Help-Seeking Behavior and Treatment Barriers in Anxiety Disorders: Results from a Representative German Community Survey.
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SUBMITTER: Heinig I
PROVIDER: S-EPMC8531057 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Anxiety and depressive disorders are the most common mental health disorders in adolescents, yet only a minority of young people with these disorders access professional help. This study aims to address this treatment gap by improving our understanding of barriers and facilitators to seeking/accessing professional help as perceived by adolescents with anxiety/depressive disorders identified in the community. Twenty-two adolescents, aged 11-17 years, who met diagnostic criteria for a current anxiety and/or depressive disorder were identified through school-based screening. In-depth qualitative interviews were conducted one-to-one with each adolescent and adolescents' parents were interviewed separately for the purpose of data triangulation. Data were analysed using reflexive thematic analysis. We identified four themes capturing adolescent perceived barriers and facilitators to seeking/accessing professional help for anxiety and depressive disorders: (1) making sense of difficulties, (2) problem disclosure, (3) ambivalence to seeking help, and (4) the instrumental role of others. Barriers/facilitators identified within each theme reflect important developmental characteristics of adolescence, such as a growing need for autonomy and concerns around negative social evaluation. At the same time, the results highlight adolescents' dependency on other people, mainly their parents and school staff, when it comes to successfully accessing professional help for their mental health difficulties. This study identifies a number of barriers/facilitators that influence help-seeking behaviour of adolescents with anxiety and/or depressive disorders. These factors need to be addressed when targeting treatment utilisation rates in this particular group of young people.
| S-EPMC9209355 | biostudies-literature
Project description:Background: Some individuals with chronic pain do not seek care. This decision may be due to characteristics of the individual, pain, and/or their health professional(s). Aims: This study aimed to identify and compare features of individuals with chronic pain, their pain and general health, and their health care professional between community-dwelling adults who did and did not seek care. Methods: Randomly selected adults were mailed a study questionnaire that screened for chronic pain (pain persisting ≥3 months) and asked about their general well-being (Short Form [SF]-36), pain location (body diagram), pain intensity and characteristics (Leeds Assessment of Neuropathic Symptoms and Signs), experiences with health care professionals (Chronic Illness Resources Survey), and visits made to health professionals over the past year. Respondents were categorized as help-seeking (≥1 visit in the past year) and non-help-seeking (zero visits in the past year). Results: Six percent of respondents (44/696) were non-help-seeking. These respondents differed in individual, pain, and health care professional characteristics when compared to those who did seek care. Specifically, when other variables were controlled, non-help-seeking individuals were less likely to be male (relative risk [RR] = 0.39, 95% confidence interval [CI], 0.18-0.86), report comorbid conditions (RR = 0.46, 95% CI, 0.22-0.98), report being treated as an equal partner in decision making (RR = 0.40, 95% CI, 0.18-0.93), and rate their health care professional as important to their pain management (RR = 0.39, 95% CI, 0.18-0.85). They were more likely to use over-the-counter medication to manage their pain (RR = 2.52, 95% CI, 1.14-5.58). Conclusions: Experiences with health professionals play a role in determining whether an individual manages his or her pain independently. Future research should explore the safety of those who do not seek care.
| S-EPMC8730570 | biostudies-literature
Project description:BackgroundCommunity attitude towards mental health problems and help-seeking behavior plays a major role in designing effective community based mental health interventions. This study aimed to assess the attitude, help-seeking behavior, and associated factors of the Jimma zone community towards mental health and mental health problems.MethodsA community-based cross-sectional study design was employed. A respondent from each of the 423 systematically selected households was interviewed using a pretested, structured, and interviewer-administered questionnaire. Accordingly, a community's attitude towards mental health problems was measured by the adapted version of the "Community Attitude towards Mentally Ill questionnaire (CAMI)" and help-seeking behavior was measured by a general help-seeking questionnaire. Data were entered into Epi-data version 3.1 and exported to SPSS version 23.0 for analysis. Bivariate and multivariate logistic regression analysis was done to determine the independent predictors of the outcome variable.ResultsAmong the total 420 study participants (197,46.9%) of them had an overall unfavorable attitude towards mental illness. The majority (153,36.4%) of the study participants agreed on avoidance of anyone who has mental health problems and (150,35.7%) participants described marrying a person with a mental health problem or recovered from the problem is foolishness. Moreover, regression analysis showed family monthly income (AOR = 0.24, 95%CI:0.06-0.91) and occupational status (AOR = 0.57, 95%CI:0.34-0.96) were found to be the predictors of community attitude towards mental health problems. The study finding also revealed a significant number of the respondents preferred non- medical treatment approaches.ConclusionAlmost half of the respondents had an unfavorable attitude towards mental health problems and the traditional and religious help-seeking intention was high. This suggests the need for designing effective community based mental health interventions to improve the general public attitude and help-seeking behavior towards mental health problems.
| S-EPMC7660493 | biostudies-literature
Project description:BackgroundWorldwide, the internet is an increasingly important channel for health information. Many theories have been applied in research on online health information seeking behaviors (HISBs), with each model integrating a different set of predictors; thus, a common understanding of the predictors of (online) HISB is still missing. Another shortcoming of the theories explaining (online) HISB is that most existing models, so far, focus on very specific health contexts such as cancer. Therefore, the assumptions of the Planned Risk Information Seeking Model (PRISM) as the latest integrative model are applied to study online HISB, because this model identifies the general cognitive and sociopsychological factors that explain health information seeking intention. We shift away from single diseases and explore cross-thematic patterns of online HISB intention and compare predictors concerning different health statuses as it can be assumed that groups of people perceiving themselves as ill or healthy will differ concerning their drivers of online HISB. Considering the specifics of online HISB and variation in individual context factors is key for the development of generalizable theories.ObjectiveThe objective of our study was to contribute to the development of the concept of online HISB in 2 areas. First, this study aimed to explore individual-level predictors of individuals' online HISB intention by applying the postulates of PRISM. Second, we compared relevant predictors of online HISB in groups of people with different health statuses to identify cross-thematic central patterns of online HISB.MethodsData from a representative sample of German internet users (n=822) served to explain online HISB intentions and influencing patterns in different groups of people. The applicability of the PRISM to online HISB intention was tested by structural equation modeling and multigroup comparison.ResultsOur results revealed PRISM to be an effective framework for explaining online HISB intention. For online HISB, attitudes toward seeking health information online provided the most important explanatory power followed by risk perceptions and affective risk responses. The multigroup comparison revealed differences both regarding the explanatory power of the model and the relevance of predictors of online HISB. The online HISB intention could be better explained for people facing a health threat, suggesting that the predictors adopted from PRISM were more suitable to explain a problem-driven type of information-seeking behavior.ConclusionsOur findings indicate that attitudes toward seeking health information online and risk perceptions are of central importance for online HISB across different health-conditional contexts. Predictors such as self-efficacy and perceived knowledge insufficiency play a context-dependent role-they are more influential when individuals are facing health threats and the search for health information is of higher personal relevance and urgency. These findings can be understood as the first step to develop a generalized theory of online HISB.
| S-EPMC8709915 | biostudies-literature
Project description:BackgroundOnline health information-seeking behavior (OHISB) is currently a widespread and common behavior that has been described as an important prerequisite of empowerment and health literacy. Although demographic factors such as socioeconomic status (SES), age, and gender have been identified as important determinants of OHISB, research is limited regarding the gender-specific motivational determinants of OHISB and differences between women and men in the use of online resources for health information purposes.ObjectiveThe aim of this study was to identify gender-specific determinants and patterns of OHISB by analyzing data from a representative German sample of adults (N=1728) with special attention to access and frequency of use as well as topics and sources of OHISB.MethodsWe employed a 2-step analysis, that is, after exploring differences between users and nonusers of online health information using logistic regression models, we highlighted gender-specific determinants of the frequency of OHISB by applying zero-truncated negative binomial models.ResultsAge (odds ratio, OR for females=0.97, 95% CI 0.96-0.99) and degree of satisfaction with one's general practitioner (GP) (OR for males=0.73, 95% CI 0.57-0.92) were gender-specific determinants of access to OHISB. Regarding the frequency of OHISB, daily Internet use (incidence rate ratio, IRR=1.67, 95% CI 1.19-2.33) and a strong interest in health topics (IRR=1.45, 95% CI 1.19-1.77) were revealed to be more important predictors than SES (IRR for high SES=1.25, 95% CI 0.91-1.73).ConclusionsUsers indicate that the Internet seems to be capable of providing a valuable source of informational support and patient empowerment. Increasing the potential value of the Internet as a source for health literacy and patient empowerment requires need-oriented and gender-specific health communication efforts, media, and information strategies.
| S-EPMC5395693 | biostudies-literature
Project description:BACKGROUND:Globally, the mental health help-seeking behavior of university students is reported to be poor; less than one-third of university students with common mental disorders (CMDs) report having sought help from formal sources. Failure to seek treatment is associated with prolonged disability and poor mental health outcomes, including suicide. In Ethiopia, little is known about the help-seeking behavior of university students for CMDs. OBJECTIVE:This study aimed to assess the prevalence and determinants of help seeking, and sources of help sought by Jimma University undergraduate students with CMDs. METHOD:Seven hundred and sixty students were selected to participate in this cross-sectional study using multi-stage sampling. Sources of help were identified using the Actual Help-Seeking Questionnaire. CMDs were assessed using the 10-item Kessler Psychological Distress Scale. Binary logistic regression analysis was used for both univariate and multivariable analysis. RESULTS:Of the sampled students, 58.4% were found to have current CMDs. Of those with current CMDs, 78.4% had sought help for their problems. The majority (83.8%) of participants who sought help did so from informal sources. Compared to students who had 'very good' overall levels of satisfaction with life, those who had 'good', 'fair', and 'poor or very poor' overall level of satisfaction with life were less likely to seek help (p-value = 0.021, 0.014, and 0.011, respectively). Lastly, having no previous history of help-seeking was significantly associated with seeking help for CMDs (p-value<0.001). CONCLUSION:More than half of Jimma University students were found to have a high risk of CMDs and the majority of those with CMDs sought help from informal sources. Future studies are needed to explore the barriers of seeking help from formal resources, and the effects of not receiving help from formal sources for CMDs symptoms.
| S-EPMC6386312 | biostudies-literature
Project description:AimsTo examine: (1) gender-specific determinants of help-seeking for mental health, including health professional consultation and the use of non-clinical support services and self-management strategies (SS/SM) and; (2) gender differences among individuals with unmet perceived need for care.MethodAnalyses focused on 689 males and 1075 females aged 16-85 years who met ICD-10 criteria for a past-year affective, anxiety or substance use disorder in an Australian community-representative survey. Two classifications of help-seeking for mental health in the previous year were created: (1) no health professional consultation or SS/SM, or health professional consultation, or SS/SM only, and; (2) no general practitioner (GP) or mental health professional consultation, or GP only consultation, or mental health professional consultation. Between- and within-gender help-seeking patterns were explored using multinomial logistic regression models. Characteristics of males and females with unmet perceived need for care were compared using chi-square tests.ResultsMales with mental or substance use disorders had relatively lower odds than females of any health professional consultation (adjusted odds ratio [AOR] = 0.46), use of SS/SM only (AOR = 0.59), and GP only consultation (AOR = 0.29). Notably, males with severe disorders had substantially lower odds than females of any health professional consultation (AOR = 0.29) and GP only consultation (AOR = 0.14). Most correlates of help-seeking were need-related. Many applied to both genders (e.g., severity, disability, psychiatric comorbidity), although some were male-specific (e.g., past-year reaction to a traumatic event) or female-specific (e.g., past-year affective disorder). Certain enabling and predisposing factors increased the probability of health professional consultation for both genders (age 30+ years) or for males (unmarried, single parenthood, reliance on government pension). Males with unmet perceived need for care were more likely to have experienced a substance use disorder and to want medicine or tablets or social intervention, whereas their females peers were more likely to have experienced an anxiety disorder and to want counselling or talking therapy. For both genders, attitudinal/knowledge barriers to receiving the types of help wanted (e.g., not knowing where to get help) were more commonly reported than structural barriers (e.g., cost).ConclusionsFindings suggest a need to address barriers to help-seeking in males with severe disorders, and promote GP consultation. Exploring gender-specific attitudinal/knowledge barriers to receiving help, and the types of help wanted, may assist in designing interventions to increase consultation. Mental health promotion/education efforts could incorporate information about the content and benefits of evidence-based treatments and encourage males to participate in other potentially beneficial actions (e.g., physical activity).
| S-EPMC7137666 | biostudies-literature
Project description:Evidence suggests that male victims of intimate partner violence (IPV) are less likely to seek help for their victimization than female victims. Studies exploring barriers to help seeking are relatively scarce in the United Kingdom (UK) and those that have been undertaken across Europe, United States, Canada, and Australia have tended to rely on small samples of help-seeking men who have self-identified as victims of IPV. With a view to include more male victim voices in the literature, an anonymous qualitative questionnaire was distributed via social media. In total, 147 men (85% from the UK) who self-identified as being subject to abuse from their female partners, completed the questionnaire. The data was subjected to a deductive thematic analysis and one superordinate and two overarching themes were identified. The superordinate theme was stigmatized gender and the two overarching themes (subthemes in parentheses) were barriers prohibiting help seeking (status and credibility, health and well-being) and responses to initial help seeking (discreditation, exclusion/isolation, and helpfulness). The findings are discussed in the context of Overstreet and Quinn's (2013) interpersonal violence and stigma model and findings from previous research. The conclusions and recommendations promote education and training and advocate a radical change to policy.
| S-EPMC9554285 | biostudies-literature
Project description:IntroductionGambling can have serious consequences for many aspects of a person's life. Yet relatively few people with gambling problems seek help. This study examines the extent to which exclusion from casino venues among other factors may act as a motivator for further help-seeking among casino gamblers (both landbased and remote) with at-risk or disordered gambling behavior. In addition, the barriers that prevent gamblers from accepting help are examined.MethodsGamblers from Swiss casinos completed a written questionnaire twice, at 6-month intervals. The questions included whether they had sought help in the past 6 months.ResultsFor those with a SOGS-R rating of 1 or over (n = 173) at the second survey point, a difference in help-seeking was found between the excluded and non-excluded gamblers (p < .001), suggesting that exclusion may be a motivator for help-seeking. Reported differences in levels of debt (p = .006), recognition of gambling problems (p = .010) and severity of gambling-related problems (p = .004) can be taken to suggest that other motivating factors may also influence help-seeking behavior. With regard to the support sought, the most frequently used forms of support were specialized addiction counseling centers (39.5%), followed by self-help groups (21.1%) and remote counseling centers (10.5%). In terms of barriers, reasons relating to attitude, such as denial, appear to pose greater barriers than treatment-related concerns.DiscussionFrom a public health perspective, an overarching strategy is required to increase the share of help-seekers among casino gamblers through targeted measures.
| S-EPMC10249729 | biostudies-literature
Project description:BackgroundAs a result of demographic changes, the number of people aged 60 years and older has been increasing steadily. Therefore, older adults have become more important as a target group for health communication efforts. Various studies show that online health information sources have gained importance among younger adults, but we know little about the health-related internet use of senior citizens in general and in particular about the variables explaining their online health-related information-seeking behavior. Media use studies indicate that in addition to sociodemographic variables, lifestyle factors might play a role in this context.ObjectiveThe aim of this study was to examine older people's health-related internet use. Our study focused on the explanatory potential of lifestyle types over and above sociodemographic variables to predict older adults' internet use for health information.MethodsA telephone survey was conducted with a random sample of German adults aged 60 years and older (n=701) that was quota-allocated by gender, age, educational status, and degree of urbanity of their place of residence.ResultsThe results revealed that participants used the internet infrequently (mean 1.82 [SD 1.07]), and medical personnel (mean 2.89 [SD 1.11]), family and friends (mean 2.86 [SD 1.21]), and health brochures (mean 2.85 [SD 1.21]) were their main sources of health information. A hierarchical cluster analysis based on values, interests, and leisure time activities revealed three different lifestyle types for adults aged over 60 years: the Sociable Adventurer, the Average Family Person, and the Uninterested Inactive. After adding these types as second-step predictors in a hierarchical regression model with sociodemographic variables (step 1), the explained variance increased significantly (R2=.02, P=.001), indicating that the Average Family Person and the Sociable Adventurer use the internet more often for health information than the Uninterested Inactive, over and above their sociodemographic attributes.ConclusionsOur findings indicate that the internet still plays only a minor role in the health information-seeking behavior of older German adults. Nevertheless, there are subgroups including younger, more active, down-to-earth and family-oriented males that may be reached with online health information. Our findings suggest that lifestyle types should be taken into account when predicting health-related internet use behavior.
| S-EPMC7320311 | biostudies-literature