Development and preliminary validation of a scale to measure self-efficacy in seeking mental health care (SE-SMHC)

Treatment histories, barriers, and preferences for individuals with symptoms of generalized anxiety disorder

Generalized anxiety disorder (GAD) is a prevalent and chronic mental health condition, associated with considerable individual and economic burden. Despite the availability of effective treatments, many individuals do not access support. The current study explores treatment histories, barriers to help-seeking, and cognitive behavioral therapy (CBT) treatment preferences for individuals with clinically significant GAD symptoms. The utility of Health Belief Model (HBM) in predicting help-seeking is also examined. A cross-sectional design with 127 participants (Mage = 29.17; SD = 11.86; 80.3% female) was used. Sixty-two percent of participants reported previously seeking psychological treatment, and approximately 28% received CBT in the first instance. The most influential treatment barriers were a desire to solve the problem on one's own (M = 1.96, SD = 0.96), followed by affordability (M = 1.75, SD = 1.15) and feeling embarrassed or ashamed (M = 1.75, SD = 1.06). The most preferred treatment modes were in-person individual treatment (M = 7.59, SD = 2.86) followed by remote treatment via videoconferencing (M = 4.31, SD = 3.55). Approximately 38% of the variance in intention to seek treatment was associated with the HBM variables, with perceived benefit of treatment being the strongest predictor. Results have the potential to inform mental health service delivery by reducing treatment barriers and aligning public health campaigns with benefits of psychological treatments.

Understanding Health-Promoting Behaviors and Influential Factors in Schizophrenia Patients

(1) Background: People who are diagnosed with schizophrenia experience a reduced average lifespan compared to the general population. Also, approximately 85% of individuals with schizophrenia have chronic physical illnesses. Moreover, 60% of premature deaths in this population could be prevented through the adoption of health-promoting behaviors. (2) Methods: This study involved the recruitment of 220 participants from an outpatient clinic in Seoul, South Korea. Inclusion criteria comprised adults aged 19 years or older with a confirmed diagnosis of schizophrenia. Data collection occurred between 25 May 2021 and 2 August 2021, utilizing self-report questionnaires. A total of 202 responses were subjected to analysis using SPSS 23.0 and AMOS 23.0. (3) Results: The findings indicate that the final model is characterized by the following values: Normed x2 = 2.240, RMSEA = 0.079, TLI = 0.926, x2 = 562.2 (p < 0.001), AGFI = 0.830, GFI = 0.814, and CFI = 0.938. Notably, health knowledge did not exhibit a significant direct or overall impact on health-promoting behaviors. Conversely, social support and psychiatric symptoms demonstrated direct, indirect, and total effects on health promotion through an intervening variable. This study underscores the pivotal role of self-efficacy as the most influential factor affecting health-promoting behaviors in individuals with schizophrenia. (4) Conclusions: enhancing self-efficacy emerges as a crucial element in the design and implementation of intervention programs aimed at improving health-promoting behaviors in individuals with schizophrenia.

Are Parents the Key? How Parental Suicide Stigma and Suicide Literacy Affect Help-Seeking Attitudes and Intentions for their Child

Suicide is the leading cause of death among Australian young people, yet rates of help-seeking for suicidal ideation and behaviors in this population are concerningly low. In this study, the relationships between parental suicide stigma, parental suicide literacy, and their attitudes and intentions toward seeking professional help for their child if they were to express thoughts of suicide are investigated. Understanding this influence is critical given parents are key facilitators of their child's access to and engagement with professional mental health services. An online survey was administered to 302 parents of children aged-12-18 (Mage = 45.36, SDage = 6.23; 91.4% female). Parental suicide stigma was significantly associated with more negative help-seeking attitudes and lower help-seeking intentions. Other significant predictors of more positive help-seeking attitudes included parental self-efficacy and having a child with no history of suicidal ideation. Higher help-seeking intentions were associated with female gender, living in an urban area, and positive help-seeking attitudes. Parental suicide literacy was not significantly associated with help-seeking. Practically, outcomes of this study may inform the development and implementation of targeted education programs to increase parental help-seeking for their children.

Asian Indian American Parental Help-Seeking Intentions for ADHD

Minoritized ethnic groups experience both delay to treatment and low rate of treatment contact for attention deficit/hyperactivity disorder (ADHD). To date, Asian Indian Americans have been excluded completely from ADHD help-seeking research. To fill this void, the Theory of Planned Behavior (TPB) was used to investigate the influence of race/ethnicity on parents' help-seeking intentions for their child's elevated ADHD symptoms. Parents (n = 191, 53% Asian Indian American, 47% European American; 63.9% fathers) of treatment naïve children at high risk for ADHD completed an online survey to assess their recognition of ADHD, knowledge of ADHD etiology, attitudes towards ADHD treatment, subjective norms regarding ADHD treatment, perceived control over their ADHD help-seeking behavior, and intention to seek help for their child's elevated ADHD symptoms. Hierarchical linear regressions demonstrated that perceived behavioral control independently predicted intention to seek help in the total sample and may be more impactful for European American parents than Asian Indian American parents. In contrast, subjective norms were more influential for help-seeking intentions among Asian Indian American parents. However, attitudes towards ADHD were not significantly associated with the intention to seek help among both ethnicities. Asian Indian American parents endorsed lower levels of biopsychosocial etiology beliefs. Together, the results inform possible methods of increasing treatment engagement for both groups of parents who have children at high risk for ADHD.

Mental Health Help-Seeking Behavior of Male Video Game Players: An Online Survey

Video gaming is a popular pastime for young males, having been shown to have both positive and negative effects on players' mental health. The aim of the current study was to ascertain the rate that male video gamers may seek mental health support for mental ill-health generally. The secondary aims were to (a) identify the most prolific barriers to seeking help; (b) determine how confident this group is to seek help; and (c) whether the variance in help-seeking efficacy be explained, in part, by age, hours gamed, self-esteem, and social capital. The survey included sections on demographic information, standardized measures of self-esteem (The Rosenberg Self-Esteem Scale), social capital (The Social Capital in Gaming Scale), help-seeking efficacy (Self-Efficacy to Seek Mental Health Care Scale), and non-standardized measures of help-seeking behavior and help-seeking barriers. The survey of 2,515 participants had a mean age of 21.37 years. The analysis identified that most participants had not sought mental health support for themselves. The most prolific barriers for this cohort to seek help were cost, confidentiality, and trust. Confidence to seek help was rated the lowest for overcoming embarrassment, understanding information, and coping with others' reactions. Help-seeking efficacy was found to be significantly predicted by age, hours spent gaming, self-esteem, and social capital. Low rates of seeking help, coupled with identifying the significant barriers of this group to seek help, may inform researchers aiming to develop targeted interventions for male youth interested in gaming and who are exhibiting mental ill-health to gain initial access, or engage more often, with mental health services when needed. Further research is recommended for investigating male gamers' insights in determining how to overcome the identified barriers for this cohort to improve mental health seeking behavior rather than avoidant behavior. From this, stigma reduction and ease of access to digital mental health services could be improved.

Understanding parental knowledge, attitudes and self-efficacy in professional help-seeking for child anxiety

BACKGROUND

Child anxiety disorders are highly prevalent yet undertreated. As parents are often 'gatekeepers' to children receiving treatment and support, this study aimed to investigate modifiable parental factors affecting professional help-seeking for their children from general practitioners (GPs), psychologists, and paediatricians.

METHODS

In this study, 257 Australian parents of children aged 5-12 years with elevated anxiety symptoms completed a cross-sectional online survey. The survey assessed help-seeking from a GP, psychologist, and paediatrician (General Help Seeking Questionnaire), as well as anxiety knowledge (Anxiety Literacy Scale), help-seeking attitudes (Attitudes Toward Seeking Professional Psychological Help), personal stigma (Generalised Anxiety Stigma Scale) and self-efficacy (Self-Efficacy in Seeking Mental Health Care).

RESULTS

66.9 % of participants had sought help from a GP, 61.1 % from a psychologist, and 33.9 % from a paediatrician. Help-seeking from a GP or psychologist was associated with lower personal stigma (p = .02 and p = .03 respectively). Participants who sought help from a psychologist also had more positive attitudes toward seeking professional support (p = .01). Conversely, knowledge of anxiety disorders and self-efficacy were not associated with help-seeking from any source.

LIMITATIONS

Limitations of the study include the representativeness of our sample (female gender, higher education level); unexplained variance potentially accounted for by other factors (e.g., structural barriers); lack of prior validation of measures in a parent sample.

CONCLUSIONS

This research will inform the development of public health policy and psychoeducation interventions for parents, to reduce personal stigma and increase positive attitudes toward professional help-seeking, in turn improving help-seeking for child anxiety.

Explaining the Help-Seeking Intentions of Adolescents Subject to Sexual Exploitation in Tanzania: An Application of the Theory of Planned Behavior

The sexual exploitation (SE) of children and adolescents is a universal concern. Numerous empirical studies have examined the prevalence and consequences of this phenomenon worldwide, but there is little information on the factors that determine the help-seeking intentions of adolescents subject to SE in Tanzania. We drew on the theory of planned behavior (TPB) to address this knowledge gap. The study had two main objectives. First, we examined four TPB variables (attitudes toward seeking help, perceived social support, perceived social stigma, and generalized self-efficacy) as determinants of the Tanzanian adolescents' help-seeking intentions. Second, we explored the moderating effects of social stigma on the relationship between the examined TPB factors and the adolescents' help-seeking intentions. A cross-sectional survey design was used to collect data from a stratified random sample of 1,116 secondary school adolescents aged 13-17 (M = 15.66; SD = 1.09). The participants were recruited from two regions in the east and northwest of Tanzania and data were analyzed using hierarchical multiple regression. The results indicate that the TPB variables of attitude toward seeking help, perceived social support, and generalized self-efficacy were positively associated with the help-seeking intentions of adolescents subject to SE, but not social stigma. Through moderation analyses, we found that social stigma significantly weakened the explanatory power of the attitude toward seeking help. The findings of this study in the context of Tanzania were discussed and implications for policy, practice, and future research were suggested.

The Influence of Information Source on COVID-19 Vaccine Efficacy and Motivation for Self-Protective Behavior

This study examined the influence of health information sources on the efficacy of the COVID-19 vaccine and other motivations for self-protective behavior. Based on the protection motivation theory, the study focused on threat appraisal factors (risk perception and perceived severity), response efficacy, and health information sources (media and interpersonal channels) as predictors for vaccine efficacy and self-protective behavior. Data were gathered in Kenya through a self-administered survey (n = 715) that was conducted at the pick of the COVID-19 pandemic. Results show that media sources (newspapers, radio, television, internet, and telephone) were viewed as more useful compared to interpersonal sources (health professionals, family, friends, and other personal influencers) for COVID-19-related information. Additionally, media sources influenced risk perception, perceived severity, response efficacy, vaccine efficacy, and self-protective behavior. Interpersonal sources were also correlated with perceived severity and response efficacy, and self-protective behavior but did not influence vaccine efficacy. The study suggests exploring the use of media and other digital sources including mobile phones to enhance threat appraisal and promote vaccine efficacy among other motivations for self-protection behavior in future pandemics or disease outbreaks, especially in resource-poor settings.

Evaluation of Mental Health First Aid from the Perspective Of Workplace End UseRs-EMPOWER: protocol of cluster randomised trial phase

Background

Mental Health First Aid (MHFA) is a mental health intervention that teaches people how to identify, understand and help someone who may be experiencing a mental health issue. Reviews of the implementation of MHFA found between 68 and 88% of trained Mental Health First Aiders had used their skills when in contact with someone experiencing mental health difficulties. Reviews evaluating the impact of MHFA suggest positive outcomes. However, to date, there has been no systematic, rigorous evaluation of the impact of MHFA on recipients of the intervention, the organisations providing it and the cost-effectiveness of MHFA overall. This trial will evaluate the effectiveness and cost-effectiveness of MHFA.

Methods

The study is a multi-centred, two-arm clustered randomised controlled trial. Organisations will be randomly allocated to the control or intervention (estimated sample size 800 recipients). The intervention is the standard MHFA intervention provided by Mental Health First Aid England (MHFAE). The control condition will be organisations having a brief consultation from MHFAE on promoting mental health and well-being in the workplace. The primary outcome is health seeking behaviour, measured using the Actual Help Seeking Questionnaire, at 6 months’ follow-up. Data collection will be undertaken at baseline (T0), post-intervention—up to 3 months (T1), at 6 months (T2), 12 months (T3) and 24 months (T4). The primary analysis will be conducted on those participants who receive MHFA, a per protocol analysis.

Discussion

The study is the first to evaluate the effect of MHFA in the workplace on employees with direct and indirect experience of the intervention, when compared with usual practice. Being also the first to assess, systematically, the social impact of MHFA and investigate its cost-effectiveness adds to the originality of the study. The study promises to yield important data, as yet unknown, regarding the effectiveness, cost-effectiveness, implementation issues, and the sustainability of MHFA in the workplace.

Trial registration

Clinicaltrials.govNCT04311203. Registered on 17 March 2020.

Help-seeking behaviours, barriers to care and self-efficacy for seeking mental health care: a population-based study in Rwanda

PURPOSE

Mental disorders commonly affect young people but usually go unrecognized and untreated. This study aimed to investigate help-seeking behaviours, barriers to care and self-efficacy for seeking mental health care among young adults with current depression and/or suicidality in a low-income setting.

METHODS

This cross-sectional study used two sub-populations: a sub-sample of those suffering from current depression and/or suicidality (n = 247) and another of those not suffering from these conditions and not suffering from any other mental condition investigated (n = 502). Help-seeking behaviours, barriers to care and self-efficacy for mental health care seeking were measured among those suffering from current depression and/or suicidality (n, %). Logistic regression was used to identify risk factors for experiencing barriers to care. Self-efficacy for seeking mental health care was compared between men and women in the two sub-populations.

RESULTS

Of the 247 men and women with current depression and/or suicidality, 36.0 % sought help at a health care unit and 64.0 % from trusted people in the community. Only six people received help from a mental health professional. The identified barriers were mainly related to accessibility and acceptability of health services. For the population suffering from current depression and/or suicidality, the self-efficacy scale for seeking mental health care suggested a low confidence in accessing mental health care but a high confidence in respondents' ability to successfully communicate with health care staff and to cope with consequences of seeking care.

CONCLUSION

The current study clearly highlights young adults' poor access to mental health care services. To reach universal health coverage, substantial resources need to be allocated to mental health, coupled with initiatives to improve mental health literacy in the general population.