Explaining adults’ mental health help-seeking through the lens of the theory of planned behavior: A scoping review

Probably not a substantial claim: may not pass S3 (load-bearing).

After duplicate removal, 5626 records were screened for eligibility.

“After the removal of duplicates, 5626 records were screened for eligibility.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The review identified 8898 records through the literature searches.

“There were 8898 records identified through the literature searches.”

• Also stated in: § Results · plain

  “Initially, 8898 records were identified.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

There were 5436 records excluded at the title and abstract stage, 143 articles excluded after full-text screening, and three articles excluded after data extraction.

“There were 5436 records excluded at the title and abstract stage, 143 articles excluded after full-text screening and three articles excluded after data extraction.”

May combine two claims.

The most commonly targeted populations in non-intervention studies were students (n = 14, 33%; n = 5588), followed by armed forces or emergency service workers (n = 7, 16%; n = 1900) and community samples (n = 10, 23%; n = 7231).

“The most commonly targeted populations were students (n studies = 14, 33%; n participants = 5588), followed by armed forces or emergency service workers (n studies = 7, 16%; n participants = 1900) and community samples (n studies = 10, 23%; n participants = 7231).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Two journal articles reported on the same sample [77, 79].

“Two journal articles reported on the same sample [77, 79]”

• cites [77] Hyland P, Boduszek D, Shevlin M, Adamson G. Investigating the latent structure of the theory of planned behavior and its effectiveness in explaining intentions to participate in counseling among a sample of police officers. J Police Crim Psychol. 2012;27(2):129–40. sourceNot checked yet

  Not checked in the free run.

• cites [79] Hyland PE, McLaughlin CG, Boduszek D, Prentice GR. Intentions to participate in counselling among front-line, at-risk Irish government employees: an application of the theory of planned behaviour. Br J Guid Couns. 2012;40(3):279–99. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Most studies targeted college students (n = 16, 33%; n = 6048), followed by community samples (n = 12, 25%; n = 7305), both students and community samples (n = 1, 2%; 320 students and 208 community adults), armed forces or emergency service workers (n = 8, 16%; n = 1910), older adults (n = 2, 4%; n = 568), and other specific populations (n = 10, 20%; n = 3137).

“In terms of the populations, most targeted college students (n studies = 16, 33%; n participants = 6048), followed by community samples (n studies = 12, 25%; n participants = 7305), both students and community samples (n studies = 1, 2%; n students = 320; n community adults = 208), armed forces or emergency service workers (n studies = 8, 16%; n participants = 1910), older adults (n studies = 2, 4”

May combine two claims.

Forty-three papers reported on non-intervention studies and seven articles reported on TPB-based interventions.

“Forty-three papers reported on non-intervention studies and seven articles reported on TPB-based interventions.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Most studies were conducted in North America (n = 27, 55%), followed by Europe (n = 9, 19%), Asia (n = 8, 16%), Oceania (n = 4, 8%), and Africa (n = 1, 2%).

“Most studies were conducted in North America (n = 27, 55%), followed by Europe (n = 9, 19%), Asia (n = 8, 16%), Oceania (n = 4, 8%), and Africa (n = 1, 2%).”

Probably not a substantial claim: may not pass S3 (load-bearing).

One thesis reported pre-intervention cross-sectional data and intervention data and was included in both sections [58].

“one thesis reported pre-intervention cross-sectional data and intervention data and thus was included in both sections [58]”

• cites [58] Chang KF. An intervention to increase counseling service usage among female college students. (Publication No. 3540311) [Doctoral dissertation, University of California]. ProQuest Dissertations and Theses Global.; 2012.Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The third psychometric paper developed and tested the Mental Help-Seeking Attitudes Scale (MHSAS) [76].

“The third paper developed and tested the Mental Help-Seeking Attitudes Scale (MHSAS) [76].”

• cites [76] Hammer JH, Parent MC, Spiker DA. Mental help seeking attitudes scale (MHSAS): development, reliability, validity, and comparison with the ATSPPH-SF and IASMHS-PO. J Couns Psychol. 2018;65(1):74–85. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Depression was the only mental health problem examined independently, with eight studies (19%) focusing only on help-seeking for depression and one study (2%) focusing on depression and suicidal thoughts [35, 36, 48, 53, 58, 60, 62, 72].

“Depression was the only mental health problem to be examined independently, with eight studies (19%) focusing only on help-seeking for depression, and one study (2%) focusing on depression and suicidal thoughts [35, 36, 48, 53, 58, 60, 62, 72].”

• cites [35] Zorrilla MM, Modeste N, Gleason PC, Sealy DA, Banta JE, Trieu SL. Depression and help-seeking intention among young adults: the theory of planned behavior. Am J Health Educ. 2019;50(4):236–44. https://doi.org/10.1080/19325037.2019.1616014. sourceNot checked yet

  Not checked in the free run.

• cites [36] Bohon LM, Cotter KA, Kravitz RL, Cello PC, Fernandez y Garcia E. The theory of planned behavior as it predicts potential intention to seek mental health services for depression among college students. J Am Coll Health. 2016;64(8):593–603. sourceNot checked yet

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• cites [48] Logsdon MC, Morrison D, Myers JA, Capps J, Masterson KM. Intention to seek depression treatment in Latina immigrant mothers. Issues Ment Health Nurs. 2018;39(11):962–6 Available from: https://www.tandfonline.com/doi/full/10.1080/01612840.2018.1479905. sourceNot checked yet

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• cites [53] Schomerus G, Matschinger H, Angermeyer MC. Attitudes that determine willingness to seek psychiatric help for depression: a representative population survey applying the theory of planned behaviour. Psychol Med. 2009;39(11):1855–65. sourceNot checked yet

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• cites [58] Chang KF. An intervention to increase counseling service usage among female college students. (Publication No. 3540311) [Doctoral dissertation, University of California]. ProQuest Dissertations and Theses Global.; 2012.Not checked yet

  Not checked in the free run.

• cites [60] Farmer CS. Understanding poor help-seeking rates for major depressive disorder. [Doctoral dissertation, University of Exeter]. Open Research Exeter; 2013. Available from: https://ore.exeter.ac.uk/repository/handle/10871/14620Not checked yet

  Not checked in the free run.

• cites [62] Hussain SA. Bittersweet nature of nostalgia and its impact on depression related help-seeking. (Publication No. 10843189) [Doctoral dissertation, Michigan State University]. ProQuest Dissertations and Theses Global; 2018.Not checked yet

  Not checked in the free run.

• cites [72] Woods KC. The strong black woman archetype and intentions to seek therapy for depression: a cultural application of the theory of planned behavior. (Publication No. 3599504) [Doctoral dissertation, Michigan State University]. ProQuest Dissertations and Theses Global.; 2013.Not checked yet

  Not checked in the free run.

May combine two claims.

The depression studies included all participants irrespective of mental health status, except one paper that included only dysphoric individuals [60].

“These studies included all participants irrespective of their mental health status, with the exception of one paper which included only dysphoric individuals [60].”

• cites [60] Farmer CS. Understanding poor help-seeking rates for major depressive disorder. [Doctoral dissertation, University of Exeter]. Open Research Exeter; 2013. Available from: https://ore.exeter.ac.uk/repository/handle/10871/14620Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

A further 5 articles were identified through reference list searches and screened.

“A further 5 articles were identified through reference list searches and screened.”

Probably not a substantial claim: may not pass S3 (load-bearing).

One psychometric study also reported on predictors of help-seeking intentions [84].

“One psychometric study also reported on predictors of help-seeking intentions [84].”

• cites [84] Hyland P, Boduszek D, Dhingra K, Shevlin M, Maguire R, Morley K. A test of the inventory of attitudes towards seeking mental health services. Br J Guid Couns. 2015;43(4):397–412. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Most studies included all participants with and without symptoms of mental health problems (n = 42, 86%; n = 17371); three studies (6%; n = 1542) included only participants with psychological symptomatology; two studies (4%; n = 160) targeted people who screened positive for a mental disorder; one study (2%; n = 400) included dysphoric individuals only; and one intervention design paper (n = 1, 2;

“Most studies included all participants with and without symptoms of mental health problems (n studies = 42, 86%; n participants = 17371), three studies (6%; n participants = 1542) only included participants with psychological symptomatology, two studies (4%; n participants = 160) targeted people who screened positive for a mental disorder, one study (2%; n participants = 400) included dysphoric”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Of the non-intervention articles, 28 (65%) were journal articles and 15 (35%) were theses.

“Of these, 28 (65%) were journal articles and 15 (35%) were theses.”

May combine two claims.

Most non-intervention studies were conducted in North America (n = 23, 53%), followed by Europe (n = 9, 21%), Asia (n = 8, 19%), Oceania (n = 2, 5%), and Africa (n = 1, 2%).

“Most of the non-intervention studies were conducted in North America (n = 23, 53%), followed by Europe (n = 9, 21%), Asia (n = 8, 19%), Oceania (n = 2, 5%), and Africa (n studies = 1, 2%).”

May combine two claims.

Of the 49 included articles, 42 were non-intervention studies, six were intervention studies, and one paper reported on both cross-sectional data and an intervention.

“Of these, 42 (86%) were non-intervention studies, six (12%) were intervention studies, and one paper (2%) reported on both cross-sectional data and an intervention”

Probably not a substantial claim: may not pass S3 (load-bearing).

Two psychometric papers centered on the reliability and validity of the Inventory of Attitudes towards Seeking Mental Health Services (IASMHS) [49, 84].

“Two centered on the reliability and validity of the Inventory of Attitudes towards Seeking Mental Health Services (IASMHS) [49, 84].”

• cites [49] Mackenzie CS, Knox VJ, Gekoski WL, Macaulay HL. An adaptation and extension of the Attitudes Toward Seeking Professional Psychological Help Scale. J Appl Soc Psychol. 2004;34(11):2410–33. sourceNot checked yet

  Not checked in the free run.

• cites [84] Hyland P, Boduszek D, Dhingra K, Shevlin M, Maguire R, Morley K. A test of the inventory of attitudes towards seeking mental health services. Br J Guid Couns. 2015;43(4):397–412. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

One study reported on post-intervention data only and was included under non-intervention studies as the intervention was not based on the TPB [62].

“One study reported on post-intervention data only and was included under non-intervention studies as the intervention was not based on the TPB [62].”

• cites [62] Hussain SA. Bittersweet nature of nostalgia and its impact on depression related help-seeking. (Publication No. 10843189) [Doctoral dissertation, Michigan State University]. ProQuest Dissertations and Theses Global; 2018.Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The 49 included articles were published between 1998 and 2020; 32 were journal articles and 17 were theses.

“The 49 articles that were chosen were published between 1998 and 2020; 32 (65%) were journal articles and 17 (35%) were theses.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The review included 49 articles.

“This process resulted in the inclusion of 49 articles.”

• Also stated in: § Results · plain

  “Of these, 49 met the selection criteria and were included: 32 were journal articles and 17 were theses.”

May combine two claims.

Seven of the eight articles (88%) found intentions to be a significant predictor of mental health help-seeking behavior, and six of the eight (75%) found perceived behavioral control to be a significant predictor of behavior.

“Seven of the eight articles (88%) found intentions to be a significant predictor of mental health help-seeking behavior, and six of the eight (75%) articles found perceived behavioral control to be a significant predictor of behavior.”

• Also stated in: § Results · plain

  “Intentions and perceived behavioral control were significant predictors of behavior in seven and six studies, respectively.”

May combine two claims.

From the 39 studies that identified predictors of mental health help-seeking intentions, attitudes was a significant predictor in 35 (90%) studies, perceived behavioral control in 34 (87%) studies, and subjective norms in 23 (59%) studies.

“From the 39 studies that identified predictors of mental health help-seeking intentions, attitudes was a significant predictor of intentions in 35 (90%) studies, perceived behavioral control was a significant predictor of intentions in 34 (87%) studies, and subjective norms was a significant predictor of intentions in 23 (59%) studies.”

• Also stated in: § Results · plain

  “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.”

May combine two claims.

The variance in mental health help-seeking behavior explained by the TPB ranged from 3 to 61% for traditional models and 10 to 63% for extended models.

“Overall, the variance in mental health help-seeking behavior explained by the TPB ranged from 3 to 61% for the traditional models and 10 to 63% for the extended models.”

May combine two claims.

Overall, 39 studies identified predictors of mental health help-seeking; 31 identified predictors of intentions only, and eight identified predictors of intentions and behavior.

“Overall, 39 studies identified predictors of mental health help-seeking; 31 studies identified predictors of mental health help-seeking intentions only, and eight studies identified predictors of intentions and behavior.”

May combine two claims.

Only six TPB-based interventions were identified, all used digital technology to influence help-seeking, with mixed results.

“Only six TPB-based interventions were identified, all used digital technology to influence help-seeking, with mixed results.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Additional terminology for the source of help included counseling (n = 7, 17%), treatment (n = 5, 12%), cyber-counseling (n = 1, 2%), therapy for depression (n = 1, 2%), psychotherapy (n = 1, 2%), and prison psychologist (n = 1, 2%).

“Additional terminology included counseling (n studies = 7, 17%), treatment (n studies = 5, 12%), cyber-counseling (n studies = 1, 2%), therapy for depression (n studies = 1, 2%), psychotherapy (n studies = 1, 2%), and prison psychologist (n studies = 1, 2%).”

May combine two claims.

Some studies (n = 13, 33%) used traditional models of the TPB, n = 19 (49%) used extended models, and seven (18%) explored both traditional and extended models.

“Some studies (n = 13, 33%) used traditional models of the TPB to explore help-seeking, whereby only the original TPB variables (attitudes, subjective norms, perceived behavioral control, intentions, and where applicable, behavior) were included in the model. Other studies (n = 19, 49%) used extended models of the TPB, in which the original TPB variables and additional variables were included in”

May combine two claims.

In that additional paper, direct relationships were found between attitudes and prospective help-seeking, and between subjective norms and current help-seeking.

“and direct relationships were also found between attitudes and prospective help-seeking, and subjective norms and current help-seeking.”

• cites [60] Farmer CS. Understanding poor help-seeking rates for major depressive disorder. [Doctoral dissertation, University of Exeter]. Open Research Exeter; 2013. Available from: https://ore.exeter.ac.uk/repository/handle/10871/14620Not checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Six studies (14%) specified physicians/general practitioners within their definition of help source [49, 55, 57, 67, 71, 75].

“Six studies (14%) also specified physicians/general practitioners within their definition [49, 55, 57, 67, 71, 75].”

• cites [49] Mackenzie CS, Knox VJ, Gekoski WL, Macaulay HL. An adaptation and extension of the Attitudes Toward Seeking Professional Psychological Help Scale. J Appl Soc Psychol. 2004;34(11):2410–33. sourceNot checked yet

  Not checked in the free run.

• cites [55] Stecker T, Fortney J, Hamilton F, Sherbourne CD, Ajzen I. Engagement in mental health treatment among veterans returning from Iraq. Patient Prefer Adherence. 2010;4:45–9. sourceNot checked yet

  Not checked in the free run.

• cites [57] Westerhof GJ, Maessen M, De Bruijn R, Smets B. Intentions to seek (preventive) psychological help among older adults: an application of the theory of planned behaviour. Aging Ment Health. 2008;12(3):317–22. sourceNot checked yet

  Not checked in the free run.

• cites [67] O’Flaherty R. Factors affecting psychological help-seeking in men. [Doctoral dissertation, University of Warwick]. Warwick Research Archive Portal http://wrap.warwick.ac.uk/96714; 2017.Not checked yet

  Not checked in the free run.

• cites [71] Walther AT. Factors affecting intentions to seek professional mental health services. (Publication No. MQ73099) [Masters thesis, Queen’s University]. ProQuest Dissertations and Theses Global.; 2002.Not checked yet

  Not checked in the free run.

• cites [75] Damghanian M, Alijanzadeh M. Theory of planned behavior, self-stigma, and perceived barriers explains the behavior of seeking mental health services for people at risk of affective disorders. Soc Heal Behav. 2018;1(2):54–61 Available from: https://www.shbonweb.com/article.asp?issn=2589-9767;year=2018;volume=1;issue=2;spage=54;epage=61;aulast=Damghanian. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Seven articles were identified on TPB-based interventions; four were journal articles and three were theses.

“Seven articles were identified on TPB-based interventions; four were journal articles and three were theses [30, 37–39, 58, 85, 86].”

May combine two claims.

All six interventions used digital technology: two short videos on seeking counseling services, three web-based tools, and one theory-guided multimedia presentation.

“All six interventions used digital technology: two interventions were short videos on seeking counseling services, three were web-based tools, and one was a theory-guided multimedia presentation.”

May combine two claims.

Most studies were conducted in western countries (North America and Europe), with college students and community samples the most common populations targeted.

“Most studies were conducted in western countries (North America and Europe), with college students and community samples the most common populations targeted.”

May combine two claims.

The target population of the six interventions was mainly young adults (5 studies, 704 participants), with one study targeting USA war veterans (10 participants) and one targeting adolescent mothers with mean age 18 (289 participants).

“The target population were mainly young adults (n studies = 5, n participants = 704), one study targeted USA war veterans (n participants = 10), and one study focused on adolescent mothers with a mean age of 18 (n participants = 289).”

May combine two claims.

Logsdon et al. found a statistically significant increase in both intentions to seek treatment and actually receiving treatment over time in the intervention group compared to the control group.

“Logsdon et al. [39] employed a pre-post design to evaluate an Internet-based depression intervention encouraging adolescent mothers to seek depression treatment and found a statistically significant increase in both intentions to seek treatment and actually receiving treatment over time in the intervention group compared to the control group.”

• cites [39] Logsdon MC, Myers J, Rushton J, Gregg JL, Josephson AM, Davis DW, et al. Efficacy of an internet-based depression intervention to improve rates of treatment in Adolescent mothers. Arch Womens Ment Health. 2018;21(3):273–85. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Of the 49 articles included, the earliest paper was published in 1998, with a rise in the number of studies since 2008, indicating growing interest in this field.

“Of the 49 articles included, the earliest paper identified was published in 1998, with a rise in the number of studies since 2008, indicating growing interest in this field.”

May combine two claims.

An online navigation tool for young adults designed to match participants with appropriate services did not demonstrate improvements in help-seeking intentions; changes in other TPB variables were not assessed.

“Finally, an online navigation tool for young adults designed to match participants with appropriate services did not demonstrate improvements in help-seeking intentions; changes in other TPB variables were not assessed [37, 38].”

• cites [37] Kauer S, Buhagiar K, Sanci L. Facilitating mental health help seeking in young adults: the underlying theory and development of an online navigation tool. Adv Ment Health. 2017;15(1):71–87. https://doi.org/10.1080/18387357.2016.1237856. sourceNot checked yet

  Not checked in the free run.

• cites [38] Kauer SD, Buhagiar K, Blake V, Cotton S, Sanci L. Facilitating mental health help-seeking by young adults with a dedicated online program: a feasibility study of Link. BMJ Open. 2017;7(7):1–12. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Lindsley's guided multimedia presentation reported overall improvements in TPB predictor variables after intervention, but these declined over time and no differences between experimental and control group were found.

“Furthermore, Lindsley’s [86] guided multimedia presentation on treatment seeking reported findings consistent with overall improvements in TPB predictor variables after intervention; however, this declined over time and no differences between the experimental and control group were found.”

• cites [86] Lindsley TW. A multimedia intervention to increase the likelihood that university students in need will utilize counseling services. (Publication No. 3606867) [Doctoral dissertation, Utah State University]. ProQuest Dissertations and Theses Global; 2013.Not checked yet

  Not checked in the free run.

May combine two claims.

Three of the interventions were evaluated in randomized controlled trials, two in pre-post studies, and one using a randomized post-test-only design.

“Three of the interventions were evaluated in randomized controlled trials, two were evaluated in pre-post studies, and one was assessed using a randomized post-test-only design.”

May combine two claims.

Attitudes and perceived behavioral control were frequently found to be significant predictors of help-seeking intentions, and subjective norms were found to be a significant predictor in more than half of the studies.

“Of the theoretical factors, which influence mental health help-seeking intentions, attitudes and perceived behavioral control were frequently found to be significant predictors of help-seeking intentions, and subjective norms were found to be a significant predictor in more than half of the studies.”

• Also stated in: § Conclusions · hedged

  “Attitudes and perceived behavioral control, in particular, appear to be well-cited factors influencing people’s intentions to seek or not seek help.”

May combine two claims.

Most studies found the TPB accounted for a large amount of variance in intentions, but the range in variance explained was large.

“Most studies found the TPB accounted for a large amount of variance in intentions; however, the range in variance explained was large.”

May combine two claims.

In the present scoping review, most non-intervention studies (67%) used extended models or both traditional and extended models to conceptualize help-seeking intentions; however, the variances explained by these models were comparable to traditional TPB models.

“In the present scoping review, most non-intervention studies (67%) used extended models or both traditional and extended models to conceptualize help-seeking intentions; however, the variances explained by these models were comparable to traditional TPB models.”

May combine two claims.

In some extended and modified models of the TPB, variables such as adherence to Asian values, shame/izzat, and a Strong Black Woman ideal were included and were shown to significantly predict help-seeking intentions.

“In some extended and modified models of the TPB, variables such as adherence to Asian values, shame/izzat, and a Strong Black Woman ideal were included and were shown to significantly predict help-seeking intentions [22, 47, 72].”

• cites [22] Pilkington A, Msetfi RM, Watson R. Factors affecting intention to access psychological services amongst British Muslims of South Asian origin. Ment Heal Relig Cult. 2012;15(1):1–22. sourceNot checked yet

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• cites [47] Li W, Denson LA, Dorstyn DS. Help-seeking intentions and behaviors among mainland Chinese college students: integrating the theory of planned behavior and behavioral model of health services use. Int J Adv Couns. 2017;39(2):125–48. sourceNot checked yet

  Not checked in the free run.

• cites [72] Woods KC. The strong black woman archetype and intentions to seek therapy for depression: a cultural application of the theory of planned behavior. (Publication No. 3599504) [Doctoral dissertation, Michigan State University]. ProQuest Dissertations and Theses Global.; 2013.Not checked yet

  Not checked in the free run.

May combine two claims.

Of the seven studies located on TPB-based interventions to improve mental health help-seeking, six used digital technology, mostly to target young adults.

“Of the seven studies we located on TPB-based interventions to improve mental health help-seeking, six used digital technology, mostly to target young adults.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

National data from Australia and Canada indicate a little over half of the people who experienced emotional distress in 2013 and 2016 received treatment; however, many people (37% in Australia and 30% in Canada) reported that they did not want treatment.

“Furthermore, national data from Australia and Canada indicate a little over half of the people who experienced emotional distress in 2013 and 2016 received treatment; however, many people (37% in Australia and 30% in Canada) reported that they did not want treatment [11].”

• cites [11] Corscadden L, Callander EJ, Topp SM. Who experiences unmet need for mental health services and what other barriers to accessing health care do they face? Findings from Australia and Canada. Int J Health Plann Manage. 2019;34(2):761–72. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Knowledge on the TPB for predicting mental health help-seeking behavior, and on TPB-based interventions, is limited.

“Knowledge on the TPB for predicting mental health help-seeking behavior, and on TPB-based interventions, is limited.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Recent prevalence estimates indicate 10.7% of the world's population live with a mental health disorder, and the number of years lived with a mental health disorder increased by 13.5% from 2007 to 2017.

“Recent prevalence estimates indicate 10.7% of the world’s population live with a mental health disorder, and the number of years lived with a mental health disorder has increased by 13.5% from 2007 to 2017”

• cites [1] James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789–858. sourceNot checked yet

  Not checked in the free run.

• cites [2] Ritchie H, Roser M. Mental health. Our World in Data; 2018. Available from: https://ourworldindata.org/mental-healthNot checked yet

  Not checked in the free run.

• cites [3] Whiteford HA, Ferrari AJ, Degenhardt L, Feigin V, Vos T. The global burden of mental, neurological and substance use disorders: an analysis from the global burden of disease study 2010. PLoS One. 2015;10(2):1–14. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Results of the World Mental Health Surveys conducted across 21 countries revealed only 27.6% of people with anxiety disorders received treatment over the course of one year, and less than one in 10 received adequate treatment.

“For example, results of the World Mental Health Surveys conducted across 21 countries revealed only 27.6% of people with anxiety disorders received treatment over the course of one year, and less than one in 10 received adequate treatment [10].”

• cites [10] Alonso J, Liu Z, Evans-Lacko S, Sadikova E, Sampson N, Chatterji S, et al. Treatment gap for anxiety disorders is global: results of the World Mental Health Surveys in 21 countries. Depress Anxiety. 2018;35(3):195–208. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

People in low- and middle-income countries were the least likely to receive treatment (13.1%).

“People in low- and middle-income countries were the least likely to receive treatment (13.1%).”

• cites [10] Alonso J, Liu Z, Evans-Lacko S, Sadikova E, Sampson N, Chatterji S, et al. Treatment gap for anxiety disorders is global: results of the World Mental Health Surveys in 21 countries. Depress Anxiety. 2018;35(3):195–208. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Unmet mental health needs are associated with greater levels of disability, reduced quality of life, and an increased likelihood of suicidal ideation and suicide attempts.

“Unmet mental health needs not only extend the period in which someone lives with the burden of ill mental health, but are also associated with greater levels of disability, reduced quality of life, and an increased likelihood of suicidal ideation and suicide attempts [4, 5].”

• cites [4] Ali MM, Lackey S, Mutter R, McKeon R. The relationship between perceived unmet mental health care needs and suicidal ideation and attempt. Adm Policy Ment Heal Ment Heal Serv Res. 2018;45(5):709–15. https://doi.org/10.1007/s10488-018-0856-z. sourceNot checked yet

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• cites [5] Alonso J, Codony M, Kovess V, Angermeyer MC, Katz SJ, Haro JM, et al. Population level of unmet need for mental healthcare in Europe. Br J Psychiatry. 2007;190(4):299–306 Available from: https://www.cambridge.org/core/product/identifier/S0007125000171776/type/journal_article. sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

Subjective norms, defined as perceived social pressures from significant others to perform a behavior, influence a person's intentions and behavior.

“Subjective norms, defined as perceived social pressures from significant others to perform a behavior, also influence a person’s intentions and behavior [26].”

• cites [26] Conner M, Sparks P. Theory of planned behaviour and health behaviour. In: Conner M, Norman P, editors. Predicting Health Behaviour. 2nd ed. Maidenhead: Open University Press; 2005. p. 170–222.Not checked yet

  Not checked in the free run.

May combine two claims.

Zorrilla et al. found attitudes was a strong, significant predictor of help-seeking intention for mental health services, followed by perceived behavioral control and subjective norms, among young adults in the USA.

“Moreover, Zorrilla et al. [35] explored predictors of help-seeking intentions among young adults in the USA and found attitudes was a strong, significant predictor of help-seeking intention for mental health services, followed by perceived behavioral control and subjective norms.”

• cites [35] Zorrilla MM, Modeste N, Gleason PC, Sealy DA, Banta JE, Trieu SL. Depression and help-seeking intention among young adults: the theory of planned behavior. Am J Health Educ. 2019;50(4):236–44. https://doi.org/10.1080/19325037.2019.1616014. sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

The scoping review was based on the methodology outlined by Arksey and O'Malley.

“The current scoping review was based on the methodology outlined by Arksey and O’Malley [40].”

• cites [40] Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Tomczyk et al. found attitudes, subjective norms, and self-efficacy (a component of perceived behavioral control) significantly influence intentions, and intentions significantly predict behavior, among people with untreated depressive symptoms in Germany.

“For example, Tomczyk et al. [29] found attitudes, subjective norms, and self-efficacy (a component of perceived behavioral control), significantly influence intentions, and intentions significantly predict behavior, among people with untreated depressive symptoms in Germany.”

• cites [29] Tomczyk S, Schomerus G, Stolzenburg S, Muehlan H, Schmidt S. Ready, willing and able? An investigation of the theory of planned behaviour in help-seeking for a community sample with current untreated depressive symptoms. Prev Sci. 2020;21(6):749–60. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Bohon et al. found partial support for the influence of TPB variables on help-seeking, with attitudes and perceived behavioral control significantly predictive of intentions to seek help, but not subjective norms.

“Conversely, Bohon et al. [36] found partial support for the influence of TPB variables on help-seeking, with attitudes and perceived behavioral control significantly predictive of intentions to seek help, but not subjective norms.”

• cites [36] Bohon LM, Cotter KA, Kravitz RL, Cello PC, Fernandez y Garcia E. The theory of planned behavior as it predicts potential intention to seek mental health services for depression among college students. J Am Coll Health. 2016;64(8):593–603. sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim. May combine two claims.

The TPB proposes that attitudes, subjective norms, and perceived behavioral control influence behavioral intentions, which predict behavior.

“Thus, the TPB proposes that attitudes, subjective norms, and perceived behavioral control influence behavioral intentions, which predict behavior [24].”

• cites [24] Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The scoping review is reported based on the PRISMA-ScR checklist.

“This process was followed, and the scoping review is reported based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist (see Additional file 1) [41].”

• cites [41] Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467–73. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Many people with mental health problems go undiagnosed and untreated, often due to a lack of knowledge about mental health disorders and their treatments, as well as a lack of help-seeking for mental health problems.

“Researchers have noted that many people with mental health problems go undiagnosed and untreated, often due to a lack of knowledge about mental health disorders and their treatments, as well as a lack of help-seeking for mental health problems [12, 13].”

• cites [12] Bonabi H, Müller M, Ajdacic-Gross V, Eisele J, Rodgers S, Seifritz E, et al. Mental health literacy, attitudes to help seeking, and perceived need as predictors of mental health service use: a longitudinal study. J Nerv Ment Dis. 2016;204(4):321–4. sourceNot checked yet

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• cites [13] Tay JL, Tay YF, Klainin-Yobas P. Mental health literacy levels. Arch Psychiatr Nurs. 2018;32(5):757–63. https://doi.org/10.1016/j.apnu.2018.04.007. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

Seeking help from a professional is considered optimal for the receipt of evidence-based treatments.

“Seeking help from a professional is considered optimal for the receipt of evidence-based treatments [23, 32].”

• cites [23] Gulliver A, Griffiths KM, Christensen H, Brewer JL. A systematic review of help-seeking interventions for depression, anxiety and general psychological distress. BMC Psychiatry. 2012;12(81):1–12.Not checked yet

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• cites [32] Brown JSL, Evans-Lacko S, Aschan L, Henderson MJ, Hatch SL, Hotopf M. Seeking informal and formal help for mental health problems in the community: a secondary analysis from a psychiatric morbidity survey in South London. BMC Psychiatry. 2014;14(1):1–15. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

A widely recognized mental health treatment gap exists whereby more individuals are diagnosed with mental health problems than those who receive treatment.

“This has led to a widely recognized mental health treatment gap, whereby more individuals are diagnosed with mental health problems than those who receive treatment [14, 15].”

• cites [14] Kohn R, Saxena S, Levav I, Saraceno B. The treatment gap in mental health care. Bull World Health Organ. 2004;82(11):858–66.Not checked yet

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• cites [15] Wainberg ML, Scorza P, Shultz JM, Helpman L, Mootz JJ, Johnson KA, et al. Challenges and opportunities in global mental health: a research-to-practice perspective. Curr Psychiatry Rep. 2017;19(5):28–44 Available from: http://link.springer.com/10.1007/s11920-017-0780-z. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

By considering the role of perceived behavioral control, the TPB includes non-motivational factors that influence behavior, thereby overcoming criticisms of the TRA.

“By considering the role of perceived behavioral control, the TPB includes non-motivational factors that influence behavior, thereby overcoming criticisms of the TRA [26, 27].”

• cites [26] Conner M, Sparks P. Theory of planned behaviour and health behaviour. In: Conner M, Norman P, editors. Predicting Health Behaviour. 2nd ed. Maidenhead: Open University Press; 2005. p. 170–222.Not checked yet

  Not checked in the free run.

• cites [27] Ajzen I. Attitudes, personality and behavior. Maidenhead: Open University Press; 1988.Not checked yet

  Not checked in the free run.

May combine two claims.

Despite the effectiveness of evidence-based mental health treatments, most people do not seek help, or delay seeking help, which has significant personal, social, and economic costs.

“The literature indicates that despite the effectiveness of evidence-based mental health treatments, most people do not seek help, or delay seeking help, which has significant personal, social, and economic costs [14, 16].”

• cites [14] Kohn R, Saxena S, Levav I, Saraceno B. The treatment gap in mental health care. Bull World Health Organ. 2004;82(11):858–66.Not checked yet

  Not checked in the free run.

• cites [16] Rickwood D, Thomas K, Bradford S. Help-seeking measures in mental health: a rapid review. New South Wales: The Sax Institute; 2012. Available from: https://www.saxinstitute.org.au/wp-content/uploads/02_Help-seeking-measures-in-mental-health.pdf.Not checked yet

  Not checked in the free run.

Classified as probably not a substantial claim. May combine two claims.

The TPB posits that attitudes towards a behavior influence a person's plan or intention to act, and subsequently, the action or behavior itself.

“The theory posits that attitudes towards a behavior influence a person’s plan or intention to act, and subsequently, the action or behavior itself [25].”

• cites [25] Ajzen I, Fishbein M. Understanding attitudes and predicting social behavior. Englewood Cliffs: Prentice-Hall; 1980.Not checked yet

  Not checked in the free run.

Classified as probably not a substantial claim. May combine two claims.

The TPB is an extension of Ajzen and Fishbein's Theory of Reasoned Action and suggests people make conscious decisions to act, or not act, based on their attitudes, subjective norms, and perceived behavioral control.

“The TPB is an extension of Ajzen and Fishbein’s Theory of Reasoned Action (TRA) and suggests people make conscious decisions to act, or not act, based on their attitudes, subjective norms, and perceived behavioral control [24].”

• cites [24] Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Recent research has attempted to improve rates of mental health help-seeking through TPB-based interventions, but these are yet to be reviewed.

“Recent research has attempted to improve rates of mental health help-seeking through TPB-based interventions [37–39], however these are yet to be reviewed.”

• cites [37] Kauer S, Buhagiar K, Sanci L. Facilitating mental health help seeking in young adults: the underlying theory and development of an online navigation tool. Adv Ment Health. 2017;15(1):71–87. https://doi.org/10.1080/18387357.2016.1237856. sourceNot checked yet

  Not checked in the free run.

• cites [38] Kauer SD, Buhagiar K, Blake V, Cotton S, Sanci L. Facilitating mental health help-seeking by young adults with a dedicated online program: a feasibility study of Link. BMJ Open. 2017;7(7):1–12. sourceNot checked yet

  Not checked in the free run.

• cites [39] Logsdon MC, Myers J, Rushton J, Gregg JL, Josephson AM, Davis DW, et al. Efficacy of an internet-based depression intervention to improve rates of treatment in Adolescent mothers. Arch Womens Ment Health. 2018;21(3):273–85. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The inclusion of perceived behavioral control as an antecedent to intentions and behavior is the main difference between the TPB and the TRA.

“The inclusion of perceived behavioral control as an antecedent to intentions and behavior is the main difference between the TPB and the TRA.”

• cites [24] Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The reviewers met during the title and abstract screening and at the conclusion of this stage to discuss and resolve conflicts regarding the inclusion of articles.

“The reviewers met during the title and abstract screening and at the conclusion of this stage to discuss and resolve conflicts regarding the inclusion of articles.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

A third senior reviewer was consulted to resolve conflicts regarding the inclusion of articles, and a final decision was reached once a consensus was achieved.

“A third senior reviewer was consulted to resolve conflicts regarding the inclusion of articles, and a final decision was reached once a consensus was achieved.”

May combine two claims.

The belief that seeing a mental health professional will be helpful, and beliefs regarding potential costs of mental health consultations, influence help-seeking intentions.

“For example, the belief that seeing a mental health professional will be helpful, and beliefs regarding potential costs of mental health consultations, influence help-seeking intentions [53].”

• cites [53] Schomerus G, Matschinger H, Angermeyer MC. Attitudes that determine willingness to seek psychiatric help for depression: a representative population survey applying the theory of planned behaviour. Psychol Med. 2009;39(11):1855–65. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

The inclusion of participants with and without mental health problems aligns with an early intervention approach to mental health care.

“Participants with and without mental health problems were typically included, which aligns with an early intervention approach to mental health care [87].”

• cites [87] Wilson CJ, Bushnell JA, Caputi P. Early access and help seeking: practice implications and new initiatives. Early Interv Psychiatry. 2011;5(Suppl 1):34–9. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Western cultures are typically individualistic, and people from these cultures may be more motivated to act according to their own goals and beliefs.

“For example, western cultures are typically individualistic and therefore, people from these cultures may be more motivated to act according to their own goals and beliefs [88].”

• cites [88] Cohen AB, Wu MS, Miller J. Religion and culture: individualism and collectivism in the east and west. J Cross Cult Psychol. 2016;47(9):1236–49. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing).

A standard data charting form was developed and pilot-tested in Microsoft Excel before data extraction.

“A standard data charting form was developed and pilot-tested in Microsoft Excel before data extraction.”

Probably not a substantial claim: may not pass S3 (load-bearing).

All titles and abstracts retrieved through the literature searches were reviewed independently by two researchers to identify studies that met the inclusion criteria.

“All titles and abstracts retrieved through the literature searches were reviewed independently by two researchers to identify studies that met the inclusion criteria.”

May combine two claims.

Across population groups, a person's favorable or unfavorable evaluation towards using mental health-related services, and their perceived resources, skills, and opportunities to access services, influence their intentions to seek help.

“This indicates that across population groups, a person’s favorable or unfavorable evaluation towards using mental health-related services, and their perceived resources, skills, and opportunities to access services, influence their intentions to seek help.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The full-text was retrieved and read independently by two researchers to determine eligibility for inclusion.

“Once the relevant studies had been selected, the full-text was retrieved and read independently by two researchers to determine eligibility for inclusion, based on the criteria described above.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Mental health problems are commonly stigmatized in Chinese societies, which hinders people's intentions to seek help for fear of social rejection.

“For example, mental health problems are commonly stigmatized in Chinese societies, which hinders people’s intentions to seek help for fear of social rejection [50, 64].”

• cites [50] Mak HW, Davis JM. The application of the theory of planned behavior to help-seeking intention in a Chinese society. Soc Psychiatry Psychiatr Epidemiol. 2014;49(9):1501–15. sourceNot checked yet

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• cites [64] Lee AM-S. Understanding the help-seeking process among second generation Chinese Canadians using the theory of planned behaviour: what is the role of culture? [Doctoral dissertation, University of Ottawa]. University of Ottawa digital repository; 2016. https://doi.org/10.20381/ruor-5103. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The scoping review protocol was drafted using Arksey and O'Malley's five-stage process and was published on the Open Science Framework on 9th November 2017.

“The scoping review protocol was drafted using Arksey and O’Malley’s five-stage process and was published on the Open Science Framework on 9th November 2017 (https://osf.io/73c5a/).”

Classified as probably not a substantial claim. May combine two claims.

Researchers have recommended using the TPB to promote behavioral change across populations, and various approaches can be trialed to facilitate the greatest change in behavior, e.g., persuasive communications, face-to-face discussions, and observational modeling.

“This is of concern, given recommendations from researchers to use the TPB to promote behavioral change across populations, and the various approaches which can be trialed to facilitate the greatest change in behavior, e.g., persuasive communications, face-to-face discussions, and observational modeling [42, 92, 93].”

• cites [42] Ajzen I, Manstead ASR. Changing health-related behaviours: an approach based on the theory of planned behaviour. In: Hewstone M, Schut HAW, De Wit JBF, Van Den Bos K, Stroeb MS, editors. The scope of social psychology: theory and applications. London: Psychology Press; 2007. p. 43–64.Not checked yet

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• cites [92] Fife-Schaw C, Sheeran P, Norman P. Simulating behaviour change interventions based on the theory of planned behaviour: impacts on intention and action. Br J Soc Psychol. 2007;46(1):43–68. sourceNot checked yet

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• cites [93] Ajzen I. Behavioral interventions based on the theory of planned behavior. Amherst: University of Massachusetts Amherst; 2006. Available from: https://people.umass.edu/aizen/pdf/tpb.intervention.pdf.Not checked yet

  Not checked in the free run.

May combine two claims.

Attitudes towards and beliefs about mental health problems and treatments among diverse groups may differ from dominant Western approaches, and access to culturally appropriate care is often limited.

“Moreover, attitudes towards and beliefs about mental health problems and treatments among diverse groups may differ from dominant Western approaches, and access to culturally appropriate care is often limited [98].”

• cites [98] Cross W, Singh C. Dual vulnerabilities: mental illness in a culturally and linguistically diverse society. Contemp Nurse. 2012;42(2):156–66. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

Validated tools such as the ATSPPHS and IASMHS have been constructed and applied to mental health help-seeking, but do not necessarily reflect the true nature of the TPB.

“Additionally, validated tools such as the Attitude Toward Seeking Professional Psychological Help Scale (ATSPPHS) and IASMHS have been constructed and applied to mental health help-seeking, but do not necessarily reflect the true nature of the TPB.”

Probably not a substantial claim: may not pass S3 (load-bearing).

By employing a scoping review methodology and a systematic approach to study selection, the authors conducted a comprehensive and structured review of the literature in line with current recommendations for good practice.

“By employing a scoping review methodology and a systematic approach to the selection of studies, we conducted a comprehensive and structured review of the literature in line with current recommendations for good practice [99].”

• cites [99] Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097 Available from: https://dx.plos.org/10.1371/journal.pmed.1000097. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In Rathbone (2014) and Mills (2010), the target samples were college students, and it is possible that the mean age of participants was <18 years.

“In Rathbone (2014) and Mills (2010), however, the target samples were college students, and it is, therefore, possible that the mean age of participants in these studies was <18 years [66, 68].”

• cites [66] Mills JL. Does the theory of planned behavior predict intentions to seek help for suicidality? (Publication No. 3461849) [Doctoral dissertation, Marshall University]. ProQuest Dissertations and Theses Global.; 2010.Not checked yet

  Not checked in the free run.

• cites [68] Rathbone J. Understanding psychological help-seeking behaviour: the application of the theory of planned behaviour to medical professionals in training. (Publication No. 10137130) [Doctoral dissertation, University of Leicester]. ProQuest Dissertations and Theses Global.; 2014.Not checked yet

  Not checked in the free run.

May combine two claims.

The current state of knowledge on TPB-based interventions for mental health help-seeking is in its infancy, with few studies published, all within the last decade.

“The current state of knowledge on TPB-based interventions for mental health help-seeking is in its infancy, with few studies published, all within the last decade.”

May combine two claims.

Studies have found past behavior to be a good indicator of future behavior, but this is not always the case.

“Whilst studies have found past behavior to have been a good indicator of future behavior, this is not always the case [24].”

• cites [24] Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

The IASMHS was designed to improve upon the ATSPPHS by including items that directly target TPB predictor variables, but its three subscales only loosely reflect the TPB and contain other constructs such as mental health literacy, self-disclosure, avoidance coping, or self-concept clarity.

“The IASMHS was designed to improve upon this measure by including items, which directly target the TPB predictor variables; however, the three subscales of the IASMHS only loosely reflect the TPB and contain other constructs such as mental health literacy, self-disclosure, avoidance coping, or self-concept clarity [49, 76].”

• cites [49] Mackenzie CS, Knox VJ, Gekoski WL, Macaulay HL. An adaptation and extension of the Attitudes Toward Seeking Professional Psychological Help Scale. J Appl Soc Psychol. 2004;34(11):2410–33. sourceNot checked yet

  Not checked in the free run.

• cites [76] Hammer JH, Parent MC, Spiker DA. Mental help seeking attitudes scale (MHSAS): development, reliability, validity, and comparison with the ATSPPH-SF and IASMHS-PO. J Couns Psychol. 2018;65(1):74–85. sourceNot checked yet

  Not checked in the free run.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

It is possible that the authors did not locate all relevant studies or misclassified relevant papers.

“It is still possible that we did not locate all relevant studies or misclassified relevant papers.”

May combine two claims.

The ATSPPHS has been widely used as a measure of help-seeking attitudes, but it precedes the TPB and its development was not guided by any explicit theoretical framework.

“For example, the ATSPPHS has been widely used as a measure of help-seeking attitudes; however, this tool precedes the TPB and its development was not guided by any explicit theoretical framework [49, 76].”

• cites [49] Mackenzie CS, Knox VJ, Gekoski WL, Macaulay HL. An adaptation and extension of the Attitudes Toward Seeking Professional Psychological Help Scale. J Appl Soc Psychol. 2004;34(11):2410–33. sourceNot checked yet

  Not checked in the free run.

• cites [76] Hammer JH, Parent MC, Spiker DA. Mental help seeking attitudes scale (MHSAS): development, reliability, validity, and comparison with the ATSPPH-SF and IASMHS-PO. J Couns Psychol. 2018;65(1):74–85. sourceNot checked yet

  Not checked in the free run.

May combine two claims.

People from culturally and linguistically diverse groups are less likely to engage mental health services than members of the wider population, due to a lack of knowledge of services and how to access them, communication barriers, financial barriers, racism, and culturally insensitive practices.

“For example, people from culturally and linguistically diverse groups are less likely to engage mental health services than members of the wider population, due to a lack of knowledge of services and how to access them, communication barriers, financial barriers, racism, and culturally insensitive practices [95–97].”

• cites [95] Wohler Y, Dantas JA. Barriers accessing mental health services among culturally and linguistically diverse (CALD) immigrant women in Australia: Policy implications. J Immigr Minor Health. 2017;19(3):697–701 Available from: http://link.springer.com/10.1007/s10903-016-0402-6. sourceNot checked yet

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• cites [96] Le CB, Trinh NH, Li Z, Hou SSY, Progovac AM. Trends in racial-ethnic disparities in access to mental health care, 2004-2012. Psychiatr Serv. 2017;68(1):9–16. sourceNot checked yet

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• cites [97] Thomson MS, Chaze F, George U, Guruge S. Improving immigrant populations’ access to mental health services in Canada: a review of barriers and recommendations. J Immigr Minor Heal. 2015;17(6):1895–905 Available from: http://link.springer.com/10.1007/s10903-015-0175-3. sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

The authors chose strict criteria to strengthen understanding of the original TPB framework without modifications.

“We chose this approach to strengthen our understanding of the original TPB framework, without modifications.”

Probably not a substantial claim: may not pass S2 (checkable).

The current scoping review provides a broad map of the evidence related to mental health help-seeking, which can inform future research, policy, and practice.

“The current scoping review provides a broad map of the evidence related to mental health help-seeking, which can inform future research, policy, and practice.”

• AssumptionRests on an assumption: The TPB is one of the most prominent theories in the social and behavioral sciences.

May combine two claims.

Studies that used the IASMHS but did not reference the TPB would not have been identified by the searches but may add to understanding of mental health help-seeking within a TPB framework.

“Furthermore, studies that used the IASMHS but did not reference the TPB would not have been identified by our searches but may add to our understanding of mental health help-seeking within a TPB framework.”