SEEKING HELP FOR PSYCHOLOGICAL DISTRESS IN URBAN CHINA

Based on data gathered through a household survey of 1,474 urban residents in Beijing, this study examines Chinese help‐seeking behaviors in times of psychological distress and perceived barriers to seeking professional help. The results demonstrate that most respondents rely on informal means of seeking help whereas mental health and medical services are underused. The Internet has become a preferred alternative help‐seeking approach, particularly among the young educated migrant population. Respondents with higher socioeconomic status are more likely to utilize professional services. The tendency to seek help informally is associated with refusal to recognize the need of professional help, whereas embarrassment and stigma are significant factors in the use of alternative services, particularly the Internet. In addition to showing a general lack of trust in professional mental health services, the more psychologically distressed subgroup also expressed concerns about the affordability of professional treatment.     

“We almost had the whole block's phone number on the wall”: A mixed methods investigation of informal helping in a predominantly rural sample

Community psychologists have noted the limitations of professional models of mental health treatment, demonstrating that people are more likely to use informal familial or community support during adversity. However, relatively little is known about the forms and functions of informal help seeking and provision. Semistructured interviews (N = 170), in which a sample of predominantly rural‐dwelling adolescents and adults described significant life experiences, were coded for instances of receiving help. Codes thematically categorized the type of adversity, role of the helper, and nature of the help received. Most participants (67.64%) reported the presence of at least one informal helper; only 8.82% of participants discussed receiving professional help. Chi‐square analyses suggested that the nature of the help received varied by the types of helper and adversity being experienced and that different helpers were more likely to aid with particular adversities. The presence of a nonfamilial, nonprofessional helper was associated with higher posttraumatic growth, generativity, and perceived social support.     

Cultural factors in help‐seeking for child behavior problems: Value orientation,affective responding,and severity appraisals among Chinese‐American parents

This study explored the relationships between cultural values, appraisal of child behavior problems, and associated help‐seeking intentions among Chinese‐American parents. Questionnaires were administered to 120 Chinese‐American parents of elementary‐school‐aged children. Parents were asked how they might respond if their child displayed the behavioral problems depicted in a hypothetical vignette. Influences of Chinese value orientation, severity appraisal, and affective reactions on help‐seeking intentions were examined using regression analyses and structural equation modeling. The study examined three hypotheses regarding the nature of the influence of cultural value orientation on help‐seeking intentions: (a) a direct effect model, (b) an indirect effect through cultural differences in severity appraisal, and (c) an indirect effect through cultural differences in affective responding. Results supported the hypothesis that cultural value orientation exerted an indirect effect on help‐seeking intentions through its influence on affective responding. Those parents who had more traditional Chinese values responded with more feelings of shame to child behavior problems and, in turn, reported lower intentions to seek help. Findings are discussed with reference to the literature on help‐seeking among Asian Americans. © 2001 John Wiley & Sons, Inc.     

The need for control,safety and trust in healthcare: A qualitative study among adolescents and young adults exposed to family violence

ObjectiveAdolescents and young adults (AYA) exposed to family violence are in need of professional healthcare. However, only one-third of them seek professional help.MethodsThis study investigates healthcare needs of twelve AYA exposed to family violence. Semi-structured face-to-face interviews using purposive sampling to reach diversity. Open thematic coding was used to identify the most important themes.ResultsParticipants experienced emotional problems, distrusted others and felt unsafe as an important consequence of their exposure to family violence. All participants expressed a need for help, but as help involved informing others, they considered it unsafe. Trust, safety and control regarding healthcare interventions emerged as vital needs. The anonymity of the Internet was considered as offering safeguards in seeking and receiving help.ConclusionTrust, safety and control regarding healthcare interventions emerged as vital needs for AYA exposed to family violence. The great importance of being in control of healthcare interventions has not been reported earlier. A personal bond can lower the need for control.Practice implicationsTo comply with the three basic needs, healthcare providers should grant AYA as much control as possible while still monitoring patient safety. The Internet can be an important resource for offering low-threshold professional and peer support.     

Help‐seeking intentions for breast‐cancer symptoms: A comparison of the self‐regulation model and the theory of planned behaviour

Purpose: Delays in seeking help for symptoms have been found to be associated with poorer outcome in breast‐cancer patients. This study explores symptom perceptions and health beliefs as predictors of intentions to seek medical help in a general female population. The utility of the self‐regulation model of illness cognition and the theory of planned behaviour were examined in predicting help‐seeking intentions for potential symptoms of breast cancer in a general population sample. Methods: A general population sample of 546 women completed a postal questionnaire comprising items examining components of the self‐regulation model and the theory of planned behaviour. Help‐seeking intention was determined by asking participants to rate the likelihood of visiting their GP for a range of breast symptoms. Results: Hierarchical multiple regression analysis revealed that the cognitive component of the self‐regulation model accounted for approximately 22% of the variance in help‐seeking intention. Identity (β = 0.45, p < .001) emerged as a significant predictor of intention to seek help. Inclusion of the components of the theory of planned behaviour accounted for an additional 7% of the variance; the significant predictors were attitude to help‐seeking (β = 0.19, p <.001) and perceived behavioural control (β = 0.12, p <.01). Conclusions: Intention to seek medical help for a potential breast‐cancer symptom may be mediated, partly, by cognitive representations of the identity and consequences of breast cancer and by attitudes towards help‐seeking and perceived behavioural control. Although less than one‐third of the variance was accounted for, these results have important implications for future research (in terms of identifying which variables should be examined) and for the development of a model of help‐seeking behaviour in women with breast‐cancer symptoms.     

Racial differences in informal help seeking for mental health problems

The present study examined the hypothesis of greater African American informal help seeking for mental health problems in a comparison of African Americans and Whites. Controlling for sociodemographic factors, symptom distress, and diagnosis, African Americans were less likely than Whites to report turning for assistance to a friend, family member, or religious figure. Nor did African Americans use informal help as a substitute for professional care; they turned to informal helpers in conjunction with formal helpers, and demonstrated complementarity to a greater extent than Whites. Supportive ties found among African Americans may be advantageous for many purposes, but provide no benefit for the face-to-face discussion of emotional problems. © 1998 John Wiley & Sons, Inc.     

Health e-Cards as a Means of Encouraging Help Seeking for Depression Among Young Adults: Randomized Controlled Trial

Background

There is a need to identify interventions that increase help seeking for depression among young adults.

Objective

The aim was to evaluate a brief depression information intervention employing health e-cards (personalized emails containing links to health information presented on a Web page).

Methods

A randomized controlled trial was carried out with 348 19- to 24-year-olds drawn from the community. Participants were randomized to receive one of three conditions, all of which delivered a short series of health e-cards. Two active conditions involved the delivery of depression information designed to increase help-seeking behavior and intentions and to improve beliefs and knowledge associated with help seeking. A control arm delivered information about general health issues unrelated to depression. The primary outcome was help-seeking behavior. Secondary outcomes were help-seeking intentions; beliefs about the efficacy of depression treatments and help sources; ability to recognize depression; knowledge of the help-seeking process; and depressive symptoms. The study’s primary focus was outcomes relating to formal help seeking (consultation with a general practitioner or mental health professional) but also targeted behaviors, intentions, and beliefs relating to informal help seeking.

Results

Relative to the control condition, depression health e-cards were not associated with an increase in formal help-seeking behavior, nor were they associated with improved beliefs about depression treatments; ability to recognize depression; knowledge of the help-seeking process; or depressive symptoms. Depression e-cards were associated with improved beliefs about the overall efficacy of formal help sources (z = 2.4, P = .02). At post-intervention, participants in all conditions, relative to pre-intervention, were more likely to have higher intentions of seeking help for depression from a formal help source (t ₆₄₁ = 5.8, P < .001) and were more likely to rate interpersonal psychotherapy as being helpful (z = 2.0, P = .047). Depression e-cards were not associated with any significant changes in informal help-seeking behavior, intentions, or beliefs.

Conclusions

The study found no evidence that providing depression information in the form of brief e-cards encourages help seeking for depression among young adults. Involvement in the study may have been associated with increased help-seeking intentions among participants in all conditions, suggesting that mechanisms other than depression information may increase help seeking.

Trial Registration

International Standard Randomized Controlled Trial Number (ISRCTN): ISRCTN98406912; http://www.controlled-trials.com/ISRCTN98406912/ISRCTN98406912 (Archived by WebCite at http://www.webcitation.org/5k221KiMi)     

Israeli soldiers' intentions and actions toward seeking mental health help: Barriers and facilitators

Background

While military settings may increase psychological distress, soldiers frequently avoid seeking professional help. This study aimed to examine barriers and facilitators associated with intentions to seek help and actually seeking help from a mental health officer (MHO) and how these differ among soldiers who had sought help in the past and those who had not.

Method

This cross-sectional study included 263 combat and noncombat soldiers. The Health Belief Model and the Help-Seeking Model were the theoretical framework used to map the potential variables associated with soldiers' decision to seek help.

Results

Stigma and administrative barriers were found to be significant barriers to both the intention to seek help and actually consulting an MHO. These findings were more definitive among combat soldiers. The belief in the effectiveness of mental health treatment was positively associated with the intention to seek help. Positive associations were found between well-being, perceived seriousness of one's condition, and belief in the effectiveness of mental health care and intention to seek MHO help. Distress and self-concealment were positively associated with actual consultation with an MHO. Public stigma about seeking help was associated with both the intention to seek mental health assistance and actually consulting an MHO.

Conclusion

Military commanders should make an effort to make soldiers feel safe to seek mental health assistance by creating a supportive organizational atmosphere to reduce the stigma associated with mental health care.     

Can hopelessness and adolescents' beliefs and attitudes about seeking help account for help negation?

Avoidance of appropriate help is common in acutely suicidal samples and has been confirmed in nonclinical samples but factors that contribute to this help negation effect remain unclear. In a sample of 269 nonclinical Australian high school students, the current study examines the impact of hopelessness, previous mental health care, beliefs, and attitudes toward professional psychological help on the help negation relationship. Results revealed that suicidal ideation significantly predicted lower help seeking intentions and that although hopelessness could not explain the help negation effect, it moderated the effect for seeking help from family. They also revealed that although previous mental health care was unable to explain the effect fully for professional mental health sources, beliefs and attitudes about professional psychological help could. Implications of the findings for prevention, primary health care, and professional psychological practice are discussed.     

Youth exposed to violence: the role of protective factors

Using a sample of 174 inner‐city urban high school students, this study examined the degree to which family and peer support would moderate the negative impact of exposure to violence on academic performance, symptoms of distress, and persistence intentions. Over 94% of the students reported having been exposed to at least one form of community violence at some point in their lives. Using hierarchical linear regression, the results indicated that family support provided a protective‐stabilizing moderating effect between exposure to violence and symptoms of distress. Peer support was found to have a protective‐stabilizing moderating effect between exposure to violence and persistence intentions. Although exposure to violence and persistence intentions were both related to grade point average, family and peer support were not found to moderate the impact of violence exposure and grades. © 2009 Wiley Periodicals, Inc.     

What would your neighbor do? An experimental approach to the study of informal social control of intimate partner violence in South Korea

Although research on bystander intervention and informal social control of intimate partner violence (IPV) is increasingly common, empirical anomalies remain and experimental studies on population samples are rare. This study reports the effects of a new experimental approach to the study of informal social control of IPV by neighbors on a small population sample of 100 married men in Seoul, South Korea. We hypothesized that men randomly assigned to a high‐perceived informal social control condition would have lower self‐estimated likelihoods of IPV perpetration in response to a vignette. We also hypothesized that the effect of random assignment would be different for that portion of the sample that reported perpetration of family violence (IPV or child abuse). Compared to the nonperpetrating portion of the sample, perpetrators of family violence in the sample randomly assigned to the high perceived control condition experienced a significant drop in self‐estimated likelihood of IPV perpetration.     

Suicidal ideation and help-negation: Not just hopelessness or prior help.

Few distressed young people seek professional psychological help and little is known about what sources of help young people seek for different problems. In suicidal youth, the process of help-negation may exacerbate poor help-seeking. Three hundred and two undergraduate university students completed a questionnaire measuring suicidal ideation, hopelessness, prior help-seeking experience, and help-seeking intentions. Participants indicated they would seek help from different sources of help for different types of problems, but friends consistently were rated as the most likely source of help. Help-negation was suggested by higher levels of suicidal ideation being associated with lower help-seeking intentions. However, the negative suicidal ideation/help-seeking-intentions relationship was not explained by hopelessness or prior help-seeking. Help-negation appears to involve more than just negative expectations regarding the future. The discussion proposes social problem-solving orientation as one of a number of potential explanatory variables.     

Seeking help from a mental health professional: the influence of one's social network

The decision to seek psychological help may be hindered or facilitated by many factors. Two potential factors that might facilitate help seeking are having a relationship with someone (a) who recommends seeking help or (b) who themselves have sought help. In two studies (N = 780, N = 746), we explored the relationship between these factors and intentions to seek mental health services. In Study 1, being prompted to seek help and knowing someone who had sought help were both related to positive expectations about mental health services. In Study 2, being prompted to seek help and knowing someone who had sought help were related to more positive attitudes toward help seeking. Also, knowing someone who had sought help was related to the intention to seek help. Of those who sought psychological help, approximately 75% had someone recommend that they seek help and about 94% knew someone who had sought help.     

Perfectionistic traits and self‐presentation are associated with negative attitudes and concerns about seeking professional psychological help

Numerous factors influence whether an individual is able and willing to seek professional help for psychological difficulties. One of these may be perfectionism, a multidimensional personality construct that has been linked to poor psychological adjustment. The current study investigated whether perfectionism traits and self‐presentational facets were associated with negative help‐seeking attitudes and concerns about psychotherapy. Samples of university (N = 299) and community (N = 77) men and women completed the Multidimensional Perfectionism Scale, Perfectionistic Self‐Presentation Scale, Attitudes Towards Seeking Professional Help Scale, and Thoughts About Psychotherapy Survey. Various components of perfectionism were associated with both negative help‐seeking attitudes and concerns about psychotherapy. The findings suggest that perfectionistic behaviour may be an important dispositional factor that interferes with seeking and obtaining help for psychological difficulties. Theoretical and clinical implications are discussed.     

Buffering the effects of violence: communication and problem‐solving skills as protective factors for adolescents exposed to violence

Although many adolescents exposed to violence evidence negative outcomes, some report few deleterious effects, indicating the presence of moderating variables. This study examined the moderating role of family communication and problem solving on positive and negative outcomes in adolescents exposed to school and neighborhood violence. Participants were 90 adolescents and their parents, who completed measures of violence exposure, psychological and behavioral functioning, and communication and problem‐solving skills. Results indicated that after controlling for demographic variables and violence exposure in the home, communication and problem‐solving skills moderated the association between school and neighborhood violence exposure and psychological distress. There was no moderation of the violence exposure‐positive outcome association. The findings suggest that family communication and problem‐solving skills might serve a protective function for adolescents, thereby decreasing psychological distress in the face of school and neighborhood violence exposure. © 2011 Wiley Periodicals, Inc.     

THE ROLE OF FAMILY CONFLICT IN THE RELATION BETWEEN EXPOSURE TO COMMUNITY VIOLENCE AND DEPRESSIVE SYMPTOMS

The current study examined the role of family conflict as a mediator in the relation between exposure to community violence and depressive symptoms. Two hundred thirty‐two early adolescents (aged 11–16 years) completed a demographics questionnaire, the Survey of Exposure to Community Violence, the 9‐item conflict subscale of the Family Environment Scale, and the Children's Depression Inventory. Family conflict was found to be a significant mediator of the relation between exposure to community violence via victimization and depressive symptoms. Clinical efforts should seek to prevent or reduce conflict in families of youth experiencing community violence victimization. Future research should continue to evaluate microsystem factors as mechanisms through which exposure to community violence affects the psychological well‐being of youth.     

Factors affecting help-seeking during depression in a community sample

Little is known about factors that influence community residents to seek professional help while experiencing diagnosable episodes of depression. The present study utilized longitudinal data from 96 female subjects to examine whether clinical and psychosocial features of a recent depressive episode, as well as preexisting psychiatric and psychosocial characteristics, could distinguish between individuals who (a) did and did not seek help during their episode and (b) chose to consult one professional source rather than another. Results showed that less than half of the sample sought professional help. Few variables could distinguish subjects who sought help from those who did not. Instead, subjects consulting mental health specialists were more clinically impaired and had fewer psychosocial assets than both those consulting nonpsychiatric physicians and those seeking no help. Subjects in the latter two groups were indistinguishable from one another on the assessed variables. Results were cross-validated with a smaller sample of male community residents.     

Family‐ and community‐level predictors of parent support seeking

The influences of community‐ and family‐level socio‐demographic factors on parent formal and informal support‐seeking activities were examined. Data analyzed were collected from 1,260 parents of sixth graders from 26 rural Iowa communities. Hierarchical linear modeling results indicated that both family‐ and community‐level factors were significant predictors of parent support seeking. Findings at the family level indicated that household income, parent gender, and number of children were significantly predictive of informal support seeking; parent education and parent gender were significantly predictive of formal support seeking. In addition, significant community population size effects on informal parent support seeking were found. © 2002 John Wiley & Sons, Inc.     

MENTAL HEALTH SERVICE SEEKING AMONG KOREAN INTERNATIONAL STUDENTS IN THE UNITED STATES: A PATH ANALYSIS

South Koreans represent the third largest group of international students in the United States, yet little is known about their help‐seeking behaviors, nor how these behaviors might be influenced by Asian cultural values. The purpose of this study is to (a) explore the effects of public stigma, self‐stigma, and attitudes associated with seeking counseling services on the relationship between cultural values and willingness to seek counseling services and (b) develop a more culturally sensitive help‐seeking model based on modified labeling theory. Participants included 177 Korean international students in the United States. Results indicated that the effect of cultural values on mental health service‐seeking behaviors is mediated by one's perception of public stigma toward counseling services, self‐stigma, and attitudes toward counseling services among Korean international students. Implications for developing outreach programs to promote help‐seeking behaviors among Asian international students are discussed.     

Factors influencing help seeking in mentally distressed young adults: a cross-sectional survey.

BACKGROUND: Young adults, especially men, are among those least likely to consult healthcare professionals when mentally distressed or suicidal. AIMS: To investigate the help-seeking behaviours of mentally distressed young adults. Design of study: Cross-sectional survey. SETTING: Bristol and surrounding areas, including inner-city, suburban and urban locations. METHOD: A questionnaire was sent to a sample of 3004 young adults aged 16-24 years. This assessed probable mental disorder (using the 12-item general health questionnaire [GHQ-12]), suicidal thoughts (GHQ-28 suicide subscale), and help-seeking behaviours. RESULTS: Most responders who were assessed as having probable mental disorders (GHQ "cases") had not sought help. Help seeking was more common in female GHQ cases than male cases (34.8% and 21.8%,respectively; P = 0.003) and women with suicidal thoughts more commonly sought help than men with suicidal thoughts (41.6% and 30.9%, respectively; P = 0.15). Small proportions of male and female GHQ cases (7.5% and 8.9%, respectively; P = 0.6), and less than one in five responders with suicidal thoughts, had consulted a general practitioner. In more female than male cases, help was sought from family and friends (30.7% and 18.4%, respectively; P = 0.004). GHQ score was the strongest predictor of help seeking. Men had a higher threshold of severity at which they would seek help than women. Recent experience of suicidal thoughts appeared to be a stronger predictor of formal help seeking in mentally distressed women than mentally distressed men. CONCLUSION: Distressed young adults are reluctant to seek help. Men are particularly unlikely to do so unless severely distressed and tend not to seek lay support. Sex differences in help seeking may be important in understanding the high suicide rate for men.