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Adams C, Gringart E, Strobel N. Explaining adults' mental health help-seeking through the lens of the theory of planned behavior: a scoping review. Syst Rev 2022; 11:160. [PMID: 35945633 PMCID: PMC9361557 DOI: 10.1186/s13643-022-02034-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/26/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Despite evidence-based efficacy, mental health services are underutilized due to low rates of help-seeking, leaving unmet mental health needs a global concern. The Theory of Planned Behavior (TPB) has been applied to understand the help-seeking process and in the development of behavior change interventions. The aim of this scoping review was to map the literature on the TPB as applied to mental health help-seeking in adults aged >18 years. METHODS This scoping review was conducted based on the methodology presented by Arksey and O'Malley (2005). Six databases (CINAHL, PsycINFO, MEDLINE, ProQuest Health and Medicine, ProQuest Dissertations and Theses, Web of Science) and two grey literature sources (OpenGrey, Google Scholar) were systematically searched in February 2018 and updated in March 2020. Studies that explicitly discussed the TPB in the context of mental health help-seeking were initially selected; only studies that explored formal help-seeking for mental health problems and were published in English were retained. Data were extracted using Microsoft Excel. RESULTS Initially, 8898 records were identified. Of these, 49 met the selection criteria and were included: 32 were journal articles and 17 were theses. Forty-three papers reported on non-intervention studies and seven articles reported on TPB-based interventions. Most studies (n = 39) identified predictors of help-seeking intentions. Attitudes and perceived behavioral control were significant predictors of intentions in 35 and 34 studies, respectively. Subjective norms were a significant predictor of intentions in 23 studies. Few studies aimed to predict help-seeking behavior (n = 8). Intentions and perceived behavioral control were significant predictors of behavior in seven and six studies, respectively. Only six TPB-based interventions were identified, all used digital technology to influence help-seeking, with mixed results. CONCLUSIONS The present scoping review identified a considerable evidence base on the TPB for predicting mental health help-seeking intentions. Attitudes and perceived behavioral control were frequently found to be significant predictors of help-seeking intentions. Knowledge on the TPB for predicting mental health help-seeking behavior, and on TPB-based interventions, is limited. Thus, the role of the TPB in developing help-seeking interventions remains unclear. Recommendations are presented to address such research gaps and inform policy and practice.
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Affiliation(s)
- Claire Adams
- School of Arts and Humanities, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, Western Australia, 6027, Australia. .,Kurongkurl Katitjin, Edith Cowan University, 2 Bradford Street, Mount Lawley, Western Australia, 6050, Australia.
| | - Eyal Gringart
- School of Arts and Humanities, Edith Cowan University, 270 Joondalup Drive, Joondalup, Perth, Western Australia, 6027, Australia
| | - Natalie Strobel
- Kurongkurl Katitjin, Edith Cowan University, 2 Bradford Street, Mount Lawley, Western Australia, 6050, Australia
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Fikretoglu D, Sharp ML, Adler AB, Bélanger S, Benassi H, Bennett C, Bryant R, Busuttil W, Cramm H, Fear N, Greenberg N, Heber A, Hosseiny F, Hoge CW, Jetly R, McFarlane A, Morganstein J, Murphy D, O'Donnell M, Phelps A, Richardson DJ, Sadler N, Schnurr PP, Smith P, Ursano R, Hooff MV, Wessely S, Forbes D, Pedlar D. Pathways to mental health care in active military populations across the Five-Eyes nations: An integrated perspective. Clin Psychol Rev 2021; 91:102100. [PMID: 34871868 DOI: 10.1016/j.cpr.2021.102100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/29/2021] [Accepted: 11/05/2021] [Indexed: 12/19/2022]
Abstract
Military service is associated with increased risk of mental health problems. Previous reviews have pointed to under-utilization of mental health services in military populations. Building on the most recent systematic review, our narrative, critical review takes a complementary approach and considers research across the Five-Eyes nations from the past six years to update and broaden the discussion on pathways to mental healthcare in military populations. We find that at a broad population level, there is improvement in several indicators of mental health care access, with greater gains in initial engagement, time to first treatment contact, and subjective satisfaction with care, and smaller gains in objective indicators of adequacy of care. Among individual-level barriers to care-seeking, there is progress in improving recognition of need for care and reducing stigma concerns. Among organizational-level barriers, there are advances in availability of services and cultural acceptance of care-seeking. Other barriers, such as concerns around confidentiality, career impact, and deployability persist, however, and may account for some remaining unmet need. To address these barriers, new initiatives that are more evidence-based, theoretically-driven, and culturally-sensitive, are therefore needed, and must be rigorously evaluated to ensure they bring about additional improvements in pathways to care.
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Affiliation(s)
- Deniz Fikretoglu
- Defence Research and Development Canada, 1133 Sheppard Ave. West, Toronto, ON, Canada.
| | | | - Amy B Adler
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | | | | | | | | | | | - Heidi Cramm
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | | | | | | | - Fardous Hosseiny
- Centre of Excellence on Post-Traumatic Stress Disorder (PTSD), Ottawa, ON, Canada
| | - Charles W Hoge
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - Rakesh Jetly
- Department of National Defence, Ottawa, ON, Canada
| | | | | | - Dominic Murphy
- Combat Stress, Leatherhead, Surrey, UK; King's College London, London, UK
| | - Meaghan O'Donnell
- Phoenix, Australia: Centre for Posttraumatic Mental Health, Carlton, Australia
| | - Andrea Phelps
- Phoenix, Australia: Centre for Posttraumatic Mental Health, Carlton, Australia
| | - Don J Richardson
- Parkwood Institute- St. Joseph's Health Care London, London, ON, Canada
| | - Nicole Sadler
- Phoenix, Australia: Centre for Posttraumatic Mental Health, Carlton, Australia
| | | | - Patrick Smith
- Centre of Excellence on Post-Traumatic Stress Disorder (PTSD), Ottawa, ON, Canada
| | | | - Miranda Van Hooff
- Military and Emergency Services Health Australia (MESHA), Woodville, SA, Australia
| | | | - David Forbes
- Phoenix, Australia: Centre for Posttraumatic Mental Health, Carlton, Australia
| | - David Pedlar
- Canadian Institute for Military and Veteran Health Research, Queen's University, Kingston, ON, Canada
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Adams C, Gringart E, Strobel N, Masterman P. Help-seeking for mental health problems among older adults with chronic disease: an application of the theory of planned behaviour. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2021. [DOI: 10.1080/00049530.2021.1952850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Claire Adams
- School of Arts and Humanities, Edith Cowan University, Perth, Australia
| | - Eyal Gringart
- School of Arts and Humanities, Edith Cowan University, Perth, Australia
| | - Natalie Strobel
- Kurongkurl Katitjin, Edith Cowan University, Perth, Australia
| | - Paul Masterman
- School of Arts and Humanities, Edith Cowan University, Perth, Australia
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