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Predictors of help-seeking behaviour in people with mental health problems: a 3-year prospective community study

Doll, Carolin M., Michel, Chantal, Rosen, Marlene, Osman, Naweed, Schimmelmann, Benno G., Schultze-Lutter, Frauke·2021·BMC Psychiatry

Abstract

Background: The majority of people with mental illness do not seek help at all or only with significant delay. To reduce help-seeking barriers for people with mental illness, it is therefore important to understand factors predicting help-seeking. Thus, we prospectively examined potential predictors of help-seeking behaviour among people with mental health problems ( N = 307) over 3 years. Methods: Of the participants of a 3-year follow-up of a larger community study (response rate: 66.4%), data of 307 (56.6%) persons with any mental health problems (age-at-baseline: 16–40 years) entered a structural equation model of the influence of help-seeking, stigma, help-seeking attitudes, functional impairments, age and sex at baseline on subsequent help-seeking for mental health problems. Results: Functional impairment at baseline was the strongest predictor of follow-up help-seeking in the model. Help-seeking at baseline was the second-strongest predictor of subsequent help-seeking, which was less likely when help-seeking for mental health problems was assumed to be embarrassing. Personal and perceived stigma, and help-seeking intentions had no direct effect on help-seeking. Conclusions: With only 22.5% of persons with mental health problems seeking any help for these, there was a clear treatment gap. Functional deficits were the strongest mediator of help-seeking, indicating that help is only sought when mental health problems have become more severe. Earlier help-seeking seemed to be mostly impeded by anticipated stigma towards help-seeking for mental health problems. Thus, factors or beliefs conveying such anticipated stigma should be studied longitudinally in more detail to be able to establish low-threshold services in future.

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Fig. 1 Recruitment process of the add-on study to the BEAR study according to the American Association for Public Opinion Research (AAPOR) Outcome Rate Calculator, version 3.1 [32]
Fig. 1 Recruitment process of the add-on study to the BEAR study according to the American Association for Public Opinion Research (AAPOR) Outcome Rate Calculator, version 3.1 [32]CC BY · PubMed Central
Fig. 2 Final model of associations between stigma, assumptions about help-seeking and healthcare utilization with standardized path coefficients (N = 307)
Fig. 2 Final model of associations between stigma, assumptions about help-seeking and healthcare utilization with standardized path coefficients (N = 307)CC BY · PubMed Central

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Metadata

Authors
Doll, C. M., Michel, C., Rosen, M., Osman, N., Schimmelmann, B. G., & Schultze-Lutter, F.
Venue
BMC Psychiatry
Published
2021-09-03
Volume
21
Issue
1
ISSN
1471-244X
Cited by
99
References
17
Language
en
Funders
  • Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (32003B_135381)
  • Universitätsklinikum Düsseldorf. Anstalt öffentlichen Rechts

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Doll, C. M., Michel, C., Rosen, M., Osman, N., Schimmelmann, B. G., & Schultze-Lutter, F. (2021). Predictors of help-seeking behaviour in people with mental health problems: a 3-year prospective community study. BMC Psychiatry. https://doi.org/10.1186/s12888-021-03435-4