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Pathways to Help-Seeking Among Black Male Trauma Survivors: A Fuzzy Set Qualitative Comparative Analysis.

ABSTRACT: Many Black men suffer symptoms of traumatic stress in the aftermath of traumatic injury, and they also often carry social concerns, including experiences of discrimination and stigma, and a lack of financial resources. The objective of the present study was to understand how traumatic symptoms and social factors combine in complex ways toward the outcome of psychological help-seeking. We analyzed qualitative and quantitative data from 32 injured Black men admitted to a Level 1 trauma center. Qualitative interviews explored their attitudes toward seeking professional psychological help. We analyzed quantitative data, collected using validated instruments, on posttraumatic stress and depression symptoms, financial worry, and discrimination/stigma. Fuzzy set qualitative comparative analysis (fsQCA) was conducted by calibrating each condition to fuzzy set membership scores based on our knowledge of the causal conditions and the cases. We then constructed truth tables for QCA analysis using fsQCA software. Three causal pathways for psychological help-seeking were identified: Two pathways showed that severe trauma symptoms in the absence of financial worry were sufficient for seeking help, whereas the third showed that financial worry and discrimination in the absence of trauma symptoms were sufficient for help-seeking. We identified two causal pathways for negated help-seeking, in which low posttraumatic symptom severity and low levels of discrimination or financial worry were sufficient for not seeking psychological help. The QCA analysis revealed multiple pathways for psychological help-seeking among Black men who suffer trauma. These findings highlight the need for further research to understand complex pathways toward psychological help-seeking in this population.

SUBMITTER: Rich JA

PROVIDER: S-EPMC7719085 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Background: Firefighters often do not avail of psychological support services within fire services. Hence, investigating help-seeking behaviour is crucial to determine viable support options. Objective: This study attempted to characterize help-seeking behaviour among UK firefighters by profiling and identifying patterns of help-seeking. Methods: An online survey was administered to 1282 UK firefighters who were asked which help-seeking options they availed of within and outside professional settings. The analysis was conducted in two linked phases. First, latent class analysis was used to identify the fewest profiles that most accurately described help-seeking behaviour. Second, multinomial logistic regression analysis was employed to describe class composition using demographic and years in service variables, while ANOVA was employed to identify variation in alcohol consumption and openness to discussing emotions across help-seeking classes. Results: Five distinct help-seeking classes were identified. Class 1 (9.2%) represented firefighters who availed of all forms of support. Class 2, the smallest class (6.9%) represented firefighters who independently sought External Professional Psychological Support. Class 3 (12.2%) represented those who mainly sought Friends Support. Class 4, the largest class (48.7%) represented those who mainly sought Spousal Support. Class 5 (23%) represented firefighters who sought all avenues of Social Support. Regression analyses indicated that the External Psychological Support class was more likely to be single with fewer years in service. Firefighters longest in service were less likely to seek Social Support, and those who relied on Spousal support had the lowest alcohol consumption. Conclusion: Variations in help-seeking behaviour among UK firefighters were found. Firefighters who sought spousal support had the lowest alcohol consumption rates, indicating a protected profile. Firefighters who only sought friends and informal colleagues' support had the highest alcohol consumption rates and the most difficulty in discussing feelings, indicating a potential at-risk profile. Recognizing these differences in help-seeking patterns is important for targeting interventions.

Project description:ObjectivesTo understand help-seeking by male victims of domestic violence and abuse (DVA) and their experiences of support services by systematically identifying qualitative and mixed-method studies and thematically synthesising their findings.DesignSystematic review and qualitative evidence synthesis. Searches were conducted in 12 databases and the grey literature with no language or date restrictions. Quality appraisal of the studies was carried out using the Critical Appraisal Skills Programme tool. Reviewers extracted first and second order constructs related to help-seeking, identified themes and combined them by interpretative thematic synthesis.SettingDVA experienced by male victims and defined as any incident or pattern of incidents of controlling coercive or threatening behaviour, violence or abuse among people aged 18 or over who are or have been intimate partners or family members, regardless of gender or sexuality.ParticipantsMale victims of DVA.InterventionsAny intervention which provides practical and/or psychological support to male victims of DVA including but not limited to DVA-specific services, primary healthcare and sexual health clinics.Primary and secondary outcome measuresQualitative data describing help-seeking experiences and interactions with support services of male victims of domestic violence RESULTS: We included twelve studies which were published between 2006 and 2017. We grouped nine themes described over two phases (a) barriers to help-seeking: fear of disclosure, challenge to masculinity, commitment to relationship, diminished confidence/despondency and invisibility/perception of services; and (b) experiences of interventions and support: initial contact, confidentiality, appropriate professional approaches and inappropriate professional approaches.ConclusionThe recent publication of the primary studies suggests a new interest in the needs of male DVA victims. We have confirmed previously identified barriers to help-seeking by male victims of DVA and provide new insight into barriers and facilitators to service provision.Prospero registration numberCRD42016039999.

Project description:BackgroundAdolescents and young adults often suffer from depression, but tend to avoid seeking professional help. The aim of this study was to explore the reasons for non-professional-help-seeking in a sample of young adults resident in Catalonia with depressive symptoms through a qualitative study. In addition, the subjects were invited to offer their recommendations for making mental health care services more accessible.MethodsWe recruited 105 young persons (17-21 years of age) who had participated in a national survey on adolescents. The sample was divided into thirds, with 37 who had a previous diagnosis of depression, 33 who had self-perceived emotional distress, and 35 controls. The participants were interviewed in depth about their reasons for avoiding professional mental health care services, and the interview results were analyzed using both qualitative and cultural domain techniques and corroborated through comparison with the results of three focus groups.ResultsParticipants' reasons for avoidance varied both by gender and according to prior experience with health services. Male study participants and female controls mainly understood depressive symptoms as normal and therefore not requiring treatment. Female participants with self-perceived distress were more likely to cite problems of access to treatment and fear of speaking to an unknown person about their problems. Females with a diagnosis expressed lack of trust in the benefits of treatment and fear of the social consequences of help-seeking. In their recommendations for best practices, the study participants suggested educational initiatives, as well as changes in the organization of mental health care services.ConclusionsA better understanding of the views of young people and a greater effort to involve them as active participants is important for facilitating help-seeking in this age group, and for adapting mental health care services to adolescent users and their social context.

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Pathways to Help-Seeking Among Black Male Trauma Survivors: A Fuzzy Set Qualitative Comparative Analysis.

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