n = 1,093) and randomly assigned participants to one of three video conditions (117 s each): depressed (DEP); depressed, adjusted to aspects unique to being a Black adolescent girl (including experienced or internalized racism; ADJ); and control (CONT). The primary outcome was the Depression Stigma Scale (DSS); secondary outcomes were the General Health-Seeking Questionnaire (GHSQ), and thermometers for Black and white race perception "warmth". RESULTS Following the intervention, the DSS changed from baseline across the three conditions (p < .001). ADJ outperformed both DEP (p = .031) and CONT (p < .001). A race-by-intervention interaction (p < .001) revealed different response profiles between Black (ADJ = DEP = CONT; p = .726) and non-Black participants (ADJ > DEP > CONT; p < .001). DEP and ADJ both resulted in higher treatment-seeking intentions for both the emotional problems and the suicidal thought subscales of the GHSQ. We found a race-by-intervention interaction (p = .01) for the Black thermometer, which revealed a significant 2° increase in warmth among white (p < .001), but not Black, viewers (p = .06). CONCLUSIONS On a short-term basis, brief social contact-based videos proved effective among adolescents in reducing depression-related stigma, increasing help-seeking intentions, and providing an "empathic foothold" in the lives of racially stigmatized groups. Even as the enduring effects of these interventions remain to be determined, the deployment on social media of short videos opens new opportunities to reach a large number of at-risk youth."
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Affiliation(s)
- Andrés Martin
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
- Simulated Participant Program, Teaching and Learning Center, Yale School of Medicine, New Haven, CT, USA
| | - Amanda Calhoun
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - José Páez
- Child Study Center, Yale School of Medicine, New Haven, CT, USA
| | - Doron Amsalem
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
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Exploring the Potential of a School-Based Online Health and Wellbeing Screening Tool: Young People's Perspectives. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074062. [PMID: 35409747 PMCID: PMC8998184 DOI: 10.3390/ijerph19074062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 02/06/2023]
Abstract
Despite high levels of need, many young people who experience health issues do not seek, access or receive support. Between May and November 2021, using semi-structured interviews, we explored the perspectives of 51 young people (aged 13–14) from two schools who had taken part in a novel online health and wellbeing screening programme, the Digital Health Contact (DHC). One school delivered the DHC during home-learning due to COVID-19 restrictions, whilst the other delivered it in school when restrictions were lifted. The DHC was seen as a useful approach for identifying health need and providing support, and had high levels of acceptability. Young people appreciated the online format of the DHC screening questionnaire and thought this facilitated more honest responses than a face-to-face approach might generate. Completion at home, compared to school-based completion, was perceived as more private and less time-pressured, which young people thought facilitated more honest and detailed responses. Young people’s understanding of the screening process (including professional service involvement and confidentiality) influenced engagement and responses. Overall, our findings afford important insights around young people’s perspectives of participating in screening programmes, and highlight key considerations for the development and delivery of health screening approaches in (and out of) school.
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Amsalem D, Martin A. Reducing depression-related stigma and increasing treatment seeking among adolescents: randomized controlled trial of a brief video intervention. J Child Psychol Psychiatry 2022; 63:210-217. [PMID: 33821507 DOI: 10.1111/jcpp.13427] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Confronting stigma early in life could enhance receptivity to seeking treatment. We evaluated the efficacy of social contact interventions to reduce stigma toward depression and to enhance treatment-seeking intentions among adolescents. We hypothesized that the brief video-based interventions would be more effective than their matched controls. METHOD Using crowdsourcing, we recruited and randomly assigned 1,183 participants aged 14-18 to one of four video-based stimuli on a 4:4:1:1 ratio: (a) adolescent girl with depression; (b) adolescent boy with depression; (c) same girl, without depression; or (d) same boy, without depression. In each of the ~100-second-long videos, two simulated patients (SPs) depicted empowered presenters sharing their personal stories. In the depression conditions, SPs described how social support from family, friends, and professionals helped them overcome their symptoms and recover. RESULTS We found a significant effect for the Depression Stigma Scale (DSS) between active and control groups (F = 27.4, p < .001). We found a significant increase in treatment-seeking intentions, as measured by the General Help-Seeking Questionnaire (GHSQ; p < .001). Secondary analyses revealed that racial (but not gender) congruence between protagonists and participants resulted in greater stigma reduction and treatment seeking, as compared to racially incongruent pairings (t = 2.9, p = .004). CONCLUSION A brief video-based intervention effectively reduced stigma toward depression and increased treatment seeking among adolescents. Favorable changes were greater when race (but not gender) was congruent between protagonists and participants. Future studies should explore how to optimize brief contact-based interventions according to adolescents' race and ethnicity and how to scale such interventions to novel online platforms of dissemination.
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Affiliation(s)
- Doron Amsalem
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | - Andrés Martin
- Child Study Center, Yale School of Medicine, New Haven, CT, USA.,Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Amsalem D, Halloran J, Penque B, Celentano J, Martin A. Effect of a Brief Social Contact Video on Transphobia and Depression-Related Stigma Among Adolescents: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e220376. [PMID: 35212749 PMCID: PMC8881766 DOI: 10.1001/jamanetworkopen.2022.0376] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
IMPORTANCE Transphobia and stigma remain barriers to seeking mental health care for gender-diverse adolescents. OBJECTIVE To examine the utility of brief social contact-based video interventions of transgender protagonists with depression to reduce transphobia and depression-related stigma and increase treatment-seeking intentions among adolescents in the general population. DESIGN, SETTING, AND PARTICIPANTS During August 2021, a total of 1437 participants were recruited and randomly assigned to 1 of 4 video-based conditions in a 2:2:1:1 ratio: (1) transgender adolescent girls, (2) transgender adolescent boys, (3) cisgender adolescent girls, or (4) cisgender adolescent boys. INTERVENTIONS In each of the approximately 110-second videos, an empowered presenter shared their personal story about coping with depression and reaching out for help. MAIN OUTCOMES AND MEASURES The primary outcome was the score on the Attitudes Toward Transgender Men and Women (ATTMW) scale. Secondary outcomes were (1) a "gender thermometer" rating for warmth in transgender perception, (2) the Depression Stigma Scale (DSS) score, and (3) the General Health-Seeking Questionnaire (GHSQ) score. RESULTS Of the 1437 randomized participants, 1098 (76%) completed the postintervention assessment and passed all the validity tests (mean [SD] age, 16.9 [1.2] years; 481 [44%] male; 640 [58%] White). A significant change in attitudes toward transgender youth was found within the intervention group only (mean [SD] ATTMW scores: intervention group, 34.6 [23.1] at baseline to 32.8 [24.2] after intervention; P < .001; control group, 33.5 [23.4] at baseline to 32.4 [24.1] after intervention; P = .01). The mean (SD) total DSS scores decreased significantly across study groups (intervention: 1.3 [3.3]; control: 1.7 [3.3]; P < .001). A significant increase in intention to seek help from a parent was found in the intervention (mean [SD] GHSQ score, 0.2 [1.1]) and control (mean [SD] GHSQ score, 0.3 [1.2]) groups (P < .001), as was a decrease in those not wanting to seek help from anyone (mean [SD] GHSQ score: intervention, 0.2 [1.6], P = .009; control, 0.3 [1.2], P < .001) Secondary analyses revealed significant differences in baseline ATTMW scores and intervention effects between transgender and gender-diverse and cisgender participants and between lesbian, gay, bisexual, or queer (LGBQ) and straight participants (F = 36.7, P < .001) and heterosexual participants (F = 37.0, P < .001). A significant difference was also found in mean (SD) transgender warmth scores from baseline to after intervention between groups (2.6° [13.1°] in the intervention group vs 0.4° [8.3°] in the control group; P < .001). CONCLUSIONS AND RELEVANCE In this randomized clinical trial, brief social contact-based videos proved efficacious in reducing transphobia and depression-related stigma and in increasing treatment-seeking intentions among adolescents in the general population. By personifying, individualizing, and providing face and voice to the experience of transgender youth, other adolescents, especially those who are cisgender and/or of a heterosexual orientation, can gain empathetic insights into the lives of their often marginalized and stigmatized fellow youth. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04969003.
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Affiliation(s)
- Doron Amsalem
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York
| | - Justin Halloran
- Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - Brent Penque
- Child Study Center, Yale School of Medicine, New Haven, Connecticut
| | - Jillian Celentano
- Department of Social Work and Marriage and Family Therapy, Southern Connecticut State University, New Haven
- Simulated Participant Program, Teaching and Learning Center, Yale School of Medicine, New Haven, Connecticut
| | - Andrés Martin
- Child Study Center, Yale School of Medicine, New Haven, Connecticut
- Simulated Participant Program, Teaching and Learning Center, Yale School of Medicine, New Haven, Connecticut
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Radez J, Reardon T, Creswell C, Lawrence PJ, Evdoka-Burton G, Waite P. Why do children and adolescents (not) seek and access professional help for their mental health problems? A systematic review of quantitative and qualitative studies. Eur Child Adolesc Psychiatry 2021; 30:183-211. [PMID: 31965309 PMCID: PMC7932953 DOI: 10.1007/s00787-019-01469-4] [Citation(s) in RCA: 260] [Impact Index Per Article: 86.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 12/31/2019] [Indexed: 11/28/2022]
Abstract
Mental health disorders in children and adolescents are highly prevalent yet undertreated. A detailed understanding of the reasons for not seeking or accessing help as perceived by young people is crucial to address this gap. We conducted a systematic review (PROSPERO 42018088591) of quantitative and qualitative studies reporting barriers and facilitators to children and adolescents seeking and accessing professional help for mental health problems. We identified 53 eligible studies; 22 provided quantitative data, 30 provided qualitative data, and one provided both. Four main barrier/facilitator themes were identified. Almost all studies (96%) reported barriers related to young people's individual factors, such as limited mental health knowledge and broader perceptions of help-seeking. The second most commonly (92%) reported theme related to social factors, for example, perceived social stigma and embarrassment. The third theme captured young people's perceptions of the therapeutic relationship with professionals (68%) including perceived confidentiality and the ability to trust an unknown person. The fourth theme related to systemic and structural barriers and facilitators (58%), such as financial costs associated with mental health services, logistical barriers, and the availability of professional help. The findings highlight the complex array of internal and external factors that determine whether young people seek and access help for mental health difficulties. In addition to making effective support more available, targeted evidence-based interventions are required to reduce perceived public stigma and improve young people's knowledge of mental health problems and available support, including what to expect from professionals and services.
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Affiliation(s)
- Jerica Radez
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
| | - Tessa Reardon
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK. .,Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK.
| | - Cathy Creswell
- Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
| | | | - Georgina Evdoka-Burton
- Slough Community Mental Health Team, Berkshire Healthcare NHS Foundation Trust, Slough, UK
| | - Polly Waite
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK ,Departments of Experimental Psychology and Psychiatry, University of Oxford, Oxford, UK
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11
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Aguirre Velasco A, Cruz ISS, Billings J, Jimenez M, Rowe S. What are the barriers, facilitators and interventions targeting help-seeking behaviours for common mental health problems in adolescents? A systematic review. BMC Psychiatry 2020; 20:293. [PMID: 32527236 PMCID: PMC7291482 DOI: 10.1186/s12888-020-02659-0] [Citation(s) in RCA: 187] [Impact Index Per Article: 46.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 05/11/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Increasing rates of mental health problems among adolescents are of concern. Teens who are most in need of mental health attention are reluctant to seek help. A better understanding of the help-seeking in this population is needed to overcome this gap. METHODS Five databases were searched to identify the principal barriers, facilitators and interventions targeting help-seeking for common mental health problems in adolescents aged 10-19 years. The search was performed in June 2018 and updated in April 2019. Two independent screening processes were made using the eligibility criteria. Quality assessment of each study was performed, and findings summarised using a narrative synthesis. RESULTS Ninety studies meet the inclusion criteria for this review for barrier and facilitators (n = 54) and interventions (n = 36). Stigma and negative beliefs towards mental health services and professionals were the most cited barriers. Facilitators included previous positive experience with health services and mental health literacy. Most interventions were based on psychoeducation, which focused on general mental health knowledge, suicide and self-harm, stigma and depression. Other types of interventions included the use of multimedia and online tools, peer training and outreach initiatives. Overall, the quality of studies was low to medium and there was no general agreement regarding help-seeking definition and measurements. CONCLUSION Most of the interventions took place in an educational setting however, it is important to consider adolescents outside the educational system. Encouraging help-seeking should come with the increased availability of mental health support for all adolescents in need, but this is still a major challenge for Child and Adolescent Mental Health Services. There is also a need to develop shared definitions, theoretical frameworks and higher methodological standards in research regarding help-seeking behaviours in adolescents. This will allow more consistency and generalisability of findings, improving the development of help-seeking interventions and ensuring timely access to mental health treatments.
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Affiliation(s)
- Antonia Aguirre Velasco
- Child and Adolescent Mental Health Service, Children’s Hospital Dr. Roberto del Río, Santiago, Chile
| | | | - Jo Billings
- División of Psychiatry, University College London, London, UK
| | | | - Sarah Rowe
- División of Psychiatry, University College London, London, UK
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12
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Lubman DI, Cheetham A, Sandral E, Wolfe R, Martin C, Blee F, Berridge BJ, Jorm AF, Wilson C, Allen NB, McKay-Brown L, Proimos J. Twelve-month outcomes of MAKINGtheLINK: A cluster randomized controlled trial of a school-based program to facilitate help-seeking for substance use and mental health problems. EClinicalMedicine 2020; 18:100225. [PMID: 31922118 PMCID: PMC6948229 DOI: 10.1016/j.eclinm.2019.11.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/21/2019] [Accepted: 11/26/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Young people experiencing mental health problems are often reluctant to seek help, particularly from professionals (i.e., doctors or mental health workers). MAKINGtheLINK is a school-based intervention that aims to help adolescents overcome barriers to seeking professional help for mental health and substance use problems. METHODS A cluster randomised controlled trial was conducted to evaluate the 12-month outcomes of MAKINGtheLINK among 2447 participants (Mean age=14.9 years, SD=0.5 years, 50% male). Randomisation resulted in 1130 students from 11 schools allocated to receive the intervention, and 1317 students from 10 schools allocated to the wait-list control group. After the baseline assessment, follow-ups were conducted at 6-weeks (n = 2045), 6-months (n = 1874), and 12-months (n = 1827). The primary outcome measure was help-seeking behaviour, from both formal (e.g., health professionals) and informal (e.g., friends, family members) sources. The trial was registered with the Australia and New Zealand Clinical Trials Register (ANZCTR) on the 27th of February 2013 (registration number ACTRN12613000235707). FINDINGS The intervention was not associated with overall help-seeking at the 12-month follow-up (p = 0.99, odds ratio [OR]=1.00, 95% CI for OR = 0.70-1.42), or help-seeking for depression (p = 0.28, OR = 1.21, 95%CI =0.86-1.69), stress and anxiety (p = 0.73, OR = 1.04, 95%CI = 0.74-1.47), or alcohol/other drugs (p = 0.84, OR=1.12, CI=0.37-3.37). However, the intervention was associated with increased help-seeking from formal sources (compared to informal sources) both overall (p = 0.005, OR = 1.81, 95%CI = 1.19-2.75), as well as for depression (p = 0.01, OR=2.09, 95%CI=1.19-3.67), and stress and anxiety (p < 0.006, OR = 1.72, 95%CI = 1.17-2.54). INTERPRETATION Rates of help-seeking remained unchanged following the intervention. However, MAKINGtheLINK effectively improved the quality of adolescent help-seeking behaviour by increasing help-seeking from formal sources. As prompt treatment is essential in reducing the long-term impact of early onset mental health problems, MAKINGtheLINK has the potential to make a significant contribution to existing early intervention and prevention efforts. FUNDING National Health and Medical Research Council (APP1047492).
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Affiliation(s)
- Dan I Lubman
- Turning Point, Eastern Health, Richmond, Victoria 3121, Australia
- Eastern Health Clinical School, Monash University, Box Hill, Victoria 3128, Australia
- Corresponding author at: Turning Point, 100 Church St, Richmond, Victoria 3121, Australia.
| | - Ali Cheetham
- Turning Point, Eastern Health, Richmond, Victoria 3121, Australia
- Eastern Health Clinical School, Monash University, Box Hill, Victoria 3128, Australia
| | - Emma Sandral
- Turning Point, Eastern Health, Richmond, Victoria 3121, Australia
- Eastern Health Clinical School, Monash University, Box Hill, Victoria 3128, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Victoria 3004, Australia
| | - Catherine Martin
- School of Public Health and Preventive Medicine, Monash University, Victoria 3004, Australia
| | - Fiona Blee
- Turning Point, Eastern Health, Richmond, Victoria 3121, Australia
- Eastern Health Clinical School, Monash University, Box Hill, Victoria 3128, Australia
| | - Bonita J Berridge
- Turning Point, Eastern Health, Richmond, Victoria 3121, Australia
- Eastern Health Clinical School, Monash University, Box Hill, Victoria 3128, Australia
| | - Anthony F. Jorm
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Coralie Wilson
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
- Graduate Medicine, School of Medicine University of Wollongong, Wollongong, NSW 2522, Australia
- Centre for Personal and Professional Development (CPPD), Wollongong 2517, Australia
| | - Nicholas B. Allen
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Victoria 3052, Australia
- Department of Psychology, University of Oregon, Eugene 6200, United States
| | - Lisa McKay-Brown
- Travancore School, Victorian Department of Education and Training, Travancore, Victoria 6200, Australia
- Melbourne Graduate School of Education, The University of Melbourne, Victoria 6200, Australia
| | - Jenny Proimos
- Victorian Department of Education and Training, Melbourne, Victoria 6200, Australia
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13
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Olivari C, Guzmán M. Adaptación y Validación del Cuestionario de Barreras para la Búsqueda de Ayuda para Problemas de Salud Mental, en Adolescentes chilenos. UNIVERSITAS PSYCHOLOGICA 2018. [DOI: 10.11144/javeriana.upsy17-1.avcb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
La presente investigación tuvo como objetivo, adaptar y validar en adolescentes chilenos, el cuestionario de barreras para la búsqueda de ayuda para problemas de salud mental, versión breve (BASH-B). Este cuestionario mide las barreras o razones percibidas por los adolescentes para no buscar ayuda profesional cuando presentan algún problema psicológico. Los participantes fueron 387 adolescentes de entre 14 y 19 años (M = 15.71 años), escolarizados en establecimientos de enseñanza media de la comuna de Talca (Chile). Se analizaron las propiedades psicométricas del instrumento. El análisis confirmatorio corroboró la estructura factorial unidimensional. Además, los índices de confiabilidad fueron adecuados. La escala presentó asociación significativa con las variables depresión y autoeficacia en las direcciones esperadas. En base a estos resultados, es posible decir que el BASH-B es un instrumento que posee propiedades psicométricas adecuadas para medir las barreras de la búsqueda de ayuda en el ámbito de la salud mental en adolescentes.
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Swartz K, Musci RJ, Beaudry MB, Heley K, Miller L, Alfes C, Townsend L, Thornicroft G, Wilcox HC. School-Based Curriculum to Improve Depression Literacy Among US Secondary School Students: A Randomized Effectiveness Trial. Am J Public Health 2017; 107:1970-1976. [PMID: 29048969 PMCID: PMC5678387 DOI: 10.2105/ajph.2017.304088] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To determine the effectiveness of a universal school-based depression education program. METHODS In 2012-2015, we matched 6679 students from 66 secondary schools into pairs by state (Maryland, Delaware, Pennsylvania, Michigan, and Oklahoma) and randomized to the Adolescent Depression Awareness Program (ADAP; n = 3681) or to a waitlist control condition (n = 2998). Trained teachers delivered ADAP as part of the health education curriculum to students aged 14 to 15 years. The primary outcome was depression literacy. Secondary outcomes included mental health stigma and, in a subset of the sample, the receipt of mental health services. Follow-up was at 4 months. RESULTS ADAP resulted in significantly higher levels of depression literacy among participating students than did waitlist controls, after adjusting for pretest assessment depression literacy (P < .001). Overall, ADAP did not significantly affect stigma (P = .1). After ADAP, students approached 46% of teachers with concerns about themselves or others. Of students who reported the need for depression treatment, 44% received treatment within 4 months of ADAP implementation. CONCLUSIONS ADAP is an effective public health intervention for improving depression literacy among students. TRIAL REGISTRATION Clinicaltrials.gov NCT02099305.
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Affiliation(s)
- Karen Swartz
- Karen Swartz, Mary Beth Beaudry, Leslie Miller, Clarissa Alfes, Lisa Townsend, and Holly C. Wilcox are with the Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD. Rashelle J. Musci is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore. Kathryn Heley is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health. Graham Thornicroft is with the Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rashelle J Musci
- Karen Swartz, Mary Beth Beaudry, Leslie Miller, Clarissa Alfes, Lisa Townsend, and Holly C. Wilcox are with the Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD. Rashelle J. Musci is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore. Kathryn Heley is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health. Graham Thornicroft is with the Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mary Beth Beaudry
- Karen Swartz, Mary Beth Beaudry, Leslie Miller, Clarissa Alfes, Lisa Townsend, and Holly C. Wilcox are with the Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD. Rashelle J. Musci is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore. Kathryn Heley is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health. Graham Thornicroft is with the Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kathryn Heley
- Karen Swartz, Mary Beth Beaudry, Leslie Miller, Clarissa Alfes, Lisa Townsend, and Holly C. Wilcox are with the Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD. Rashelle J. Musci is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore. Kathryn Heley is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health. Graham Thornicroft is with the Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Leslie Miller
- Karen Swartz, Mary Beth Beaudry, Leslie Miller, Clarissa Alfes, Lisa Townsend, and Holly C. Wilcox are with the Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD. Rashelle J. Musci is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore. Kathryn Heley is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health. Graham Thornicroft is with the Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Clarissa Alfes
- Karen Swartz, Mary Beth Beaudry, Leslie Miller, Clarissa Alfes, Lisa Townsend, and Holly C. Wilcox are with the Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD. Rashelle J. Musci is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore. Kathryn Heley is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health. Graham Thornicroft is with the Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lisa Townsend
- Karen Swartz, Mary Beth Beaudry, Leslie Miller, Clarissa Alfes, Lisa Townsend, and Holly C. Wilcox are with the Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD. Rashelle J. Musci is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore. Kathryn Heley is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health. Graham Thornicroft is with the Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Graham Thornicroft
- Karen Swartz, Mary Beth Beaudry, Leslie Miller, Clarissa Alfes, Lisa Townsend, and Holly C. Wilcox are with the Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD. Rashelle J. Musci is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore. Kathryn Heley is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health. Graham Thornicroft is with the Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Holly C Wilcox
- Karen Swartz, Mary Beth Beaudry, Leslie Miller, Clarissa Alfes, Lisa Townsend, and Holly C. Wilcox are with the Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD. Rashelle J. Musci is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore. Kathryn Heley is with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health. Graham Thornicroft is with the Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Lubman DI, Cheetham A, Jorm AF, Berridge BJ, Wilson C, Blee F, Mckay-Brown L, Allen N, Proimos J. Australian adolescents' beliefs and help-seeking intentions towards peers experiencing symptoms of depression and alcohol misuse. BMC Public Health 2017; 17:658. [PMID: 28814325 PMCID: PMC5559792 DOI: 10.1186/s12889-017-4655-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 07/30/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Many young people are reluctant to seek professional help for mental health problems, preferring to rely on their friends for support. It is therefore important to ensure that adolescents can identify signs of psychological distress in their peers, talk to them about these, and help them access appropriate services when necessary. The current study examined adolescents' ability to recognise symptoms of depression and alcohol misuse, perceived barriers to help-seeking, and their intentions to encourage a peer to seek help from a range of informal and formal help sources. METHOD The current study used baseline data from a randomised controlled trial of a school-based intervention that teaches adolescents how to overcome barriers to accessing professional help for mental health and substance use problems (MAKINGtheLINK). Participants (n = 2456) were presented with two vignettes portraying depression and alcohol misuse, respectively, and were asked to identify the problems described. Participants provided data on their past help-seeking behaviour, confidence to help a peer, perceived barriers to help-seeking, and intentions to encourage a peer to seek help. RESULTS Health professionals were the main source of help that participants had relied on for depressive symptoms, followed by friends and parents. In contrast, friends were the main source of help that participants had relied on for alcohol and other drug problems, followed by health professionals and parents. Just over half of the sample correctly identified the problems described in the two vignettes, although the majority of participants were confident that they could talk to a peer and help them seek professional help if needed. Most agreed that the vignettes described problems that warranted professional help, however approximately half the sample was unsure or considered it unlikely that they would seek help if they experienced similar problems. For both disorders, participants were most likely to encourage a peer to seek help from their family, followed by formal help sources and friends. CONCLUSIONS While the results point towards a greater willingness to approach formal help sources, particularly for depression, peers remain an important source of support for young people experiencing mental health and substance use problems.
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Affiliation(s)
- D. I. Lubman
- Turning Point, Eastern Health, Fitzroy, VIC Australia
- Eastern Health Clinical School, Monash University, Box Hill, VIC Australia
| | - A. Cheetham
- Turning Point, Eastern Health, Fitzroy, VIC Australia
- Eastern Health Clinical School, Monash University, Box Hill, VIC Australia
| | - A. F. Jorm
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC Australia
| | - B. J. Berridge
- Turning Point, Eastern Health, Fitzroy, VIC Australia
- Eastern Health Clinical School, Monash University, Box Hill, VIC Australia
| | - C. Wilson
- Illawarra Health and Medical Research Institute, Wollongong, NSW Australia
- School of Medicine, University of Wollongong, Wollongong, NSW Australia
| | - F. Blee
- Turning Point, Eastern Health, Fitzroy, VIC Australia
- Eastern Health Clinical School, Monash University, Box Hill, VIC Australia
| | - L. Mckay-Brown
- Travancore School, Victorian Department of Education and Training, Travancore, VIC Australia
- Melbourne Graduate School of Education, The University of Melbourne, Parkville, VIC Australia
| | - N. Allen
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC Australia
- Department of Psychology, University of Oregon, Eugene, OR USA
| | - J. Proimos
- Victorian Department of Education and Training, Melbourne, VIC Australia
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Li W, Denson LA, Dorstyn DS. Help-Seeking Intentions and Behaviors among Mainland Chinese College Students: Integrating the Theory of Planned Behavior and Behavioral Model of Health Services Use. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2017. [DOI: 10.1007/s10447-017-9287-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Liebling EJ, Yedinak JL, Green TC, Hadland SE, Clark MA, Marshall BDL. Access to substance use treatment among young adults who use prescription opioids non-medically. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2016; 11:38. [PMID: 27894311 PMCID: PMC5127054 DOI: 10.1186/s13011-016-0082-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 11/23/2016] [Indexed: 02/03/2023]
Abstract
Background Non-medical prescription opioid (NMPO) use is a substantial public health problem in the United States, with 1.5 million new initiates annually. Only 746,000 people received treatment for NMPO use in 2013, demonstrating substantial disparities in access to treatment. This study aimed to assess correlates of accessing substance use treatment among young adult NMPO users in Rhode Island, a state heavily impacted by NMPO use and opioid overdose. Methods This analysis uses data from a study of 200 Rhode Island residents aged 18 to 29 who reported NMPO use in the past 30 days. We compared individuals who had ever successfully enrolled in a substance use treatment program without ever facing barriers, individuals who had ever attempted to enroll but were unable, and individuals who never attempted to enroll. We used multinomial logistic regression to determine the independent correlates of never attempting and unsuccessfully attempting to access substance use treatment. Results Among 200 participants, the mean age was 24.5, 65.5% were male, and 61.5% were white. Nearly half (45.5%) had never attempted to enroll in substance use treatment, while 35.0% had successfully enrolled without ever facing barriers and 19.5% were unsuccessful in at least one attempt to enroll. In multivariable models, non-white participants were more likely to never have attempted to enroll compared to white participants. Previous incarceration, experiencing drug-related discrimination by the medical community, and a monthly income of $501 - $1500 were associated with a decreased likelihood of never attempting to enroll. A history of overdose and a monthly income of $501 - $1500 were associated with an increased likelihood of unsuccessfully accessing treatment. The most commonly reported barriers to accessing treatment were waiting lists (n = 23), health insurance not approving enrollment (n = 20), and inability to pay (n = 16). Conclusions This study demonstrates significant disparities in access to treatment among young adults who report NMPO use. A history of overdose was shown to correlate with experiencing barriers to substance use treatment utilization. Interventions are needed to reduce drug-related discrimination in clinical settings and to provide mechanisms that link young adults (particularly with a history of overdose) to evidence-based treatment.
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Affiliation(s)
- Elliott J Liebling
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S-121-4, Providence, RI, 02912, USA
| | - Jesse L Yedinak
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S-121-4, Providence, RI, 02912, USA
| | - Traci C Green
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S-121-4, Providence, RI, 02912, USA.,Department of Emergency Medicine, Boston University School of Medicine, 771 Albany Street, Room 1208, Boston, MA, 02118, USA.,The Warren Alpert School of Medicine of Brown University, Rhode Island Hospital, 55 Claverick Street, Providence, RI, 02903, USA
| | - Scott E Hadland
- Division of General Pediatrics, Department of Pediatrics, Boston University School of Medicine, 88 East Newton Street, Vose Hall Room 322, Boston, MA, 02118, USA.,Division of Adolescent/Young Adult Medicine, Department of Medicine, Boston Children's Hospital, 333 Longwood Avenue, Boston, MA, 02115, USA.,Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Melissa A Clark
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S-121-4, Providence, RI, 02912, USA.,Department of Quantitative Health Sciences & Center for Health Policy and Research, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA, 01605, USA
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S-121-4, Providence, RI, 02912, USA.
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18
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Lubman DI, Berridge BJ, Blee F, Jorm AF, Wilson CJ, Allen NB, McKay-Brown L, Proimos J, Cheetham A, Wolfe R. A school-based health promotion programme to increase help-seeking for substance use and mental health problems: study protocol for a randomised controlled trial. Trials 2016; 17:393. [PMID: 27502480 PMCID: PMC4976510 DOI: 10.1186/s13063-016-1510-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 07/06/2016] [Indexed: 12/02/2022] Open
Abstract
Background Adolescence is a high-risk time for the development of mental health and substance use problems. However, fewer than one in four 16–24 year-olds with a current disorder access health services, with those experiencing a substance use disorder being the least likely to seek professional help. Research indicates that young people are keeping their problems to themselves or alternatively, turning to peers or trusted adults in their lives for help. These help-seeking preferences highlight the need to build the mental health literacy of adolescents, to ensure that they know when and how to assist themselves and their peers to access support. The MAKINGtheLINK intervention aims to introduce these skills to adolescents within a classroom environment. Methods/design This is a cluster randomised controlled trial (RCT) with schools as clusters and individual students as participants from 22 secondary schools in Victoria, Australia. Schools will be randomly assigned to either the MAKINGtheLINK intervention group or the waitlist control group. All students will complete a self-report questionnaire at baseline, immediately post intervention and 6 and 12 months post baseline. The primary outcome to be assessed is increased help-seeking behaviour (from both formal and informal sources) for alcohol and mental health issues, measured at 12 months post baseline. Discussion The findings from this research will provide evidence on the effectiveness of the MAKINGtheLINK intervention for teaching school students how to overcome prominent barriers associated with seeking help, as well as how to effectively support their peers. If deemed effective, the MAKINGtheLINK programme will be the first evidence-informed resource that is able to address critical gaps in the knowledge and behaviour of adolescents in relation to help-seeking. It could, therefore, be a valuable resource that could be readily implemented by classroom teachers. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12613000235707. Registered on 27 February 2013. Electronic supplementary material The online version of this article (doi:10.1186/s13063-016-1510-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dan I Lubman
- Turning Point, Eastern Health, 54-62 Gertrude St, Fitzroy, VIC, 3065, Australia. .,Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia.
| | - Bonita J Berridge
- Turning Point, Eastern Health, 54-62 Gertrude St, Fitzroy, VIC, 3065, Australia.,Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Fiona Blee
- Turning Point, Eastern Health, 54-62 Gertrude St, Fitzroy, VIC, 3065, Australia.,Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Anthony F Jorm
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Coralie J Wilson
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia.,Graduate School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - Nicholas B Allen
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia.,Department of Psychology, University of Oregon, Eugene, OR, USA
| | - Lisa McKay-Brown
- Victorian Department of Education and Early Childhood Development, Travancore School, Travancore, VIC, Australia.,Melbourne Graduate School of Education, The University of Melbourne, Parkvilleᅟ, VIC, Australia
| | - Jenny Proimos
- Victorian Department of Education and Early Childhood Development, Melbourne, VIC, Australia
| | - Ali Cheetham
- Turning Point, Eastern Health, 54-62 Gertrude St, Fitzroy, VIC, 3065, Australia.,Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
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19
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Ekornes S. Teacher Perspectives on Their Role and the Challenges of Inter-professional Collaboration in Mental Health Promotion. SCHOOL MENTAL HEALTH 2015. [DOI: 10.1007/s12310-015-9147-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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Larson AM, Selameab T, Bushyhead B. Teens and Preventive Care Use: Implications for EPSDT Outreach. SOCIAL WORK IN PUBLIC HEALTH 2015; 30:443-461. [PMID: 26156400 DOI: 10.1080/19371918.2015.1051260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Teens have low overall preventive care utilization compared to other age groups. Low health care use by teens is a result of a variety of complex economic, social, and cultural factors. This study, completed by one local community health board responsible for the administration of the Early Periodic Screening Diagnosis and Treatment (EPSDT) program, produced findings that enhanced outreach to teens and supported the medical providers who serve them. More than 800 teens and young adults from a variety of cultures and communities across an urban Minnesota county were surveyed to understand the conditions under which they do and do not seek medical care. Findings suggest teens with structural barriers associated with poverty such as lack of insurance and transportation to clinics could benefit from intentional connections to medical programs. Psychosocial barriers, revolving around trust, relationships with providers, communication, and privacy, might be ameliorated through enhanced education and targeted outreach to clinics and teens, activities appropriate under the objectives and program activities of EPSDT. This study could be replicated in any community to gather data unique to local populations being served.
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Affiliation(s)
- Anita M Larson
- a Saint Paul-Ramsey County Public Health Department , Saint Paul , Minnesota , USA
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21
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Rassy J, St-Cyr Tribble D, Bonin JP, Mathieu L, Michaud C. La recherche d’aide sur Internet chez des adolescents ayant des idées suicidaires : une analyse de concept. Rech Soins Infirm 2015. [DOI: 10.3917/rsi.120.0078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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22
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Hartman LI, Michel NM, Winter A, Young RE, Flett GL, Goldberg JO. Self-Stigma of Mental Illness in High School Youth. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2013. [DOI: 10.1177/0829573512468846] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Despite the prevalence of mental health problems, society continues to stigmatize and discriminate against people with mental illness and in particular, schizophrenia. Among the negative consequences of stigma, is that some individuals with mental illness internalize negative stereotypes about themselves, referred to as self-stigma, which is associated with a reluctance to seek needed treatment. The challenge to overcome mental illness stigma has led to the development of global anti-stigma initiatives, which effectively engage young people in school-based programs. The present study examines the effectiveness of a single-session anti-stigma intervention with high school youth ( n = 254). The findings replicate and extend previous work demonstrating that a brief anti-stigma initiative can produce significant improvements in knowledge, social distance, and self-stigma. Self-stigma was found to be associated with low self-esteem and factors affecting self-disclosure were identified. Implications for school curricula, mental health policy, and future research are discussed.
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23
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Fuller-Thomson E, Hamelin GP, Granger SJR. Suicidal ideation in a population-based sample of adolescents: implications for family medicine practice. ISRN FAMILY MEDICINE 2013; 2013:282378. [PMID: 24967322 PMCID: PMC4041249 DOI: 10.5402/2013/282378] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 12/23/2012] [Indexed: 11/23/2022]
Abstract
Introduction. This study investigated the relationship between suicidal ideation and demographic characteristics, health conditions, depression, and health care utilization patterns among adolescents. Methods. Secondary analysis of the regionally representative Canadian Community Health Survey conducted in 2000/2001 (response rate 85%). Adolescents aged 15 to 19 who reported suicidal ideation in the previous year (n = 260) were compared with their peers who did not (n = 5528). The association between suicidal ideation and socio-demographic and health characteristics were investigated. Findings. Almost three-quarters (73%) of suicidal adolescents had not spoken with any health professional about mental health issues in the preceding year. Despite the fact that 80% of suicidal adolescents had regular contact with their family doctor, only 5% had consulted with them about mental health issues. In addition to the well-known risk factors of depression and stress, suicidal ideation was highly elevated in adolescents with two or more chronic health conditions, self-reported poor health, migraines, and back pain and those whose activities were prevented by pain (P < .05). Other characteristics significantly correlated with suicidal ideation included smoking, living in single parent families, and having lower levels of social support. Conclusions. Family physicians should regularly screen for suicidal thoughts in their adolescent patients with these characteristics.
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Affiliation(s)
- Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work and Department of Family and Community Medicine, University of Toronto, 246 Bloor Street West, Toronto, ON, Canada M5S 1A1
| | - Gail P Hamelin
- Kinark Child and Family Services, 34 Simcoe Street, Suite 301, Barrie, ON, Canada L4N 6T4
| | - Stephen J R Granger
- Parent and Child Capacity Building Team, Peel Children's Aid Society, 6860 Century Avenue, Mississauga, ON, Canada L5N 2W5
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24
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Wright A, Jorm AF, Mackinnon AJ. Labels used by young people to describe mental disorders: which ones predict effective help-seeking choices? Soc Psychiatry Psychiatr Epidemiol 2012; 47:917-26. [PMID: 21626056 DOI: 10.1007/s00127-011-0399-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Accepted: 05/16/2011] [Indexed: 11/30/2022]
Abstract
PURPOSE Mental disorders are common in young people, yet many do not seek help. Being able to label the problem may facilitate effective help-seeking, but it is not clear which labels are best. This study aims to examine which labels commonly used by young people are associated with a preference for recommended sources of help and treatment. METHOD A national telephone survey was conducted with a randomly selected sample of 2,802 Australian young people aged 12-25 years. Respondents were read out one of three vignettes describing symptoms of a mental disorder, and asked a series of questions regarding labelling of the problem described and related help-seeking preferences and beliefs. Binary logistic regression analyses were used to measure the association between type of label used and help-seeking preferences and beliefs. RESULTS Use of the accurate label to describe the problem in the vignette predicted a preference for recommended sources of help with greater consistency than any other labels commonly used by young people. Inaccurate mental health labels did predict some preferences for recommended sources of help and treatment, but not to the extent of the accurate label. Lay labels such as "stress", "paranoid" and "shy" predicted less intention to seek any help for the problem described in the vignette. CONCLUSIONS Labelling a disorder accurately does predict a preference for recommended sources of help and a belief in the helpfulness of recommended treatments. Importantly, it is also apparent that some commonly used lay labels cannot do this and indeed may limit appropriate help-seeking and treatment acceptance.
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Affiliation(s)
- Annemarie Wright
- Orygen Youth Health Research Centre, The University of Melbourne, Locked Bag 10, Parkville, VIC, 3052, Australia.
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25
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Rughani J, Deane FP, Wilson CJ. Rural adolescents' help-seeking intentions for emotional problems: The influence of perceived benefits and stoicism. Aust J Rural Health 2011; 19:64-9. [DOI: 10.1111/j.1440-1584.2011.01185.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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26
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Wilson CJ, Bushnell JA, Caputi P. Early access and help seeking: practice implications and new initiatives. Early Interv Psychiatry 2011; 5 Suppl 1:34-9. [PMID: 21208389 DOI: 10.1111/j.1751-7893.2010.00238.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM Seeking appropriate help for early signs and symptoms of psychological distress can reduce the long-term impact of many mental disorders. This article describes practice implications and new initiatives for promoting early access and help-seeking among young people. METHODS Relevant help-seeking research is reviewed, and prominent help-seeking barriers are discussed. RESULTS Prominent barriers for young people include: incomplete mental health and emotional literacy, beliefs about having little need for help versus having a need for autonomy, and the process of help-negation for different symptoms of psychological distress. CONCLUSIONS To improve early access to appropriate help and mental health services, barriers that can be reduced, and in particular, psychological distress symptoms that promote the help-negation process, must be reduced as soon as they can be. Strategies that can be used by clinicians, parents and others, including young people, to encourage appropriate help-seeking are provided. Examples of how these strategies are implemented in several innovative programs and approaches are discussed.
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Affiliation(s)
- Coralie J Wilson
- Graduate School of Medicine School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia.
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27
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Gulliver A, Griffiths KM, Christensen H. Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry 2010; 10:113. [PMID: 21192795 PMCID: PMC3022639 DOI: 10.1186/1471-244x-10-113] [Citation(s) in RCA: 1416] [Impact Index Per Article: 101.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Accepted: 12/30/2010] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Adolescents and young adults frequently experience mental disorders, yet tend not to seek help. This systematic review aims to summarise reported barriers and facilitators of help-seeking in young people using both qualitative research from surveys, focus groups, and interviews and quantitative data from published surveys. It extends previous reviews through its systematic research methodology and by the inclusion of published studies describing what young people themselves perceive are the barriers and facilitators to help-seeking for common mental health problems. METHODS Twenty two published studies of perceived barriers or facilitators in adolescents or young adults were identified through searches of PubMed, PsycInfo, and the Cochrane database. A thematic analysis was undertaken on the results reported in the qualitative literature and quantitative literature. RESULTS Fifteen qualitative and seven quantitative studies were identified. Young people perceived stigma and embarrassment, problems recognising symptoms (poor mental health literacy), and a preference for self-reliance as the most important barriers to help-seeking. Facilitators were comparatively under-researched. However, there was evidence that young people perceived positive past experiences, and social support and encouragement from others as aids to the help-seeking process. CONCLUSIONS Strategies for improving help-seeking by adolescents and young adults should focus on improving mental health literacy, reducing stigma, and taking into account the desire of young people for self-reliance.
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Affiliation(s)
- Amelia Gulliver
- Centre for Mental Health Research, The Australian National University, Canberra, Australia.
| | - Kathleen M Griffiths
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
| | - Helen Christensen
- Centre for Mental Health Research, The Australian National University, Canberra, Australia
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28
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Wilson CJ, Deane FP, Marshall KL, Dalley A. Adolescents' suicidal thinking and reluctance to consult general medical practitioners. J Youth Adolesc 2009; 39:343-56. [PMID: 20229227 DOI: 10.1007/s10964-009-9436-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2009] [Accepted: 07/01/2009] [Indexed: 10/20/2022]
Abstract
Appropriate help-seeking is widely recognized as a protective factor, and vital for early treatment and prevention of mental health problems during adolescence. General medical practitioners (GPs), that is, family doctors, provide a vital role in the identification of adolescents with mental health problems and the provision of treatment as well as access to other specialists in mental health care services. The current study examined the association between suicidal ideation and intentions to seek help from a GP for suicidal thoughts, emotional problems and physical health problems, using a sample of 590 Australian high school students that was 56.7% female and aged 13-18 years (M = 15.56 years, SD = .66 years). Higher levels of suicidal ideation and general psychological distress were related to lower intentions to seek help from a GP for suicidal and physical problems. The results suggest that even at subclinical levels, increases in suicidal ideation or psychological distress may lead to help avoidance. School personnel and other gatekeepers need to be aware of this trend in order to be more assertive in encouraging and supporting appropriate help-seeking for mental health problems. School health promotion programs should consider including information to explicitly address the help-negation process.
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Affiliation(s)
- Coralie J Wilson
- Illawarra Institute for Mental Health, Wollongong, NSW, Australia.
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