Attitudes about mental illness and help seeking among adolescent males

COVID-19 and Adolescent Outpatient Mental Health Service Utilization

OBJECTIVE

The COVID-19 pandemic created challenges in accessing mental health (MH) services when adolescent well-being declined. Still, little is known about how the COVID-19 pandemic affected outpatient MH service utilization for adolescents.

METHODS

Retrospective data were collected from electronic medical records of adolescents aged 12-17 years at Kaiser Permanente Mid-Atlantic States, an integrated health care system from January 2019 to December 2021. MH diagnoses included anxiety, mood disorder/depression, anxiety and mood disorder/depression, attention-deficit/hyperactivity disorder, or psychosis. We used interrupted time series analysis to compare MH visits and psychopharmaceutical prescribing before and after the COVID-19 onset. Analyses were stratified by demographics and visit modality.

RESULTS

The study population of 8121 adolescents with MH visits resulted in a total of 61,971 (28.1%) of the 220,271 outpatient visits associated with an MH diagnosis. During 15,771 (7.2%) adolescent outpatient visits psychotropic medications were prescribed. The increasing rate of MH visits prior to COVID-19 was unaffected by COVID-19 onset; however, in-person visits declined by 230.5 visits per week (P < .001) from 274.5 visits per week coupled with a rise in virtual modalities. Rates of MH visits during the COVID-19 pandemic differed by sex, mental health diagnosis, and racial and ethnic identity. Psychopharmaceutical prescribing during MH visits declined beyond expected values by a mean of 32.8 visits per week (P < .001) at the start of the COVID-19 pandemic.

CONCLUSIONS

A sustained switch to virtual visits highlights a new paradigm in care modalities for adolescents. Psychopharmaceutical prescribing declined requiring further qualitative assessments to improve the quality of access for adolescent MH.

Measurement properties of patient-reported outcome measures of mental help-seeking attitude: a systematic review of psychometric properties

Background

At present, the phenomenon of patients with mental disorders not seeking mental help is very serious, and the mental help-seeking attitude is the central structure of the help process. However, there is no consensus on which patient-reported outcome measure (PROM) should be used to assess mental help-seeking attitudes.

Objective

The systematic review aims to critically appraise, compare, and summarize the measurement quality of the all-available PROMs about mental help-seeking attitudes to provide evidence-based guidance and reference for clinical researchers.

Methods

A systematic search was conducted in 9 databases (PubMed, Embase, Web of Science, Medline, APA, CINAHL, Sinomed, CNKI, and WanFang) since the establishment of the database until November 30, 2022 to identify articles on the PROMs of mental help-seeking attitudes. We used the COSMIN guidelines to evaluate the methodological quality and measurement properties of all-available PROMs, and a modified Grading, Recommendation, Assessment, Development, and Evaluation (GRADE) system to evaluate the level of evidence supporting each rating. Finally, the recommendation level is given according to the overall quality of each PROM.

Results

We identified 29 studies representing 13 PROMs out of 2,828 screening studies. The overall quality of the included PROMs varied, with 6 rated as class B, 6 as class C, and only the Mental Help Seeking Attitudes Scale (MHSAS) as class A.

Conclusion

The measurement characteristics of MHSAS have been the most comprehensive evaluation, and it has good reliability and validity, and high feasibility for clinical application, so it can be temporarily recommended for use, but the above conclusions still need to be supported by more high-quality evidence.

Profiles of mental health help seeking among Australian adolescent males

INTRODUCTION

Adolescent males are at increased risk of mental illness and are reluctant to engage in treatment. This study aims to identify subgroups of help-seeking intentions among a sample of Australian male adolescents.

METHODS

A sample of 1038 male adolescent sport participants in Australia (age M = 14.69 years, SD = 1.35) reported help-seeking intentions from ten sources and from 'no one'. Latent profile analysis was conducted based on these 11 items. Identified profiles were then compared across mental health measures.

RESULTS

Four latent profiles were identified: Low general help-seekers (10.5%), Moderate general help-seekers (46.8%), High general help-seekers (25.5%), High family and friends help-seekers (17.2%). Low, Moderate, and High general help-seekers had uniformly low, moderate, and high intentions to seek help from all sources, respectively. High family and friends help-seekers reported high endorsement of intentions to seek help from intimate partners, friends, parents, and other relatives, but low intentions for other sources. Low general help-seekers had lower intentions to seek help from parents compared to all other profiles. They also had significantly lower perceived family support and higher psychological distress.

CONCLUSIONS

Low general help-seekers were particularly reluctant to seek help from all sources and at high risk of experiencing psychological difficulties. Their distinct profile offers potential to identify this high-risk group through the use of ratings on the parent help-seeking intentions item. Further research should investigate the predictive utility of this item on help-seeking and mental health, and should consider the influence of masculinity and previous experiences of help-seeking.