Help-seeking behaviour for internalizing problems: perceptions of adolescent girls from different ethnic backgrounds
Open accessAbstract
OBJECTIVE: Although adolescent girls from ethnic minorities are at an increased risk of internalizing problems (e.g. depression), only a small fraction seeks formal help for these problems. To enhance help-seeking for internalizing problems among ethnic minority adolescent girls, insight into their help-seeking behaviour is required. This study explored the perceptions of adolescent girls from different ethnic backgrounds regarding their help-seeking behaviour for internalizing problems. DESIGN: A qualitative study using focus group discussions (FGDs) was employed. Eight ethnic-specific FGDs were conducted with 50 adolescent girls of mostly Turkish (n=23), Moroccan (n=13), and Dutch (n=10) backgrounds recruited in Rotterdam, a multicultural city in the Netherlands. FGDs were conceptually framed within a help-seeking model, facilitated by a vignette and analysed using NVivo software. RESULTS: When describing the internalizing problems presented in the vignette, participants of non-Dutch FGDs tended to state the causes of the problems (e.g. lack of attention) whereas participants of Dutch FGDs mentioned the emotional state. Participants did not perceive the presented internalizing problems as severe. If participants were to face internalizing problems of their own, their decision to seek help would be hampered by negative attitudes towards professionals and school-based services. Particularly in non-Dutch FGDs the fear of parental and friend's reactions was identified as a barrier. Participants identified their mother and a good friend as primary sources of help. CONCLUSION: In this study, adolescent girls of Turkish, Moroccan and Dutch backgrounds had difficulty recognizing the severity of internalizing problems, and various barriers could hamper their decision to seek help. To enhance utilization of mental health services by youth, promoting a change in their attitudes towards mental health/school-based services is recommended. Guaranteeing confidentiality within school-based services, and training for professionals in communicating with adolescent girls, may also prove beneficial. In ethnic minorities, tackling the negative reactions of family/friends requires attention.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The majority of barrier/facilitator studies were cross sectional (n=36), thirteen were qualitative, and six used a mixed-method design.
“The majority of the studies were cross sectional (n = 36) [26–61], thirteen studies were qualitative [62–74] and six used a mixed-method design [75–80].”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Three Approaches to Qualitative Content Analysis
Hsieh, H.-F., & Shannon, S. E. (2005) · Qualitative Health Research · doi:10.1177/1049732305276687 · Cited by 44,601 · see citing works
The Strengths and Difficulties Questionnaire: A research note
Goodman, R. (1997) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1997.tb01545.x · Cited by 14,908 · see citing works
Focus Groups as Qualitative Research
Morgan, D. (1997) · doi:10.4135/9781412984287 · Cited by 8,863 · see citing works
Psychometric properties of the strengths and difficulties questionnaire
GOODMAN, R. (2001) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200111000-00015 · Cited by 6,813 · see citing works
Social Learning Theory and the Health Belief Model
Rosenstock, I. M., Strecher, V. J., & Becker, M. H. (1988) · Health Education Quarterly · doi:10.1177/109019818801500203 · Cited by 5,564 · see citing works
Qualitative Research in Health Care
(2006) · Wiley eBooks · doi:10.1002/9780470750841 · Cited by 2,713 · see citing works
Goodman, R., Meltzer, H., & Bailey, V. (1998) · European Child & Adolescent Psychiatry · doi:10.1007/s007870050057 · Cited by 2,238 · see citing works
Rethinking validity and reliability in content analysis
Potter, W. J., & Levine‐Donnerstein, D. (1999) · Journal of Applied Communication Research · doi:10.1080/00909889909365539 · Cited by 1,662 · see citing works
Psychiatric Diagnosis in Child and Adolescent Suicide
Shaffer, D. (1996) · Archives of General Psychiatry · doi:10.1001/archpsyc.1996.01830040075012 · Cited by 1,250 · see citing works
When and how do young people seek professional help for mental health problems?
Rickwood, D. J., Deane, F. P., & Wilson, C. J. (2007) · Medical Journal of Australia · doi:10.5694/j.1326-5377.2007.tb01334.x · Cited by 1,195 · see citing works
Qualitative Research in Health Care
Pope, C., & Mays, N. 1. (2019) · Wiley eBooks · doi:10.1002/9781119410867 · Cited by 1,117 · see citing works
The Strengths and Difficulties Questionnaire (SDQ)
Muris, P., Meesters, C., & van den Berg, F. (2003) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-003-0298-2 · Cited by 920 · see citing works
Kuehner, C. (2003) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2003.00204.x · Cited by 839 · see citing works
Cultural and contextual influences in mental health help seeking: a focus on ethnic minority youth
Cauce, A. M., Domenech-Rodríguez, M., Paradise, M., Cochran, B. N., Shea, J. M., Srebnik, D., & Baydar, N. (2002) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.70.1.44 · Cited by 766 · see citing works
Adult Outcomes of Childhood and Adolescent Depression: I. Psychiatric Status
Harrington, R. (1990) · Archives of General Psychiatry · doi:10.1001/archpsyc.1990.01810170065010 · Cited by 764 · see citing works
Jones, G. H. (1975) · De Gruyter eBooks · doi:10.1515/9783110890594-003 · Cited by 749 · see citing works
Qualitative research in health care
Isbister, W. H. (2000) · BMJ · doi:10.1136/bmj.320.7251.1729 · Cited by 697 · see citing works
Dutch version of the Strengths and Difficulties Questionnaire (SDQ)
van Widenfelt, B. M., Goedhart, A. W., Treffers, P. D. A., & Goodman, R. (2003) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-003-0341-3 · Cited by 691 · see citing works
Sampson, E. E. (1988) · American Psychologist · doi:10.1037/0003-066x.43.1.15 · Cited by 670 · see citing works
Cultural considerations in adolescent suicide prevention and psychosocial treatment.
Goldston, D. B., Molock, S. D., Whitbeck, L. B., Murakami, J. L., Zayas, L. H., & Hall, G. C. N. (2008) · American Psychologist · doi:10.1037/0003-066x.63.1.14 · Cited by 523 · see citing works
Racial and Ethnic Differences in Utilization of Mental Health Services Among High-Risk Youths
Garland, A. F., Lau, A. S., Yeh, M., McCabe, K. M., Hough, R. L., & Landsverk, J. A. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.7.1336 · Cited by 504 · see citing works
The use of vignettes in qualitative research
Barter, C., & Renold, E. (1999) · Bristol Research (University of Bristol) · Cited by 453 · see citing works
Adult outcomes of childhood and adolescent depression.
Rc, H. (1991) · Europe PMC (PubMed Central) · Cited by 426 · see citing works
Racial/Ethnic Differences in Internalizing and Externalizing Symptoms in Adolescents
McLaughlin, K. A., Hilt, L. M., & Nolen–Hoeksema, S. (2007) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-007-9128-1 · Cited by 408 · see citing works
Adolescent help-seeking: what do they get help for and from whom?
Boldero, J., & Fallon, B. J. (1995) · Journal of Adolescence · doi:10.1006/jado.1995.1013 · Cited by 365 · see citing works
Model Minority at Risk: Expressed Needs of Mental Health by Asian American Young Adults
Lee, S., Juon, H., Martinez, G., Hsu, C. E., Robinson, E., Bawa, J., & Grace, X. (2008) · Journal of Community Health · doi:10.1007/s10900-008-9137-1 · Cited by 325 · see citing works
To Whom Do Adolescents Turn for Help? Differences between Disturbed and Nondisturbed Adolescents
Offer, D., Howard, K. I., Schonert-Reichl, K. A., & Ostrov, E. (1991) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199107000-00015 · Cited by 217 · see citing works
Varela, R. E., Vernberg, E. M., Sosa, J. J. S., Riveros, A., Mitchell, M. C., & Mashunkashey, J. (2004) · Journal of Family Psychology · doi:10.1037/0893-3200.18.4.651 · Cited by 208 · see citing works
Strengths and Difficulties Questionnaire
Goodman, R. (1997) · PsycTESTS Dataset · doi:10.1037/t00540-000 · Cited by 204 · see citing works
Symptom Attribution in Cultural Perspective *
Kirmayer, L. J., Young, A., & Robbins, J. M. (1994) · The Canadian Journal of Psychiatry · doi:10.1177/070674379403901002 · Cited by 203 · see citing works
Psychological correlates of help-seeking attitudes among children and adolescents.
Garland, A. F., & Zigler, E. (1994) · American Journal of Orthopsychiatry · doi:10.1037/h0079573 · Cited by 174 · see citing works
Sex and Age Differences in Depression: A Quantitative Synthesis of Published Research
Jorm, A. F. (1987) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048678709160898 · Cited by 172 · see citing works
Simon, N. M. (2009) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.s.7002.02 · Cited by 118 · see citing works
Latino immigrants' intentions to seek depression care.
Cabassa, L. J., & Zayas, L. H. (2007) · American Journal of Orthopsychiatry · doi:10.1037/0002-9432.77.2.231 · Cited by 112 · see citing works
Goodman, R., dos Santos, D. N., Nunes, A. P. R., de Miranda, D. P., Fleitlich‐Bilyk, B., & Filho, N. D. A. (2004) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-005-0851-z · Cited by 101 · see citing works
Coping with depression in later life: a qualitative study of help-seeking in three ethnic groups
Lawrence, V. C., Banerjee, S., Bhugra, D., Sangha, K., TURNER, S., & Murray, J. (2006) · Psychological Medicine · doi:10.1017/s0033291706008117 · Cited by 97 · see citing works
Mental health and help-seeking among ethnic minority adolescents
Barker, L. A., & Adelman, H. S. (1994) · Journal of Adolescence · doi:10.1006/jado.1994.1024 · Cited by 94 · see citing works
Operationalising the collection of ethnicity data in studies of the sociology of health and illness
Aspinall, P. J. (2001) · Sociology of Health & Illness · doi:10.1111/1467-9566.00277 · Cited by 90 · see citing works
Qualitative Study of Suicidality and Help‐Seeking Behaviors in African American Adolescents
Molock, S. D., Barksdale, C. L., Matlin, S., Puri, R., Cammack, N. L., & Spann, M. N. (2007) · American Journal of Community Psychology · doi:10.1007/s10464-007-9122-3 · Cited by 84 · see citing works
Using a vignette-based questionnaire to explore adolescents’ understanding of mental health issues
Leighton, S. (2010) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104509340234 · Cited by 84 · see citing works
Predicting externalizing problems in Moroccan immigrant adolescents in the Netherlands
Stevens, G. W. J. M., Vollebergh, W., Pels, T. V. M., & Crijnen, A. A. M. (2005) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-005-0926-x · Cited by 79 · see citing works
HAN, D., CHEN, S., HWANG, K., & WEI, H. (2006) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.2006.01580.x · Cited by 76 · see citing works
Adult and peer involvement in help-seeking for depression in adolescent population
Fröjd, S. A., MARTTUNEN, M. J., Pelkonen, M. U. I., von der Pahlen, B., & Kaltiala‐Heino, R. (2007) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-007-0254-4 · Cited by 60 · see citing works
The Parent Version of the Strengths and Difficulties Questionnaire
Stone, L. L., Otten, R., Ringlever, L., Hiemstra, M., Engels, R. C. M. E., Vermulst, A. A., & Janssens, J. (2012) · European Journal of Psychological Assessment · doi:10.1027/1015-5759/a000119 · Cited by 60 · see citing works
The challenge of diagnosing depression in childhood and adolescence
Carlson, G. A. (2000) · Journal of Affective Disorders · doi:10.1016/s0165-0327(00)00283-4 · Cited by 51 · see citing works
Knipscheer, J. W., & Kleber, R. J. (2005) · International Journal of Social Psychiatry · doi:10.1177/0020764005060853 · Cited by 42 · see citing works
Cultural Differences in Conceptual Models of Everyday Fatigue
Karasz, A., & McKinley, P. S. (2007) · Journal of Health Psychology · doi:10.1177/1359105307078168 · Cited by 40 · see citing works
Predicting internalizing problems in Moroccan immigrant adolescents in the Netherlands
Stevens, G. W. J. M., Vollebergh, W., Pels, T. V. M., & Crijnen, A. A. M. (2005) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-005-0988-9 · Cited by 33 · see citing works
Ethnic differences in utilization of youth mental health care
de Haan, A. M., Boon, A. E., Vermeiren, R. R. J. M., & de Jong, J. T. V. M. (2012) · Ethnicity and Health · doi:10.1080/13557858.2011.645150 · Cited by 27 · see citing works
Cho, H. J., Bhugra, D., & Wessely, S. C. (2008) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2008.01200.x · Cited by 22 · see citing works
Güleç, H. (2008) · Psychosomatics · doi:10.1176/appi.psy.49.3.212 · Cited by 17 · see citing works
van Oort, F. V. A., Joung, I. M. A., van der Ende, J., Mackenbach, J. P., Verhulst, F. C., & Crijnen, A. A. M. (2006) · Ethnicity and Health · doi:10.1080/13557850500460280 · Cited by 10 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Morgan, D., Krueger, R. & King, J., 1998. The focus group kit: Thousand Oaks, CA: 306 Sage Publications, Inc. 307
Cited by
Sorted by citations
Aguirre Velasco, A., Cruz, I. S. S., Billings, J., Jimenez, M., & Rowe, S. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02659-0 · Cited by 736 · see citing works
Eigenhuis, E., Waumans, R. C., Muntingh, A. D. T., Westerman, M. J., van Meijel, M., Batelaan, N. M., & van Balkom, A. J. L. M. (2021) · PLOS ONE · doi:10.1371/journal.pone.0247516 · Cited by 90 · see citing works
Onnela, A., Hurtig, T. M., & Ebeling, H. (2021) · Health Education Journal · doi:10.1177/0017896921994134 · Cited by 22 · see citing works
Expectations of barriers to psychosocial care: views of parents and adolescents in the community
Nanninga, M., Reijneveld, S. A., Knorth, E. J., & Jansen, D. E. M. C. (2015) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-015-0717-1 · Cited by 18 · see citing works
Velasco, A. A., Cruz, I. S. S., Billings, J., Jimenez, M., & Rowe, S. L. (2025) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.25023003 · Cited by 17 · see citing works
Verhulp, E. E., Stevens, G. W. J. M., Pels, T. V. M., Weert, C. M. C. V., & Vollebergh, W. (2016) · Cultural Diversity & Ethnic Minority Psychology · doi:10.1037/cdp0000092 · Cited by 10 · see citing works
Acceptance of guidance to care at the emergency department following attempted suicide
Dekker, W. B., Vergouwen, A. C. M., Buster, M. C. A., & Honig, A. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1491-z · Cited by 8 · see citing works
Ayala, E. S., & Cala, V. C. (2017) · International Journal of Inclusive Education · doi:10.1080/13603116.2017.1296035 · Cited by 7 · see citing works
Ayala, E. S., & Cala, V. C. (2016) · International Journal of Inclusive Education · doi:10.1080/13603116.2016.1251976 · Cited by 7 · see citing works
Eijgermans, D. G. M., Raat, H., Jansen, P. W., Blok, E., Hillegers, M. H. J., & Jansen, W. (2022) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-021-01937-w · Cited by 3 · see citing works
Self-citationSchool Nurses' Perspectives on the Implementation of a Behavioral Health Referral Process
Habib, L. A., Sadlon, R., Wise, T., Doe, K., Garibay, L., & Price, O. A. (2024) · The Journal of School Nursing · doi:10.1177/10598405241298469 · Cited by 2 · see citing works
Rajaram, G., Robinson, J., Zhang, L., & Witt, K. (2024) · International Journal of Mental Health Nursing · doi:10.1111/inm.13411 · Cited by 1 · see citing works
Rajaram, G., Gibson, K. L., Kartal, D., Lamblin, M., Richards, H., Davies, P., Witt, K., & Robinson, J. (2025) · BMJ Open · doi:10.1136/bmjopen-2024-093859 · Cited by 1 · see citing works
Experiences of Colorado Parents as They Recognized Their Child's Mental Illness
Salgado, L. (2016) · ScholarWorks (Walden University)
Ungas väg till vård – en kvantitativ studie om vad ungdomar vet, tycker och vill ha
Dahlöf, E., & Malmqvist, J. (2016) · Gothenburg University Publications Electronic Archive (Gothenburg University)
Verhulp, E. E., Stevens, G. W. J. M., & Vollebergh, W. (2018) · Kind en adolescent · doi:10.1007/s12453-018-0174-y
Akan, A., Green, G., Blumenfeld, F., Taggart, D., & McPherson, S. (2026) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.70084
- Authors
- Flink, I. J. E., Beirens, T. M. J., Butte, D., & Raat, H.
- Affiliations
- Erasmus MC (NL)
- GGD Rotterdam-Rijnmond (NL)
- Corresponding author
- Flink, Ilse Johanna Elisabeth
- Venue
- Ethnicity & Health
- Publisher
- Informa UK Limited
- Published
- 2013-05-30
- Volume
- 19
- Issue
- 2
- Pages
- 160-177
- ISSN
- 1355-7858 (ISSN-L)
- 1465-3419
- OpenAlex
- W2061404398
- Cited by
- 17
- References
- 52
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2022: 1 · 2021: 2 · 2020: 1 · 2018: 1 · 2017: 2 · 2016: 4 · 2015: 1
- FWCI
- 2.50
- Type
- journal article
- Language
- en
- Open access
- green
- pure.eur.nl
- Licence
- other-oa
- Locations
- Ethnicity and Health (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- Funders
- ZonMw
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Keywords
- help-seeking, internalizing problems, adolescent girls, ethnic minorities, Turkish adolescents, Moroccan adolescents, Dutch adolescents, depression, help-seeking barriers, school-based services
- MeSH terms
- Adolescent, Depression, Ethnicity, Female, Humans, Minority Groups, Models, Psychological, Morocco, Mother-Child Relations, Netherlands, Patient Acceptance of Health Care, Turkey, Focus Groups, Friends, Qualitative Research, Minority Health
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
