Cited by 115Mental Health Treatment and AccessBehavioral Health and InterventionsDigital Mental Health Interventions

The DOI matches its Crossref record; 87 of the 89 references it cites were found in a registry or an index; 6 of the 131 sources its claims cite were checked for support.

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

Open access
Adams, Claire, Gringart, Eyal, Strobel, Natalie·2022·Systematic Reviews

Abstract

Background: Despite evidence-based efficacy, mental health services are underutilized due to low rates of help-seeking, leaving unmet mental health needs a global concern. The Theory of Planned Behavior (TPB) has been applied to understand the help-seeking process and in the development of behavior change interventions. The aim of this scoping review was to map the literature on the TPB as applied to mental health help-seeking in adults aged >18 years. Methods: This scoping review was conducted based on the methodology presented by Arksey and O’Malley (2005). Six databases (CINAHL, PsycINFO, MEDLINE, ProQuest Health and Medicine, ProQuest Dissertations and Theses, Web of Science) and two grey literature sources (OpenGrey, Google Scholar) were systematically searched in February 2018 and updated in March 2020. Studies that explicitly discussed the TPB in the context of mental health help-seeking were initially selected; only studies that explored formal help-seeking for mental health problems and were published in English were retained. Data were extracted using Microsoft Excel. Results: Initially, 8898 records were identified. Of these, 49 met the selection criteria and were included: 32 were journal articles and 17 were theses. Forty-three papers reported on non-intervention studies and seven articles reported on TPB-based interventions. Most studies ( n = 39) identified predictors of help-seeking intentions. 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. Few studies aimed to predict help-seeking behavior ( n = 8). Intentions and perceived behavioral control were significant predictors of behavior in seven and six studies, respectively. Only six TPB-based interventions were identified, all used digital technology to influence help-seeking, with mixed results. Conclusions: The present scoping review identified a considerable evidence base on the TPB for predicting mental health help-seeking intentions. Attitudes and perceived behavioral control were frequently found to be significant predictors of help-seeking intentions. Knowledge on the TPB for predicting mental health help-seeking behavior, and on TPB-based interventions, is limited. Thus, the role of the TPB in developing help-seeking interventions remains unclear. Recommendations are presented to address such research gaps and inform policy and practice.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This scoping review mapped 49 articles applying the Theory of Planned Behavior (TPB) to adult mental health help-seeking. It found considerable evidence for predicting help-seeking intentions, especially via attitudes and perceived behavioral control, but limited evidence for predicting behavior and for TPB-based interventions.

Key findings

  • The review included 49 articles: 32 journal articles and 17 theses; 43 reported non-intervention studies and 7 reported TPB-based interventions.
  • Among 39 studies identifying predictors of help-seeking intentions, attitudes were significant in 35 (90%), perceived behavioral control in 34 (87%), and subjective norms in 23 (59%); variance explained in intentions ranged from 7 to 93%.
  • Among 8 studies examining help-seeking behavior, intentions were significant in 7 (88%) and perceived behavioral control in 6 (75%); variance explained in behavior ranged from 3 to 61% for traditional models and 10 to 63% for extended models.
  • Six unique TPB-based interventions were identified, all using digital technology, with mixed results; one improved intentions and behavior, while others showed changes in TPB predictors without corresponding improvements in intentions or behavior, or no effect.

Methods

  • Scoping review conducted using Arksey and O’Malley’s five-stage methodology and reported with PRISMA-ScR; protocol published on the Open Science Framework.
  • Searched six databases (CINAHL, PsycINFO, MEDLINE, ProQuest Health and Medicine, ProQuest Dissertations and Theses, Web of Science) and two grey literature sources (OpenGrey, Google Scholar) in February 2018, updated March 2020; included English-language studies of adults >18 years on formal mental health help-seeking that explicitly discussed the TPB.
  • Data were extracted in Microsoft Excel; two researchers independently screened titles/abstracts and full texts, with a third senior reviewer resolving conflicts; results were organized descriptively into non-intervention and intervention studies.

Limitations

  • The authors state that they may not have located all relevant studies or may have misclassified papers; three included studies did not define participant age and may have included participants <18 years.
  • The authors also note a paucity of standardized TPB questionnaires, and that measures such as the ATSPPHS and IASMHS only loosely reflect TPB constructs, limiting confidence in measurement.
  • Evident from the text: most non-intervention studies were cross-sectional (38 of 43), most studies were conducted in North America (n = 27, 55%), college students were the most targeted population (n = 16, 33%), only three studies explored prediction of future behavior, and all six TPB-based interventions used digital technology, mostly targeting young adults.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1186/s13643-022-02034-y

Cites

87 of 87 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

Fig. 1 Flow diagram of study selection
Fig. 1 Flow diagram of study selectionCC BY · PubMed Central
Fig. 2 Stacked histogram of the number of studies published per year
Fig. 2 Stacked histogram of the number of studies published per yearCC BY · PubMed Central
Fig. 3 Research gaps
Fig. 3 Research gapsCC BY · PubMed Central

Verification

Claims the paper makes

71 Not checked yet · 38 Own result · 13 Own method · 12 Own interpretation · 7 No basis given · 2 Supported so far · 1 Supported · 1 Partly supported · accuracy not yet measured

Verify all 125 references — free account
  • Probably not a substantial claim. 46
  • It may state two separate claims as one. 66
92 of 92
  • The paper relies on this without support.

    Most research on mental health help-seeking has been exploratory and devoid of a theoretical orientation.

    “Still, most of the research on mental health help-seeking has been exploratory and devoid of a theoretical orientation, which has been identified as a gap in the body of knowledge.”
  • The paper relies on this without support.

    There is a need to synthesize what is known about the TPB in the context of mental health help-seeking.

    “There is a need to synthesize what is known about the TPB in the context of mental health help-seeking, to facilitate the identification of factors related to mental health help-seeking, which may provide viable targets for intervention to encourage mental health service utilization and potentially reduce the treatment gap.”
  • The paper relies on this without support.

    There is no commonly accepted definition of professional help-seeking.

    “Whilst there is no commonly accepted definition of professional help-seeking, Cornally and Mccarthy [31] defined help-seeking as “a problem focused, planned behavior, involving interpersonal interaction with a selected health-care professional”.”
  • The authors state this as an assumption.

    The age of participants in Miller [65] was >18 years because the sample comprised lawyers.

    “As the sample in Miller [65] comprised lawyers, it is safe to assume that the age of participants was >18 years.”
  • The paper relies on this without support.

    The TPB is one of the most prominent theories in the social and behavioral sciences.

    “As the TPB is one of the most prominent theories in the social and behavioral sciences, the current scoping review was prudent to improve our understanding of the role of the TPB in explaining mental health help-seeking among adults.”
5 of 5

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Each contradiction between two passages listed here was confirmed by an independent check.

2 of 2

Citations

Cites

Show all 89 references

Research works printed but not linked: 13

  1. Ritchie H, Roser M. Mental health. Our World in Data; 2018. Available from: https://ourworldindata.org/mental-health
  2. 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.
  3. Covidence. Covidence systematic review software. Melbourne: Veritas Health Innovation; n.d. Available from: www.covidence.org.
  4. Pumpuang W, Seeherunwong A, Vongsirimas N. Factors predicting intention among nursing students to seek professional psychological help. Pacific Rim Int J Nurs Res. 2018;22(3):200–11 Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/89827.
  5. 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.
  6. Clansy CD. The relationship between mental health ministries in the African Amercian church and professional mental health help-seeking. (Publication No. 9822860) [Doctoral dissertation, Saint Louis University]. ProQuest Dissertations and Theses Global.; 1998.
  7. 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/10871/14620
  8. 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.
  9. Jarvis J. If we build it will they come? The impact of attitudes, subjective social norms, and perceived behavioral control on help-seeking intentions. (Publication No. 3049630) [Doctoral dissertation, Long Island University]. ProQuest Dissertations and Theses Global.; 2002.
  10. 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.
  11. 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.
  12. Chandrasekara WS. Help seeking attitudes towards mental health problems and actual help seeking behavior. Res J Soc Sci Manag. 2016;5(9):45–53 Available from: https://www.researchgate.net/publication/342926067_Help_Seeking_Attitudes_towards_Mental_Health_Problems_and_Actual_Help_Seeking_Behavior.
  13. Kgathi C, Pheko MM. Application of theory of planned behaviour on Batswana men’s psychological help-seeking behaviours. J Couns Dev High Educ South Africa. 2011;2(1):63–75 Available from: https://www.researchgate.net/publication/288653630_Application_of_Theory_of_Planned_Behaviour_on_Batswana_Men’s_Psychological_Help-seeking_Behaviours.

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Metadata

Authors
Adams, C., Gringart, E., & Strobel, N.
Affiliations
Edith Cowan University (AU)
Corresponding author
Adams, Claire
Venue
Systematic Reviews
Published
2022-08-09
Volume
11
Issue
1
Pages
160-160
ISSN
2046-4053 (ISSN-L)
OpenAlex
W4290729306
Cited by
115
References
89
Citations by year
2026: 42 · 2025: 34 · 2024: 22 · 2023: 14 · 2022: 3
FWCI
2.73
Type
journal article
Language
en
Open access
Locations
  • Systematic Reviews (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Australasian Journal of Paramedicine (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
  • Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
mental health help-seeking, theory of planned behavior, help-seeking intentions, adults, attitudes, perceived behavioral control, subjective norms, help-seeking interventions, digital interventions, underutilization of mental health services
MeSH terms
Adult, Humans, Mental Health, Mental Health Services, Health Behavior, Behavior Control, Intention

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