Evaluating factors and interventions that influence help-seeking and mental health service utilization among suicidal individuals: A review of the literature
Abstract
Connecting suicidal individuals to appropriate mental health care services is a key component of suicide prevention efforts. This review aims to critically discuss the extant literature on help-seeking and mental health service utilization among individuals at elevated risk for suicide, as well as to outline challenges and future directions for research in this area. Across studies, the rate of mental health service use for those with past-year suicide ideation, plans, and/or attempts was approximately 29.5% based on weighted averages, with a lack of perceived need for services, preference for self-management, fear of hospitalization, and structural factors (e.g., time, finances) identified as key barriers to care. Studies also revealed facilitators to care, which include mental health literacy, positive views of services, and encouragement from family or friends to seek support. To address these low rates of help-seeking and barriers to care, a number of interventions have been developed, including psychoeducation-based programs, peer and gatekeeper training, and screening-based approaches. Despite these efforts, it appears that work is still needed to gauge the impact of these interventions on behavioral outcomes and to more rigorously test their effectiveness. Additional implications for future research on help-seeking among suicidal individuals are discussed.
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A low demand for therapeutic treatment of a suicide attempt may be associated with trauma-related avoidance behavior.
“a low demand for therapeutic treatment of a suicide attempt (78) may therefore also be associated with trauma-related avoidance behavior and must be taken into account therapeutically.”
From Ambivalence model of suicidality [ABS-model]: an orientation model for the treatment of suicidal individuals (2024) · cites this paper as [78]
Potential barriers to mental health services include lack of time, preference for self-reliance, stigma, and service unavailability.
“Potential barriers to mental health services include lack of time, preference for self-reliance, stigma, and service unavailability [21,22].”
From A mobile health intervention (LifeBuoy App) to help young people manage suicidal thoughts: protocol for a mixed-methods randomized controlled trial (2020) · cites this paper as [21]
Only 28% of adolescents and young adults with current, past year, or lifetime suicidal thoughts, plans, and/or attempts have accessed mental health services.
“Literature suggests that only 28% of adolescents and young adults with current, past year, or lifetime suicidal thoughts, plans, and/or attempts have accessed mental health services [21].”
From A mobile health intervention (LifeBuoy App) to help young people manage suicidal thoughts: protocol for a mixed-methods randomized controlled trial (2020) · cites this paper as [21]
The current mental health system addresses less than half of the need of support.
“The current mental health system addresses less than half of the need of support [21], leaving most young people to manage their symptoms alone.”
From A mobile health intervention (LifeBuoy App) to help young people manage suicidal thoughts: protocol for a mixed-methods randomized controlled trial (2020) · cites this paper as [21]
Up to 70% of those aged 12 to 18 years with suicidal thoughts and/or behaviors do not actively utilize mental health services.
“It is estimated that up to 70% of those aged 12 to 18 years with suicidal thoughts and/or behaviors do not actively utilize mental health services because of embarrassment and stigma, difficulty expressing suicide concerns, lack of support, and a preference for self-reliance [12].”
From The effect of a therapeutic smartphone application on suicidal ideation in young adults: Findings from a randomized controlled trial in Australia. (2022) · cites this paper as [12]
Rather than reaching the unreachable (nonhelp seekers), this trial appeared to appeal to young adults with high rates of treatment familiarity and engagement.
“Rather than “reach the unreachable” (i.e., the nonhelp seekers [12]), this trial appeared to appeal to young adults with high rates of treatment familiarity and engagement.”
From The effect of a therapeutic smartphone application on suicidal ideation in young adults: Findings from a randomized controlled trial in Australia. (2022) · cites this paper as [12]
Self-reliance may confer risk for suicidality.
“Self-reliance is obviously a good quality in the right circumstances, but it is easy to see how it might confer risk for suicidality [36].”
From Masculinity and suicidal thinking (2017) · cites this paper as [36]
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References 112 · Cited by 462
- Authors
- Hom, M. A., Stanley, I. H., & Joiner, T. E.
- Affiliations
- Florida State University (US)
- Corresponding author
- Hom, Melanie A.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2015-08
- Volume
- 40
- Pages
- 28-39
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W368221195
- Cited by
- 462
- References
- 112
- Citations by year
- 2026: 33 · 2025: 59 · 2024: 55 · 2023: 49 · 2022: 59 · 2021: 50 · 2020: 45 · 2019: 34 · 2018: 33 · 2017: 25 · 2016: 17 · 2015: 3
- FWCI
- 3.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- help-seeking, mental health service utilization, suicide, suicide prevention, barriers to care, facilitators of care, mental health literacy, suicidal ideation, suicide attempts, psychoeducation, screening, self-management
- MeSH terms
- Help-Seeking Behavior, Suicide Prevention, Adolescent, Adult, Humans, Mental Health Services, Patient Acceptance of Health Care, Suicide, Young Adult
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