A model of intention to provide mental health first aid in college students.

BACKGROUND: Psychologically distressed college students' peers are often the first line of mental health support. Mental health first aid (MHFA) focuses on the quality of early intervention provided by peers to those in psychological distress but has neglected what motivates college students to provide MHFA. AIMS: The current study used the MHFA framework and bystander theory as a foundation to examine factors influencing college students' intention to provide MHFA. METHODS: Participants were 778 U.S. college students from a larger group of college students (N = 29,765) from the 2015-2016 Healthy Minds Study archival dataset. Secondary data analysis using path analysis modeling was used to test for both direct and indirect effects. RESULTS: The specified path analysis model demonstrated exact fit to the data, χ2(67) = 82.359, p = 0.098. Personal stigma decreased MHFA intention, whereas both perceived MHFA efficacy and personal responsibility increased MHFA intention. Of note, perceiving campus climate as supportive of helping others indirectly increased MHFA intention. CONCLUSIONS: The current study supports a theory-driven framework rooted in the MHFA and bystander theory literature that could facilitate targeted interventions aimed at improving mental health prevention via college student prosocial behavior.

Impact of integrated care and co-location of care on mental help-seeking perceptions.

BACKGROUND: Integrated care may offer a solution to subpar mental health referral adherence, but people's openness to receiving psychological treatment in this setting is understudied. AIMS: The present study examined the influence of the integrated care context and co-location of care on people's help-seeking perceptions. METHOD: This study (N = 397) used an experimental vignette design to compare the impact of treatment type (integrated care vs. traditional psychotherapy) and distance (close vs. far) on help-seeking perceptions. RESULTS: The integrated care environment (significant effect on perceived behavioral control) and closer proximity of the psychologist (significant effect on intention, attitudes, perceived effectiveness of treatment, self-stigma) only improved help-seeking perceptions among those with prior experience with mental health treatment. In the overall sample, treatment type and distance only demonstrated an effect among women, but not men. CONCLUSIONS: Pending replication with samples from diverse populations, these findings provide a cautionary tale about lay perceptions of integrated care's anticipated utility. However, co-location and, to a lesser degree, the common attributes of the integrated care format (e.g. team approach, flexible scheduling) may represent a potential pathway for reducing resistance to help seeking that can accompany traditional psychotherapy referrals among those with past exposure to behavioral healthcare.

Collegian help seeking: the role of self-compassion and self-coldness.

BACKGROUND: Researchers have identified a two-factor structure of self-compassion (i.e. self-compassion and self-coldness). To date, no research has examined each of these constructs' role in collegian professional help-seeking intention. AIM: The current study sought to assess the role of self-compassion and self-coldness in collegian professional help-seeking intention, accounting for other theoretically and empirically-supported help-seeking constructs. METHOD: Participants included 9349 collegians recruited as part of the national 2015-2016 Healthy Minds Study archival dataset. A logistic regression was conducted to examine the unique contributions of self-compassion and self-coldness in predicting professional help-seeking intention, controlling for key help-seeking variables. RESULTS: A test of the full model against a constant only model was statistically significant, which indicated that the predictors collectively distinguished between collegians who intended to seek help from a professional clinician compared to those who did not. The Wald criterion indicated that both self-compassion and self-coldness were uniquely associated with intention to seek professional help. Self-compassion increased and self-coldness decreased the probability of seeking professional help. CONCLUSIONS: The study highlights the importance of self-compassion and self-coldness in collegian help-seeking intention. These findings can inform specific outreach efforts targeting both self-compassion and self-coldness.

Physician referral to a psychologist: Testing alternative behavioral healthcare seeking models.

OBJECTIVE: Primary care physicians (PCPs) often refer patients to psychological services, but help-seeking factors in the context of behavioral healthcare referral are understudied. This study examined perceptions of seeking psychological help for depression by comparing alternative structural equation models derived from the Theory of Reasoned Action (TRA). METHOD: Internet survey participants (N = 685 US adults, 77% female, M age = 45) imagined themselves in a vignette scenario in which they are experiencing depression symptoms and encouraged by a PCP to see a psychologist. RESULTS: Results supported the indirect model, in which the links between distal help-seeking factors (i.e., self-stigma, symptom recognition, perceived effectiveness of treatment) and intention to follow through on the referral to the psychologist were fully mediated by the more proximal TRA factors (i.e., attitudes, subjective norms, etc). CONCLUSIONS: Our findings supported the use of TRA in understanding peoples' intention to seek psychological help for depression when referred by their PCP.

Mental health literacy as theory: current challenges and future directions.

BACKGROUND: Mental health literacy (MHL) is one increasingly researched factor thought to influence mental health behaviors. Researchers have argued for expanding the definition of MHL to include additional constructs, but no consensus has yet been reached on what constructs should be included as part of MHL. AIMS: The purpose of this paper is to (i) elucidate how the expansion of the MHL construct has impeded the growth of MHL research and (ii) through the lens of construct and theory development, highlight how these challenges might be remedied. METHODS: An inclusive search of the literature was undertaken to identify MHL studies. The principles of construct and theory development guided a critical analysis of MHL. RESULTS: The review of the literature found that MHL violates many principles of what constitutes an acceptable construct definition. To address these concerns, we proposed conceptualizing MHL as a theory and recommended principles of theory development that should be taken into consideration. CONCLUSION: A theory of MHL can guide future researchers to clearly delineate important constructs and their interrelationships. For practitioners, a theory of MHL can help inform how to improve MHL at both the individual and community level.

Dimensionality, reliability, and predictive evidence of validity for three help-seeking intention instruments: ISCI, GHSQ, and MHSIS.

People's intention to seek help from a mental health professional is thought to be the proximal cause of help-seeking behavior and thus is a dependent variable frequently measured by help-seeking researchers. Using a research design that accounted for actual future help-seeking behavior, the present study documented the dimensionality, internal consistency, and predictive evidence of validity of 3 intention instruments: the Intentions to Seek Counseling Inventory (ISCI), General Help Seeking Questionnaire (GHSQ), and Mental Help-Seeking Intention Scale (MHSIS). The sample was composed of 405 community-dwelling adults who self-identified as currently experiencing a mental health concern. Results provided support for the ISCI's 3-factor structure and the internal consistency of its 3 subscale scores. In contrast, the GHSQ did not demonstrate clear evidence of adequate measurement model fit or internal consistency in the present sample. Results also tentatively suggested that the 3-item MHSIS is a unidimensional instrument that produces an internally consistent total score with appropriate construct replicability. The ability of these instruments to predict who would seek help from a mental health professional in the next 3 months was also examined. The MHSIS demonstrated the strongest evidence of predictive validity (about 70% of participants were correctly classified), followed by the GHSQ and ISCI. (PsycINFO Database Record

Mental Help Seeking Attitudes Scale (MHSAS): Development, reliability, validity, and comparison with the ATSPPH-SF and IASMHS-PO.

Attitudes is a key help-seeking construct that influences treatment seeking behavior via intention to seek help, per the theory of planned behavior (TPB). This article presents the development and psychometric evaluation of the Mental Help Seeking Attitudes Scale (MHSAS), designed to measure respondents' overall evaluation (unfavorable vs. favorable) of their seeking help from a mental health professional. In Study 1 (N = 857 United States adults), exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and item response theory (IRT) analysis were used to identify an optimal set of 9 items that demonstrated initial evidence of internal consistency, unidimensionality, and strong measurement equivalence/invariance (ME/I) across gender, past help-seeking experience, and psychological distress. Initial convergent evidence of validity was demonstrated via theoretically anticipated relationships between the MHSAS and key variables in the help-seeking nomological network (e.g., subjective norms, perceived behavioral control, intention, public stigma, self-stigma, anticipated risks and benefits, gender, previous help seeking). Initial incremental evidence of validity was demonstrated when the MHSAS demonstrated the ability to account for unique variance in help-seeking intention, beyond that accounted for by the Attitudes Toward Seeking Professional Psychological Help-Short Form scale (ATSPPH-SF) and the Psychological Openness subscale of the Inventory of Attitudes Toward Seeking Mental Health Services (IASMHS-PO). Study 2 (N = 207 United States adults at Times 1 and 2) provided initial evidence of test-retest reliability over a 3-week period. The MHSAS offers mental health professionals a new tool for measuring attitudes that may avoid limitations of current help seeking-attitudes measures (e.g., construct-irrelevant variance). (PsycINFO Database Record

Attitudes toward Help-Seeking for Sexual Problems among College Women.

Prior research has indicated that 65-70% of college age women have experienced at least one sexual problem. Sexual problems are associated with higher rates of depression, anxiety, and relationship distress; however, few college age women seek professional help for sexual difficulties. The present study used the Theory of Planned Behavior to explore how adherence to traditional feminine norms and self-stigma are associated with intention to seek professional psychological help for a sexual difficulty. Results of structural equation modeling analysis demonstrated approximate fit in a sample of 259 college women. The structural model indicated that self-stigma and stronger endorsement of specific feminine gender norms (i.e., romantic relationship, sexual fidelity, sweet and nice) were found to be associated with less intention to seek help for a sexual problem. We discuss future research directions and implications for clinical services.