Improving mental health literacy does not lead to more help-seeking behaviour, according to new review


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:

  1. Be RCTs with at least one therapy focusing on help-seeking for depression, anxiety or general psychological distress
  2. Contain extractable data on help-seeking attitudes, intentions or behaviour
  3. 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.

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Andre Tomlin

André Tomlin is an Information Scientist with 20 years experience working in evidence-based healthcare. He's worked in the NHS, for Oxford University and since 2002 as Managing Director of Minervation Ltd, a consultancy company who do clever digital stuff for charities, universities and the public sector. Most recently André has been the driving force behind the Mental Elf and the National Elf Service; an innovative digital platform that helps professionals keep up to date with simple, clear and engaging summaries of evidence-based research. André is a Trustee at the Centre for Mental Health and an Honorary Research Fellow at University College London Division of Psychiatry. He lives in Bristol, surrounded by dogs, elflings and lots of woodland!

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