Whether and how people reach care.
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1001 to 1025 of 2,047Recent intimate partner violence among people with chronic mental illness: findings from a national cross-sectional survey.
Background: People with mental illness are at increased risk of intimate partner violence (IPV) victimisation, but little is known about their risk for different forms of IPV, related health impact and help-seeking.
Aims: To estimate the odds for past-year IPV, related impact and disclosure among people with and without pre-existing chronic mental illness (CMI).
Method: We analysed data from 23 222 adult participants in the 2010/2011 British Crime Survey using multivariate logistic regression.
Results: Past-year IPV was reported by 21% and 10% of women and men with CMI, respectively. The adjusted relative odds for emotional, physical and sexual IPV among women with versus without CMI were 2.8 (CI = 1.9-4.0), 2.6 (CI = 1.6-4.3) and 5.4 (CI = 2.4-11.9), respectively. People with CMI were more likely to attempt suicide as result of IPV (aOR = 5.4, CI = 2.3-12.9), less likely to seek help fr…
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Falkenberg I, Valmaggia L, Byrnes M, Frascarelli M, Jones C, Rocchetti M, Straube B, Badger S, McGuire P, Fusar-Poli P (2015)MEDLINE-indexed journal, not yet read by usPsychiatry research118 citations Why are help-seeking subjects at ultra-high risk for psychosis help-seeking?
In addition to attenuated psychotic symptoms, individuals at high clinical risk of developing psychosis display a wide range of psychopathological features. Some of these may be subjectively perceived as more troubling than others and may therefore be more likely to trigger help-seeking behavior. We aimed at investigating the nature and prevalence of symptoms subjectively considered most distressing by high-risk individuals at the time of their presentation to early recognition services and to determine their impact on baseline and longitudinal functional and clinical outcomes. The clinical records of 221 clients meeting ultra-high risk (UHR) criteria and receiving care at a specialized early intervention service ("Outreach and Support in South London") between 2001 and 2011 were reviewed. Main outcome measures were reason to seek help as subjectively reported by the clients, comorbid DS…
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Prevalence of female urinary incontinence and its impact on quality of life in a cluster population in the United Kingdom (UK): a community survey.
Aim: To ascertain the prevalence of urinary incontinence and lower urinary tract symptoms, impact on quality of life and help-seeking behaviour.
Background: Urinary incontinence is common and will affect more individuals as the population ages. Estimates of the prevalence of urinary incontinence vary hugely. Additional information is required to inform resource allocation.
Methods: Population-based cross-sectional postal evaluation of all female patients over 21 years registered at a single medical practice in the United Kingdom.
Findings: A total of 40% of respondents suffered urinary incontinence, which caused significant problems in 8.5%. Stress urinary incontinence was the most common type of incontinence while 10% had symptoms of voiding dysfunction. A total of 17% of women had sought professional help. Patients perceived that urinary incontinence was part of the natural ageing proc…
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Predictors of help-seeking for suicidal ideation in the community: risks and opportunities for public suicide prevention campaigns.
Help-seeking behaviour for suicidality is low and the reasons for this have not systematically been examined. The aim of the current study was to examine the relationship between suicide stigma, suicide literacy and help-seeking attitudes and intentions. One thousand two hundred seventy-four Australian adults recruited via Facebook completed an online survey assessing a range of mental health outcomes. High suicide literacy and low suicide stigma were significantly associated with more positive help-seeking attitudes and, among a subsample of 534, greater intentions to seek help. Attribution of suicide to isolation was associated with more positive attitudes toward help-seeking and greater intentions to seek help, while respondents experiencing suicidal ideation had more negative attitudes toward help-seeking and lower intentions to seek help. Lower depressive symptoms, older age and fem…
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College men's depression-related help-seeking: a gender analysis.
Background: Men's health help-seeking behaviours vary considerably depending on the context. The current empirical literature on the influence of masculinity on college men's attitudes towards mental health-related help-seeking is largely limited to investigations involving psychology students.
Aim: To describe the connections between masculinities and college men's depression-related help-seeking.
Methods: Qualitative interviews with 21 college men who were diagnosed or self-identified as depressed. Constant comparison was used to inductively derive gendered understandings about participants' depression-related help-seeking.
Results: Three themes were identified: (1) denying weakness; (2) limiting self-disclosure and mustering autonomy; and (3) redefining strength.
Conclusion: The findings demonstrate connections between masculinities and help-seeking that can assist health care provide…
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Factors that influence young people's mental health help-seeking behaviour: a study based on the Health Belief Model.
Aim: To identify key predictors and moderators of mental health 'help-seeking behavior' in adolescents.
Background: Mental illness is highly prevalent in adolescents and young adults; however, individuals in this demographic group are among the least likely to seek help for such illnesses. Very little quantitative research has examined predictors of help-seeking behaviour in this demographic group.
Design: A cross-sectional design was used.
Methods: A group of 180 volunteers between the ages of 17-25 completed a survey designed to measure hypothesized predictors and moderators of help-seeking behaviour. Predictors included a range of health beliefs, personality traits and attitudes. Data were collected in August 2010 and were analysed using two standard and three hierarchical multiple regression analyses.
Findings: The standard multiple regression analyses revealed that extraversion, per…
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Mental health in immigrant men and women in Australia: the North West Adelaide Health Study.
Background: There is conflicting evidence of the healthy migrant effect with respect to mental health. This study aims to determine if there are differences in mental health and service use between Australian-born and foreign-born individuals living in South Australia and to consider the differing role of socio-demographic characteristics for Australian-born and foreign-born men and women.
Methods: Data from the North West Adelaide Health study was used to compare foreign-born men and women from English and non-English speaking backgrounds with Australian born men and women on four measures of mental health and service use. A series of logistic regression analyses were conducted.
Results: There were no differences between Australian-born and foreign-born individuals from English-speaking backgrounds on any measures. Men from non-English speaking backgrounds had higher odds of depression.…
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Identifying the barriers and facilitators to optimal hearing aid self-efficacy.
Objective: Many older adults with hearing impairment are not confident in their ability to use hearing aids (i.e. experience low hearing aid self-efficacy), which has been found to be a barrier to hearing help-seeking and hearing aid use. This study aimed to determine what factors were associated with achieving adequate hearing aid self-efficacy.
Design: A retrospective research design was employed wherein hearing aid self-efficacy was the primary outcome. Explanatory variables included personal demographics, visual disability, and experiences related to participants' hearing ability and hearing aids.
Study sample: A total of 307 older adults with hearing impairment participated in the study (147 non hearing aid owners and 160 hearing aid owners).
Results: Non-hearing aid owners were more likely to report adequate hearing aid self-efficacy if they reported no visual disability, had exper…
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Improving mental health and wellbeing for young men in the building and construction industry.
Statistics on causes of death gathered by the Australian Bureau of Statistics (2010) report that suicide was the leading cause amongst young men in Australia between the ages of 15-24. The figures have been similarly high for over a decade. In Australia these alarming statistics have led to the funding of a range of programmes tackling youth suicide and more recently programmes that are aimed at improving help-seeking behaviours of young men. The programme reported in this paper is one such programme that is working with young men in the building and construction industry who are regarded at even greater risk of poor mental health outcomes. The research that was undertaken uncovered some of the impact of a universal programme on improving the protective factors of young men in this industry. Young men can present themselves in a very positive light as robust and resilient human beings, c…
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Public stigma and self-stigma: differential association with attitudes toward formal and informal help seeking.
Objective: Individuals in need of psychiatric treatment often avoid seeking help because of stigma. This study examined the impact of two stigma dimensions on help-seeking attitudes. Perceived public stigma refers to discrimination and devaluation by others, and anticipated self-stigma refers to internalization of negative stereotypes about people who seek help.
Methods: Data were from the 2009 Stigma in a Global Context-Belgian Mental Health Study, in which face-to-face interviews were conducted with a representative sample of the general Belgian population. The study reported here included 728 respondents who received a vignette depicting major depression or schizophrenia. Perceived public stigma and anticipated self-stigma were measured with validated instruments. Respondents' attitudes toward help seeking were measured by the importance they assigned to care from formal and informal …
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Birchwood M, Connor C, Lester H, Patterson P, Freemantle N, Marshall M, Fowler D, Lewis S, Jones P, Amos T, Everard L, Singh SP (2013)MEDLINE-indexed journal, not yet read by usThe British journal of psychiatry : the journal of mental science120 citations Reducing duration of untreated psychosis: care pathways to early intervention in psychosis services.
Background: Interventions to reduce treatment delay in first-episode psychosis have met with mixed results. Systematic reviews highlight the need for greater understanding of delays within the care pathway if successful strategies are to be developed.
Aims: To document the care-pathway components of duration of untreated psychosis (DUP) and their link with delays in accessing specialised early intervention services (EIS). To model the likely impact on efforts to reduce DUP of targeted changes in the care pathway.
Method: Data for 343 individuals from the Birmingham, UK, lead site of the National EDEN cohort study were analysed.
Results: A third of the cohort had a DUP exceeding 6 months. The greatest contribution to DUP for the whole cohort came from delays within mental health services, followed by help-seeking delays. It was found that delay in reaching EIS was strongly correlated with…
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Women's perception of postpartum pelvic floor dysfunction and their help-seeking behaviour: a qualitative interview study.
Aims: To explore women's perception of postpartum pelvic floor dysfunction and their help-seeking behaviour.
Methods: We interviewed 26 patients from two family practitioners' populations in the Netherlands 1 month to 1 year after their vaginal delivery. The semi-structured interviews were independently encoded and analysed by three researchers according to a scoring list on determined topics. Three researchers independently coded themes discussed by the interviewees that matched main topics from the interview guide. In the case of encoding differences, the researchers deliberated on them until consensus was reached.
Findings: All women suffered from pelvic floor dysfunction such as urinary incontinence, pelvic floor pain, prolapse, haemorrhoids, anal fissure, constipation and dyspareunia. Midwives and gynaecologists did not prepare them for postpartum pelvic floor problems. The women di…
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Depression and social anxiety in help-seeking patients with an ultra-high risk for developing psychosis.
Knowledge on associations between ultra-high risk (UHR) for developing psychosis and on non-psychotic psychopathology in help-seeking populations is limited with respect to differences between male and female patients. The present study tests the hypothesis that both social anxiety and depression are highly prevalent in an UHR population, particularly among women. From February 2008 to February 2010 baseline data were collected from help-seeking subjects (14-35 years) who were included in the Dutch Early Detection and Intervention Evaluation (EDIE-NL) trial. Two recruiting strategies were used: a two-stage screening strategy in a population of consecutive help-seeking and distressed subjects of secondary mental health services, and a referral strategy. This study included 201 patients with a mean age of 22.7 years. Of these, 102 (51%) were female, 58% of the patients met the criteria for…
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Understanding barriers to Malaysian women with breast cancer seeking help.
Delay in help-seeking behaviour which is potentially preventable has a major effect on the prognosis and survival of patients with breast cancer. The objective of this study was to explore reasons for delay in seeking help among patients with breast cancer from the East Coast of peninsular Malaysia. A qualitative study using face- to-face in-depth interview was carried out involving 12 breast cancer patients who had been histo-pathologically confirmed and were symptomatic on presentation. Respondents were selected purposely based on their history of delayed consultation, diagnosis or treatment. All were of Malay ethnicity and the age range was 26-67 years. Three were in stage ll, seven in stage lll and two in stage lV. At the time of interview, all except one respondent had accepted treatment. The range of consultation time was 0.2-72.2 months with a median of 1.7 months, diagnosis time …
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Help-seeking behaviour of Serbian women who experienced intimate partner violence.
Objective: This study aimed to identify whom women in Serbia approach for help in case of intimate partner violence (IPV), their reasons for seeking help and their satisfaction with the received help.
Methods: A cross-sectional, population-based household survey of a random sample of women aged 15-49 years was conducted in Belgrade (WHO Multi-country Study on Women's Health and Domestic Violence against Women). A standard questionnaire was administered by trained interviewers through face-to-face interviews.
Results: The questionnaire was completed by 1456 women and 1196 of them ever had an intimate partner. Almost one in four ever-partnered women reported experiencing either physical and/or sexual violence, at least once in their life. Among these abused women, ≈ 22% had ever sought help from formal institutions. Police and health services were most commonly approached (12% and 10% of a…
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Men's discourses of help-seeking in the context of depression.
Depression is an illness increasingly constructed as a gendered mood disorder and consequently diagnosed in women more than men. The diagnostic criteria used for its assessment often perpetrate and reproduce gender stereotypes. The stigma associated with mental illness and the gendered elements of depression suggest there are likely numerous discourses that position, explain, and justify help-seeking practices. This qualitative study explored men's discourses of seeking help for depression. The methodological approach was informed by a social constructionist perspective of language, discourse and gender that drew on methods from discourse analysis. We conducted individual in-depth, semi-structured interviews with 38 men with depression, either formally diagnosed or self reported. The analysis revealed five discursive frames that influenced the men's talk about help-seeking and depression…
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Armando M, Nelson B, Yung AR, Saba R, Monducci E, Dario C, Righetti V, Birchwood M, Fiori Nastro P, Girardi P (2012)MEDLINE-indexed journal, not yet read by usEarly intervention in psychiatry34 citations Psychotic experience subtypes, poor mental health status and help-seeking behaviour in a community sample of young adults.
Background: Different subtypes of psychotic experiences (PEs) have been identified in clinical and non-clinical samples. Researchers have considered these PEs to either be variations of personality or expressions of vulnerability to psychotic disorder. This study aimed to determine which particular subtypes of PEs were more likely to be associated with poor mental health status and help-seeking behaviour in a non-clinical sample of young adults.
Methods: The study was conducted on a community sample of 997 young adults. The prevalence of PEs and distress was measured using the community assessment of psychic experiences (CAPE), depressive and anxiety symptoms were measured using Beck depression inventory-II and Beck anxiety inventory, and general functioning was measured using the general health questionnaire-12. Factorial analysis of the CAPE positive dimension was conducted and correla…
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Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries.
Background: Little is known about how the views of the public are related to self-stigma among people with mental health problems. Despite increasing activity aimed at reducing mental illness stigma, there is little evidence to guide and inform specific anti-stigma campaign development and messages to be used in mass campaigns. A better understanding of the association between public knowledge, attitudes and behaviours and the internalization of stigma among people with mental health problems is needed.
Method: This study links two large, international datasets to explore the association between public stigma in 14 European countries (Eurobarometer survey) and individual reports of self-stigma, perceived discrimination and empowerment among persons with mental illness (n=1835) residing in those countries [the Global Alliance of Mental Illness Advocacy Networks (GAMIAN) study].
Results: I…
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Urban teens and young adults describe drama, disrespect, dating violence and help-seeking preferences.
Adolescent dating violence is increasingly recognized as a public health problem. Our qualitative investigation sought input from urban, African-American adolescents at risk for dating violence concerning (Tjaden and Thoennes in Full report of the prevelance, incidence, and consequences of violence against women: findings from the national violence against women survey. US Department of Justice, Washington, DC, 2000) dating violence descriptions, (WHO multi-country study on women's health and domestic violence against women: Summary report of initial results on prevalence, health outcomes and women's responses. World Health Organization, Geneva, 2005) preferences for help-seeking for dating violence, and (Intimate partner violence in the United States. Bureau of Justice Statistics, US Department of Justice, Office of Justice Programs, Washington, DC, 2007) recommendations for a teen dati…
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Perceptions of mental health and help-seeking behavior in an urban community in Vietnam: an explorative study.
This explorative study assesses perceptions of mental health and help-seeking behavior among adults in Vietnam. Methods included questionnaires (200) and focus group discussions (eight). Respondents were often unable to name specific mental illnesses. Frequently mentioned symptoms of mental illness were talking nonsense, talking/laughing alone and wandering. Pressure/stress and studying/thinking too much were often identified causes. Most respondents showed a preference for medical treatment options, often in combination with family care. The results show that perceptions of mental health and help-seeking behaviour are influenced by a lack of knowledge and a mix of traditional and modern views.
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Assessing psychological flexibility: what does it add above and beyond existing constructs?
The construct of psychological flexibility (PF) is a central concept in acceptance and commitment therapy. It is defined as the process of contacting the present moment fully as a conscious human being and persisting in or changing behavior in the service of chosen values. PF is hypothesized to be an important aspect of healthy psychological functioning. Despite its potential importance, the distinctness of PF from other constructs has not been adequately demonstrated, and psychometric evaluations of measures designed to assess it are limited. This study aimed at extending current knowledge about PF by examining the construct in 2 help-seeking samples, including panic disorder with agoraphobia (n = 368), clinically relevant social phobia (n = 209), and 2 nonclinical samples including students (n = 495) and individuals visiting an employment office (n = 95). Results across all samples ind…
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Sexual attraction, depression, self-harm, suicidality and help-seeking behaviour in New Zealand secondary school students.
Objective: To describe the sexual attractions of New Zealand secondary school students and investigate the associations between sexual attraction and self-reported depression, self-harm, suicidality and help-seeking behaviour.
Method: Multiple logistic regression was used to examine the associations between sexual attraction and depressive symptoms, suicidality, self-harming and help-seeking behaviours in a nationally representative secondary school health and well-being survey, undertaken in 2007.
Results: Of the students surveyed, 92% were attracted to the opposite sex, 1% to the same sex, 3% to both sexes, 2% were not sure and 2% were attracted to neither sex. Students who were attracted to the same or to both sexes consistently had higher prevalence estimates of depression (p = < 0.0001), suicidality (p = < 0.0001) and self-harming (p = < 0.0001). Odds ratios were highest for student…
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What stops us from healing the healers: a survey of help-seeking behaviour, stigmatisation and depression within the medical profession.
Background: Doctors are poor at help-seeking, particularly for mental ill health; attitudes of colleagues reflecting stigmatisation may be important factors influencing decisions to seek support.
Aims: This article focuses on doctors' attitudes to depression rather than mental illness in general. It seeks to determine the extent to which doctors perceive depression is stigmatised within the medical profession and whether the level of perceived stigma affects patterns of help-seeking behaviour.
Method: : A postal survey was sent to 1488 General Practitioners and 152 psychiatrists in Devon and Cornwall. Questions assessed stigmatising attitudes to depression; help-seeking behaviour and barriers to help-seeking. Prevalence of self-reported depression and time off work was measured.
Results: The response rate was 76.6%. Doctors perceived that many of their profession hold stigmatising views …
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Chronic cough and its association with TB-HIV co-infection: factors affecting help-seeking behaviour in Harare, Zimbabwe.
Objective: To qualitatively investigate reasons why individuals who reported chronic cough of 2 weeks or more in a cross-sectional prevalence survey had not accessed community-based outreach or other diagnostic services.
Methods: This study was nested into a cluster randomised trial comparing two methods of providing community-level diagnosis for tuberculosis (TB). Twenty individuals (12 males) with previously unreported chronic cough, because of undiagnosed pulmonary TB in five cases, were interviewed. An additional 20 individuals who had attended clinical services participated in two focus group discussions. Data were coded and analysed using grounded theory principles.
Results: Participants described cough, and specifically their own symptoms, as having many possible causes other than TB. People avoided care-seeking for cough to avoid a possible diagnosis of 'TB2' (HIV-related TB). Wa…
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Help seeking for cardiac symptoms: beyond the masculine-feminine binary.
Empirical and theoretical literature suggests that stereotypical gender roles shape men's and women's health help-seeking behavior, and plays an important role in the treatment seeking delays of cardiac patients. We were interested in exploring the ways in which gender informs the experiences and help-seeking behavior of men and women who experienced the symptoms associated with acute cardiac events. We undertook 20 in-depth interviews between October 2007 and July 2008 with 11 men and 9 women recently diagnosed with an acute coronary syndrome in British Columbia, Canada. Participants were encouraged to tell their 'story' of the event that led to hospitalization and diagnosis, with a focus on the symptoms and decision making processes that occurred before and during the activation of health services: seeking the advice of others including colleagues, family members and healthcare profess…
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