Geographical variation in perceptions, attitudes and barriers to mental health care-seeking across the UK: a cross-sectional study.

OBJECTIVES: To examine the relative importance of the drivers of mental health care-seeking intention and how these, along with intention itself, are geographically distributed across integrated care systems (ICS) and health boards (HBs) in the UK. Also, to examine the degree of acceptance of virtual modes of care. DESIGN: Community-based cross-sectional survey. PARTICIPANTS AND SETTING: A national online survey of 17 309 adults between August and September 2021 recruited via a research technology company, Lucid. Sample size quotas were set to ensure coverage across the UK and match population distributions for gender, age and ethnicity. After exclusions, 16 835 participants remained (54% female, 89% white). MAIN OUTCOME MEASURES: Care-seeking intention, using a continuous measure of likelihood and a categorical measure of estimated time to seek professional help for a future mental health difficulty. RESULTS: 20.5% (95% CI 19.8% to 21.2%) reported that they would significantly delay or never seek mental healthcare, ranging from 8.3% to 25.7% across ICS/HBs. Multilevel regression analysis showed mental health knowledge was the most predictive of care-seeking intention, followed by attitudes towards others with mental illness and a combination of stigma, negative attitudes to treatment and instrumental barriers to accessing care. The model explained 17% of the variance. There was substantial geographical variation in prevalence of preclinical symptoms of depression and anxiety, attitudes to mental health, and barriers to care, leading to complex ICS/HB profiles. Remote and self-guided therapies did not pose as a major barrier to care with more than half of respondents likely or very likely to use them. CONCLUSIONS: Our locally relevant and actionable findings suggest possible interventions that may improve care-seeking intention and indicate which of these interventions need to be geographically tailored to have maximal effect.

Positive wellbeing and resilience following adolescent victimisation: An exploration into protective factors across development.

Background: Not all victims of bullying go on to develop problems with their mental health. To understand factors that may confer resilience, many have explored the moderating role of protective factors in relation to mental illness. No study to date, however, has considered moderators of adult wellbeing following victimisation. We explore 14 protective factors and test whether these promote good adult wellbeing in addition to prevent mental illness following victimisation. In doing so, we aimed to understand how positive mental health and resilience can be promoted. Methods: Data were derived from the Avon Longitudinal Study of Parents and Children. Participants were assessed for wellbeing and depressive symptoms at age 23, as well as victimisation in adolescence, and protective factors across development. Protective factors were categorised into individual-, family- and peer-level, and included factors like social skills, perceived school competence, and relationships with family and peers. The moderating role of the protective factors were examined using interactive regression models. Results: Perceived scholastic competence was the only factor that mitigated some of the negative effects of victimisation. Individuals with higher perceptions of scholastic competence had higher wellbeing in adulthood than victims with lower perceptions of competence. No protective factors positively moderated life satisfaction or the risk of depressive symptoms; although findings suggest that friendships in late adolescence may be protective for individuals exposed to less frequent victimisation. Conclusions: Our study is the first to explore a wide range of protective factors in predicting adult wellbeing following victimisation. We identify factors involved specifically in supporting wellbeing but not in reducing the risk of depression. Findings suggest that interventions aimed at increasing perceptions of scholastic competence in childhood may help to support more positive wellbeing in adulthood.