The stigma and shame associated with mental illness can prevent people from seeking help. This can lead to much poorer outcomes as patients may often miss out on vital treatment early on in their illness.
A number of theories have been put forward to explain why certain groups (e.g. young people, men, refugees) seem less willing to ask for help, but none of the models have yet gained universal agreement.
This new systematic review published in the open access BMC Psychiatry journal brings together the published research on help-seeking attitudes, intentions or behaviours for depression, anxiety, and general psychological distress.
The reviewers searched PubMed, PsycInfo and Cochrane for randomised controlled trials (RCT) and applied a fairly strict inclusion criteria by insisting that studies had to:
- Be RCTs with at least one therapy focusing on help-seeking for depression, anxiety or general psychological distress
- Contain extractable data on help-seeking attitudes, intentions or behaviour
- Not focus on other conditions such as eating disorders or substance misuse
They only found 6 RCTs to include in their analysis (involving a total of 1,499 patients), which mostly studied young adults. Eight different help-seeking interventions were covered by these studies, most of which included multiple components. Follow-up was fairly short (2 weeks to 6 months).
Here’s what they found:
- In 5 of the 6 studies, mental health literacy interventions (compared with control) improved help-seeking attitudes post-intervention (effect sizes 0.12-0.53)
- But 3 studies showed that mental health literacy interventions had no effect on help-seeking behaviour post-intervention or at follow-up (effect sizes -0.02 to +0.02)
The reviewers concluded:
Mental health literacy interventions are a promising method for promoting positive help-seeking attitudes, but there is no evidence that it leads to help-seeking behaviour. Further research investigating the effects of interventions on attitudes, intentions, and behaviour is required.
Gulliver A, Griffiths KM, Christensen H, et al. A systematic review of help-seeking interventions for depression, anxiety and general psychological distress. BMC Psychiatry 2012;12:81.