Workplace Interventions Targeting Mental Health Literacy, Stigma, Help-Seeking, and Help-Offering in Male-Dominated Industries: A Systematic Review.

Mental ill-health and suicide represent a significant proportion of the burden of global disease among men. Connell's relational theory of masculinities provides a useful framework to explore how mental health literacy, mental health stigma, and delayed help-seeking and help-offering behaviors are associated with mental ill-health among men, particularly within male-dominated industries. To address the high incidences of mental ill-health in male-dominated industries, several workplace interventions targeting these outcomes have been implemented. No review to date has examined the current state of evidence for these interventions or identified the behavior change techniques used. This review was restricted to empirical, quantitative research reporting on psychosocial interventions targeting mental health literacy, stigma, and help-seeking and help-offering behaviors in male-dominated industries. Quality appraisal was completed using the Effective Public Health Practice Project and a narrative synthesis was conducted. Twelve articles were included for review which reported on four distinct interventions. The methodological quality of two articles was strong, three moderate and seven weak. The strongest evidence of intervention effects related to mental health literacy and help-seeking intentions. There was less evidence relating to help-offering and help-seeking behaviors and mental health stigma. Sixteen behavior change techniques were identified across interventions that are discussed in relation to the wider men's health literature. The evidence on psychosocial interventions in male-dominated industries is limited due to methodological and conceptual issues. Recommendations for future research include standardized reporting of intervention descriptions, the use of theory to guide intervention development, and utilizing validated and reliable outcome measures.

Witnessing inter-parental violence in childhood and help-seeking behaviours in violence against women in Peru.

BACKGROUND: Violence against women (VAW) severely impacts their physical and mental health. In some cultures, women can normalize certain types of violence if they were linked to home models in childhood and, eventually, do not seek for help in adulthood. We aimed to determine, in Peruvian women, (1) the association between witnessing violence in their family of origin and VAW experienced in adulthood, (2) the extent to which women who have experienced VAW seek some help, and (3) identify VAW prevalence by Peruvian region. METHODS: Cross-sectional study of secondary data obtained from the 2019 National Demographic and Family Health Survey (ENDES). The outcome was VAW (psychological, physical and sexual violence), whereas the exposure was witnessing violence in the home of origin. Help-seeking behavior was a secondary outcome, for which VAW was the exposure. Prevalence ratios (PR) were estimated to assess both associations, unadjusted and adjusted for covariates (aPR). RESULTS: Data from 14,256 women aged 15 to 49 years were analysed. 51.5% reported having experienced VAW and 43.8% witnessed violence in the home of origin during childhood. Witnessing inter-parental violence in childhood was associated with psychological violence aPR = 1.25 (95% CI: 1.17-1.33), physical aPR = 1.52 (95% CI: 1.38-1.67), and sexual aPR = 1.99 (95% CI: 1.57-2.52). Women who have experienced both types of violence (physical and sexual) were more likely to help-seeking (aPR = 1.30, 95% CI: 1.14-1.50) than women suffering only one type of violence. CONCLUSION: Women who reported having witnessed home violence in their childhood are more likely to experience Violence Against Women (VAW) by their current partner. Physical and sexual violence with a current partner was more associated with witnessing inter-parental violence in childhood, and when physical and sexual violence jointly occurred women were more help-seeking. The southern region of Peru is identified as an area of high vulnerability for women. It is crucial to promote educative and community-based programs aimed at the prevention and early recognition of VAW.

Mental health and mental health help-seeking behaviors among first-generation voluntary African migrants: A systematic review.

PURPOSE: Mental health challenges are highly prevalent in African migrants. However, understanding of mental health outcomes in first-generation voluntary African migrants is limited, despite the unique challenges faced by this migrant subgroup. This review aimed to synthesize the literature to understand the mental health challenges, help-seeking behavior, and the relationship between mental health and mental health help-seeking behavior in first-generation voluntary African migrants living outside Africa. METHODS: Medline Complete, EMBASE, CINAHL Complete, and APA PsychINFO were searched for studies published between January 2012 to December 2023. Retrieved articles were processed, data from selected articles were extracted and synthesized to address the study aims, and included studies were evaluated for risk of bias. RESULTS: Eight studies were included, including four quantitative and four qualitative studies, which focused on women with postnatal depression. Mental health challenges reported in the quantitative studies were depression, interpersonal disorders, and work-related stress. Risk (e.g., neglect from health professionals and lack of social/spousal support) and protective (e.g., sensitivity of community services and faith) factors associated with mental health were identified. Barriers (e.g., cultural beliefs about mental health and racial discrimination) and facilitators (sensitizing African women about mental health) of mental health help-seeking behavior were also identified. No significant relationship was reported between mental health and mental health help-seeking behavior, and the risk of bias results indicated some methodological flaws in the studies. CONCLUSION: This review shows the dearth of research focusing on mental health and help-seeking behavior in this subgroup of African migrants. The findings highlight the importance of African migrants, especially mothers with newborns, examining cultural beliefs that may impact their mental health and willingness to seek help. Receiving countries should also strive to understand the needs of first-generation voluntary African migrants living abroad and offer mental health support that is patient-centered and culturally sensitive.

Influence of type of violence on women's help-seeking behaviour: Evidence from 10 countries in sub-Saharan Africa.

BACKGROUND: Intimate partner violence (IPV) is a major public health concern that mostly impacts women's health and social well-being. This study explored how the various types of IPV (physical, sexual, and emotional) including women's experience of childhood violence influence their help-seeking behavior in sub-Saharan Africa (SSA). METHODS: We analyzed data from the most recent Demographic and Health Surveys (DHS), carried out between 2018 and 2021. The outcome variable was help-seeking behavior. Descriptive and inferential analyses were carried out. The descriptive analysis looked at the bivariate analysis between the country and outcome variables. Using a binary logistic regression model, a multivariate analysis was utilized to determine the association between the outcome variable and the explanatory variables. Binary logistic regression modelling was used based on the dichotomous nature of the outcome variable. The results were sample-weighted to account for any under- or over-sampling in the sample. RESULTS: The proportion of women who sought help for intimate partner violence was 36.1 percent. This ranged from 19.2 percent in Mali to 49.6 percent in Rwanda. Women who experienced violence in childhood (OR = 0.75, CI = 0.69, 0.82) have a lower likelihood of seeking help compared to those who did not experience violence in their childhood. Women who had experienced emotional violence (OR = 1.94, CI = 1.80, 2.08), and physical violence (OR = 1.37, CI = 1.26, 1.48) have a higher likelihood of seeking help compared to those who have not. Women with secondary educational levels (aOR = 1.13, CI = = 1.02, 1.24) have a higher likelihood of seeking help compared to those with no education. Cohabiting women have a higher likelihood (aOR = 1.22, CI = 1.10, 1.35) of seeking help compared to married women. CONCLUSION: The study highlights the importance of early identification of IPV and fit-for-purpose interventions to demystify IPV normalization to enhance women's willingness to seek help. The study's findings suggest that education is crucial for increasing women's awareness of the legalities surrounding IPV and available structures and institutions for seeking help.

Mental health literacy and help-seeking behaviour among Egyptian undergraduates: a cross-sectional national study.

BACKGROUND: Mental health literacy (MHL) and help-seeking behaviors are pivotal in managing mental well-being, especially among Egyptian undergraduates. Despite the importance and prevalent psychological distress in this group, limited research has addressed MHL and associated behaviors in Egypt. This study aimed to assess the levels of MHL and help-seeking behavior among Egyptian university students. METHODS: A cross-sectional study was conducted across ten Egyptian universities during the academic year 2022-2023. A convenience sample of 1740 students was obtained through online questionnaires distributed via social media platforms. The survey comprised demographic characteristics, the Mental Health Literacy Scale (MHLS), and the General Help Seeking Behavior Questionnaire (GHSPQ). RESULTS: Among 1740 Egyptian undergraduates, medical students scored higher in recognizing disorders (p < 0.05), while non-medical students excelled in attitudes (p < 0.05). A strong correlation was observed between attitudes toward mental illness and total mental health literacy (coefficients of 0.664 and 0.657). Univariate analysis indicated a significant association with professional help-seeking (OR = 1.023). Females, individuals aged 21 or above, and non-medical students were more likely to seek mental health information (OR = 1.42, 1.82, 1.55 respectively). Help-seeking behavior for emotional problems was more inclined towards intimate partners, whereas suicidal thoughts prompted seeking professional help. CONCLUSION: The findings advocate for comprehensive mental health education, particularly in rural areas, and emphasis on the role of personal relationships in mental well-being. Implementing these insights could foster improved mental health outcomes and reduce related stigma in Egypt.

Suicidality associated with decreased help-seeking attitudes in college students: Implications for identifying and treating at-risk students.

Suicide is a leading cause of death in college-aged youth, yet only half of all college students report engaging in professional mental health help-seeking. We examined how the various aspects of young adults' suicidality were associated with their openness to pursue professional mental health care in the future (i.e., "future help-seeking intentions"). Multilevel binary logistic regressions were tested in a sample of 24,446 U.S. college undergraduates with suicidality. The moderating effect of past service utilization on future help-seeking intentions was also tested. Strikingly, young people reporting past-year suicidal ideation, past-year suicidal attempts, and self-reported likelihood of a future suicide attempt demonstrated decreased likelihood of future help-seeking intentions, while those reporting prior diagnosis of a mental health condition and/or past service utilization demonstrated an increased likelihood. Past service utilization also significantly moderated the effect of suicide disclosure, such that youth reporting prior disclosure and prior professional treatment-seeking demonstrated greater odds of future help-seeking intentions relative to those who had disclosed suicidality but never utilized professional services. In order to mitigate the mental health crisis facing youth, further exploration is necessary to understand why students with suicidality do not report openness to seek help. It is also imperative to develop and implement novel strategies to identify at-risk students, understand and alleviate relevant barriers to treatment, and promote positive help-seeking attitudes and behaviors.

Help-seeking intentions of UK construction workers: a cross-sectional study.

BACKGROUND: In response to the high rates of poor mental health in the construction industry, numerous workplace interventions have been designed to address the known and suspected risk factors to employee mental health and well-being. A key challenge of these strategies is low engagement in support services. AIMS: The goals of this research were to investigate the help-seeking intentions of employees in the construction industry, explore levels of mental well-being in this population and provide insight into employee engagement with mental health support strategies. METHODS: Employees from two UK construction companies completed an online cross-sectional questionnaire (n = 119), designed to measure help-seeking intentions, levels of mental well-being and worker attitudes towards workplace mental health support strategies. RESULTS: One-third of the sample reported experiencing an episode of mental health difficulties in the past 6 months. Employees reported a greater preference for seeking support from informal versus formal help sources. Participants were most likely to seek help from a partner and least likely to seek help from a Mental Health First Aider/ Champion. The study also showed some association between help-seeking intention and age of employees. CONCLUSIONS: Given the poor levels of mental well-being in this population, it is essential that adequate workplace support is provided. Whilst formal help sources are important for this population, our study highlights the potential benefits of informal help sources to support employees. Future interventions may therefore wish to consider developing tailored, informal workplace support networks and programmes.

Identification of Predictors of Mood Disorder Misdiagnosis and Subsequent Help-Seeking Behavior in Individuals With Depressive Symptoms: Gradient-Boosted Tree Machine Learning Approach.

BACKGROUND: Misdiagnosis and delayed help-seeking cause significant burden for individuals with mood disorders such as major depressive disorder and bipolar disorder. Misdiagnosis can lead to inappropriate treatment, while delayed help-seeking can result in more severe symptoms, functional impairment, and poor treatment response. Such challenges are common in individuals with major depressive disorder and bipolar disorder due to the overlap of symptoms with other mental and physical health conditions, as well as, stigma and insufficient understanding of these disorders. OBJECTIVE: In this study, we aimed to identify factors that may contribute to mood disorder misdiagnosis and delayed help-seeking. METHODS: Participants with current depressive symptoms were recruited online and data were collected using an extensive digital mental health questionnaire, with the World Health Organization World Mental Health Composite International Diagnostic Interview delivered via telephone. A series of predictive gradient-boosted tree algorithms were trained and validated to identify the most important predictors of misdiagnosis and subsequent help-seeking in misdiagnosed individuals. RESULTS: The analysis included data from 924 symptomatic individuals for predicting misdiagnosis and from a subset of 379 misdiagnosed participants who provided follow-up information when predicting help-seeking. Models achieved good predictive power, with area under the receiver operating characteristic curve of 0.75 and 0.71 for misdiagnosis and help-seeking, respectively. The most predictive features with respect to misdiagnosis were high severity of depressed mood, instability of self-image, the involvement of a psychiatrist in diagnosing depression, higher age at depression diagnosis, and reckless spending. Regarding help-seeking behavior, the strongest predictors included shorter time elapsed since last speaking to a general practitioner about mental health, sleep problems disrupting daily tasks, taking antidepressant medication, and being diagnosed with depression at younger ages. CONCLUSIONS: This study provides a novel, machine learning-based approach to understand the interplay of factors that may contribute to the misdiagnosis and subsequent help-seeking in patients experiencing low mood. The present findings can inform the development of targeted interventions to improve early detection and appropriate treatment of individuals with mood disorders.

Challenges and Implications for Menopausal Health and Help-Seeking Behaviors in Midlife Women From the United States and China in Light of the COVID-19 Pandemic: Web-Based Panel Surveys.

BACKGROUND: The global population of women of menopausal age is quickly increasing. The COVID-19 pandemic has led to an accelerated increase in the use of telehealth services, especially technological solutions targeting women's health. Understanding the factors behind midlife women's help-seeking behaviors amidst the pandemic will assist in the development of person-centered holistic telehealth solutions targeting menopausal and postreproductive health. OBJECTIVE: This study aimed to compare the factors underlying help-seeking for menopausal distress among midlife women in the United States and China. METHODS: We conducted 2 web-based panel surveys in the United States using Amazon Mechanical Turk and in China using Credamo between July and October 2022. A total of 1002 American and 860 Chinese women aged between 40 and 65 years took part in the survey. The survey was designed based on the Health Belief Model with questions related to their menopausal knowledge, perceived severity of menopausal symptoms, perceived susceptibility to menopausal distress, perceived benefits of help-seeking, perceived COVID-19- and non-COVID-19-related barriers against help-seeking, self-efficacy, and motivation to seek help. Structural equations models were fitted for the data using full information maximum likelihood to manage missing data. RESULTS: Knowledge was not directly related to help-seeking motivation in both samples. Among the Chinese sample, knowledge was negatively related to perceived severity but positively related to COVID-19-related barriers; in turn, higher perceived severity, benefits, COVID-19-related barriers, and self-efficacy and lower non-COVID-19-related barriers were related to more motivation to seek help. In the US sample, knowledge was negatively related to perceived severity, susceptibility, benefits, barriers (COVID-19- and non-COVID-19-related), and self-efficacy; in turn, higher self-efficacy, COVID-19-related barriers, and benefits were associated with more help-seeking motivation. The factors explained 53% and 45.3% of the variance of help-seeking motivation among the American and Chinese participants, respectively. CONCLUSIONS: This study revealed disparate pathways between knowledge, health beliefs, and the motivation for help-seeking among American and Chinese midlife women with respect to menopausal distress. Our findings show that knowledge may not directly influence help-seeking motivation. Instead, perceived benefits and self-efficacy consistently predicted help-seeking motivation. Interestingly, concern over COVID-19 infection was related to higher help-seeking motivation in both samples. Hence, our findings recommend the further development of telehealth services to (1) develop content beyond health education and symptom management that serves to enhance the perceived benefits of addressing women's multidimensional menopausal health needs, (2) facilitate patient-care provider communication with a focus on self-efficacy and a propensity to engage in help-seeking behaviors, and (3) target women who have greater midlife health concerns in the postpandemic era.

Elder mistreatment experiences, perceptions, and help-seeking behaviors of Asian American older adults.

This study examined the experiences and the perceptions of elder mistreatment (EM), as well as help-seeking knowledge and behaviors, particularly about Adult Protective Services (APS), among community samples of Asian American older adults, including Koreans, Chinese, and others (N = 288). Approximately 27% of the study participants experienced at least one EM incident in the past year. Between 27% and 38% of the participants reported that they were likely to seek help from APS for different types of EM. Significant differences were found across the three Asian groups in their perceptions toward EM and intention to seek help from APS in the event of EM. However, many Asian American older adults in the study did not know about APS prior to participating in the study (75.5%) and other formal sources of help (66.3%). Implications for helping professionals, particularly APS and community-based organizations serving Asian Americans, are discussed.

Perceived Reportability of Intimate Partner Violence against Women to the Police and Help-seeking: A National Survey / [La percepción de la capacidad de denunciar la violencia de pareja contra la mujer ante la policía y búsqueda de ayuda: una encuesta nacional]

The literature has consistently found that victims of intimate partner violence (IPV) against women are reluctant to make their situation visible and report it to the police. Whether victims perceive and define IPV behaviors as reportable is key to understanding in which cases the police are seen as potential providers of help or whether other potential sources of help (family, friends, professionals, etc.) are preferred. The purpose of the present study was to analyze the influence of perceived reportability of IPV on women’s selection of the police as a source of help compared to not seeking help or selecting other sources of help. Structural equation modeling was applied to data from 479 female participants drawn from a nationally representative sample of 1,112 male and female Chilean adolescents and young adults conducted by the National Youth Institute of Chile. The results showed that perceived reportability was a significant predictor of choosing the police as a source of help compared to other informal sources of help, such as family and friends. However, perceived reportability did not affect help-seeking choices between the police and other formal help sources (psychologists, public services). Participants’ IPV victimization and attitudes toward IPV also played a specific role in selecting the police as a source of help. These findings highlight the complexity of the visibility of women’s IPV victimization to the police and the need to examine its explanatory mechanisms.(AU)

Las publicaciones científicas señalan sistemáticamente la reticencia de las víctimas de violencia de pareja contra las mujeres a hacer visible su situación y denunciarla ante la policía. El hecho de que las víctimas perciban y definan las conductas de violencia de pareja como denunciables es clave para comprender en qué casos se considera a la policía como posible proveedora de ayuda o si se prefieren otros potenciales proveedores de ayuda (familiares, amigos, especialistas, etc.). El objetivo de la presente investigación ha sido analizar la influencia de la percepción de la capacidad de denunciar la violencia de pareja en la selección de la policía como proveedora de ayuda por parte de las mujeres, en comparación con la falta de búsqueda de ayuda o la selección de otros proveedores de la misma. Se han analizado los datos de 479 mujeres participantes en el estudio de una muestra representativa nacional de 1,112 adolescentes y jóvenes chilenos de ambos sexos realizado por el Instituto Nacional de la Juventud de Chile. Los resultados mostraron que la capacidad de denuncia percibida predice la selección de la policía como proveedor de ayuda en comparación con otras fuentes informales de ayuda, como la familia o los amigos. Sin embargo, no pareció tener efecto en la selección de la búsqueda de ayuda comparar a la policía con otras fuentes formales de ayuda (psicólogos, servicios públicos). La victimización y las actitudes hacia la violencia de pareja también desempeñan un papel específico en la selección de la policía como proveedora de ayuda. Los resultados demuestran la complejidad de la visibilidad para la policía de la violencia en la pareja contra las mujeres y la necesidad de examinar sus mecanismos explicativos.(AU)

Male Survivors of Domestic Violence, Challenges in Cultural Response, and Impact on Identity and Help-Seeking Behaviors: A Systematic Review.

Male experiences of domestic and relational violence have been only marginally explored in the literature. In connection to this, attitudes in the community and among service providers and criminal justice system entities can vary dramatically. This variance in attitudes creates an instability which has a differential impact on the help-seeking behaviors of victims. Additionally, help-seeking behaviors are often influenced by internalized shame and confusion on the part of the survivors themselves when their social constructions of masculinity do not align with lived experience. More is needed to understand the nature of male survivorship in situations of relational violence. A systematic review was conducted to begin organizing the data on the topic. This review started with 15,547 peer-reviewed articles. Those were systematically narrowed to a total of 16 of the most recent pieces of empirical science on the topic. The final articles were thematically analyzed. Findings suggest (a) cultural stigma around constructions of masculinity, (b) fear of disclosure, and (c) negative experiences with criminal justice and support system responses, among the highest drivers for the disparate experience and hesitation to seek help.

The Acne Education Project: An educational initiative to improve acne health literacy and promote help-seeking behavior in young adolescents.

BACKGROUND: Acne vulgaris is an inflammatory skin condition that is associated with poor acne health literacy. Diminished acne health literacy leads to delays in the access of health care, resulting in mismanagement, disfigurement, and psychosocial morbidity. This study evaluates the potential role of early acne education in young adolescent populations to improve acne health literacy and facilitate help-seeking behavior. METHODS: The Acne Education Project is a Canadian medical student-led initiative founded to create evidence-based resources to increase acne health literacy. A 45-min interactive Zoom presentation on acne was created and delivered to 2292 students ages 9-13 in British Columbia, Canada. A quality improvement survey was administered pre-intervention, immediate post-intervention, and 1-month post-intervention to evaluate baseline acne knowledge and knowledge retention to guide presentation and resource development. RESULTS: Responses from 676 unique individuals were collected. Analysis using linear mixed-effects models demonstrated that respondents were significantly more confident in their general knowledge of acne, strategies to prevent acne, identification of psychosocial sequelae of acne, and more willing to seek help immediately post-intervention (p < .001). Differences in scores were not fully preserved in magnitude at the 1-month post-intervention assessment. However, students still scored significantly higher in all categories compared to the pre-intervention baseline (p < .001). CONCLUSION: Our findings suggest that early acne education can improve acne health literacy and promote help-seeking behavior. Given the potential long-term implications, further research is needed to explore the long-term impact of early acne education and the benefit of integrating acne education into the public education curriculum in Canada.

Sex and concepts of sexuality influence sexual problems and help-seeking behaviours of older people.

In this study, we aimed to examine the prevalence, associated factors, and management of sexual problems in older people at a primary care unit. We recruited people aged 60 years old and over, who visited the Primary Care Unit of Songklanagarind Hospital, a tertiary-care and referral centre in Southern Thailand, between June and August 2021, and used a self-administered questionnaire on sexuality, sexual problems, help-seeking behaviours, and clinical consultations for sexual problems in older people. There were 190 participants in this study (120 women, 70 men, mean age = 68.3). One hundred and five (55.3%) participants reported having sexual problems. Compared to their female counterparts, males were more likely to have sexual problems (adjusted OR = 3.11; 95% CI = 1.52,6.34; p-value = 0.001). The majority (77.3%) considered non-penetrative sexual activities (outercourse) when discussing sexuality in later life, and they had lower odds of having sexual problems compared to those who relied purely on sexual intercourse (adjusted OR = 0.27 for only outercourse and 0.30 for both intercourse and outercourse; p-value = 0.016). Only 2.1% (4/190) of participants reported that a physician had asked them about sexual problems. Participants reporting sexual problems (N = 105) often consulted their partners (25.7%) and friends (10.5%) or searched information from the internet (18.1%). According to this study, sexual problems in older people are common in primary care settings, but they tend to be poorly managed. Clinical discussions and interventions that are sensitive to gender differences and acknowledge the broadened concepts of sexuality in later life, e.g., encouragement to practice outercourse, may help improve sexual problems and well-being among older people.

Mental health problems and help-seeking behaviours of Syrian refugee adolescents: mediating role of self-stigma.

BACKGROUND: Although common mental health problems have been widely studied with self-stigma, few studies have focused on the mediating effect of self-stigma in the relationship between mental health problems and help-seeking behaviours of refugee adolescents. Therefore, the purpose of the present study was to examine whether self-stigma mitigates the adverse effects of stress, anxiety, and depression symptoms on the help-seeking behaviours of Syrian adolescents living in Turkey. METHODS: The participants of this study included 488 Syrian refugee adolescents (boys, 63.73%; girls, 3627%) living in Turkey. Participants completed the Depression Anxiety Stress Scale and General Help-Seeking Scale and Self-Stigma of Seeking Psychology Help Scale. RESULTS: The findings revealed that stress (ß = 0.19, p < 0.01), anxiety (ß = 0.12, p < 0.05), and depression (ß = 0.17, p < 0.01) had significant and positive predictive effects on self-stigma, but not on help-seeking behaviours. Also, self-stigma (ß = -0.12, p < 0.01) had a significant negative predictive effect on help-seeking behaviours. With regard to the indirect effects, the findings showed that self-stigma fully mediated the associations between stress - help-seeking [effect = -0.05, 95% confidence interval (CI) -0.11 to -0.01], anxiety - help-seeking (effect = -0.04, 95% CI -0.09 to -0.01)], and depression - help-seeking (effect = -0.05, 95% CI -0.12 to -0.01). CONCLUSIONS: Our findings highlight the potential negative effects of self-stigma on the help-seeking behaviours of Syrian refugee adolescents, both directly and indirectly. These results can be used to develop and implement effective and efficient interventions to address the unmet mental health needs of refugee adolescents.

Stigma towards mental illness, resilience, and help-seeking behaviours in undergraduate students in Hong Kong.

AIM: Early interventions have great impact on reducing burden of mental illness. Young people are however the least likely to seek help for psychological issues. Resilience and stigma towards mental illness have been identified as contributing factors, although previous findings were mixed with potentially complex interaction with symptom severity. We investigated the relationship between stigma, resilience, depressive symptom severity, and help-seeking behaviours in undergraduate students in Hong Kong. METHODS: A cross-sectional online survey was conducted among undergraduates from a university in Hong Kong (n = 945). The 21-item Stigma and Acceptance Scale, Connor-Davidson Resilience Scale, and the Patient Health Questionnaire-9 were used. History of help-seeking for psychological issues was self-reported. Path analysis was conducted to test a conceptual model of their relationships. RESULTS: Among those with moderate-to-severe depressive symptoms (39.5%), only one-fourth had sought professional help. The path model showed that depressive symptom severity and stigma were positively associated with help-seeking behaviours, while resilience was negatively associated with help-seeking behaviours independently (all p < .001). Subgroup analyses showed differential contribution of stigma and resilience to a history of help-seeking in those with minimal-to-mild symptoms compared with moderate-to-severe symptoms. CONCLUSIONS: Stigma may be a barrier for help-seeking particularly in students with moderate-to-severe depression. Higher levels of resilience in young people may be protective and reduce the unnecessary seeking of professional help. Therefore, enhancing resilience among students in general, and reducing stigma and promoting help-seeking behaviours for those who have moderate-to-severe symptoms should be consider in parallel as strategies to enhance mental wellbeing of students.

Evaluating the Impact of Aevidum on Mental Health Knowledge, Attitudes, and Help-Seeking Behaviors in High School Students: A Mixed-Methods Study.

PURPOSE: To compare Aevidum's school mental health curriculum vs the curriculum plus Aevidum clubs in a mixed-methods study including pre/post surveys, a randomized clinical trial, and qualitative interviews. DESIGN: Concurrent mixed-methods: Aim 1) pre-post surveys evaluated curriculum only vs curriculum plus club schools separately regarding changes in knowledge, help-seeking, and school culture; Aim 2) randomized clinical trial compared curriculum only to curriculum plus club schools; Aim 3) qualitative school staff interviews enhanced understanding of school culture changes. SETTING: Curriculum delivered to 9th graders at ten Pennsylvania high schools; 5 schools randomized to start clubs. SUBJECTS: Students (surveys), staff (interviews). INTERVENTION: Aevidum curriculum plus/minus club. MEASURES: Aim 1, mixed effects linear and logistic regression models for longitudinal data were used to analyze survey items at each time point. Aim 2, the same regression models were used, except models included a fixed-effect for group and group by time interaction effect. Aim 3, interviews were transcribed; a codebook was developed followed by thematic analysis. RESULTS: Pre-survey 2557 respondents; 49% female, 86% non-Hispanic white. Post-survey 737 (29% response rate). Aim 1, pre-post (Likert responses, larger numbers favorable) demonstrated increased student knowledge to identify depression (4.26 [4.19-4.33] to 4.59 [4.47-4.71], P < .001) and help a friend access support (4.30 [4.21-4.38] to 4.56 [4.40-4.71], P = .001). Help-seeking increased for phone helplines (1.61 [1.57-1.66] to 1.78 [1.70-1.86], P < .001), crisis textlines (1.60 [1.55-1.64] to 1.78 [1.70-1.86], P < .001), internet/websites (1.80 [1.75-1.85] to 1.99 [1.90-2.08], P < .001), school counselors (P = .005) and teachers (.013). Aim 2, no significant differences in knowledge, help-seeking or culture between curriculum only vs curriculum plus club schools. Aim 3, staff (n = 17) interviews supported reduced stigma and increased mental health referrals. CONCLUSIONS: Aevidum's curriculum improved mental health knowledge and help-seeking; adding the club did not significantly change responses. Staff identified positive school culture impacts. Limitations include the lower post-survey response.

Exposure to stress-full life events and help-seeking behaviors among reproductive-age women in Northwest Ethiopia: Community-based cross-sectional study.

BACKGROUND: Stressful life events are a significant public health issue worldwide. Despite its mental, psychological, and social problems, important questions about the prevalence and risk factors remained unanswered. Therefore, this study aimed to show major life events and help-seeking behaviors among women in the reproductive-age group. METHODS: A community-based cross-sectional study design was conducted using a multistage cluster sampling technique to get a total of 845 study participants from March 20 to April 29, 2021. Exposure to stressful life events and help-seeking behavior was collected using Women's Exposure to the Stressful Life Events Test, and General Help-Seeking Questionnaire (GHQ) respectively. Data were cleaned, coded, and entered into EPI-Info version 3.1 and analyzed using SPSS version 20. RESULTS: The prevalence of stressful life events and help-seeking behaviors was 47.9 % and 38.7 % respectively. Reproductive-age women with poor social support (AOR = 2.392, 95 % CI: 1.422, 4.026), moderate social support (AOR = 1.861, 95 % CI: 1.341, 2.583), husband alcohol users (AOR = 1.496, 95 % CI: 1.027, 2.178), husband chat users (AOR = 2.962, 95 % CI: 1.140, 7.696), and having ever suicidal attempt (AOR = 8.702, CI: 1.719, 44.049), were positively associated with stressful life events. CONCLUSION: Nearly half of reproductive-age women had stressful life events. Thus, it is important to give serious attention to addressing those identified factors to increase public awareness, especially among husbands, their families, and elected authorities.

Effects of a stigma reduction intervention on help-seeking behaviors in university students: A 2019-2021 randomized controlled trial.

INTRODUCTION: Stigma is one of the most frequently identified help-seeking barriers, but there is a lack of research on the effects of stigma reduction interventions on actual mental health help-seeking behaviors during crucial academic years. This research explores the effects of stigma on university students' mental health care help-seeking behaviors before and during the pandemic. METHODS: A randomized control trial spanned from 2019 to 2021 at the University of Porto, along five evaluation moments, with students into one control group and two intervention groups-the interventions aimed to reduce depression stigma. RESULTS: Among the 702 participants (mean age 18.87, 59.4 % female), the intervention groups significantly increased help-seeking behaviors. In 2020, the intervention groups, having reduced stigma, continued to demonstrate to be more prompt to seek mental health help. In 2021, 22 months, the effects of the intervention on help-seeking were no longer significant; however, participants in the intervention groups showed less severe symptomatology. CONCLUSION: Stigma reduction interventions have a pronounced effect on enhancing help-seeking behaviors among university students, even during times of crisis. This study advocates for prioritizing stigma reduction in academic settings, highlighting its value in promoting mental health access during crucial academic and life challenges.