Help-Seeking Measures and Their Use in Adolescents: A Systematic Review
Help-Seeking Measures and Their Use in Adolescents: A Systematic Review
Natalie Divin 0 1 3
Patrick Harper 0 1 3
Emma Curran 0 1 3
Dagmar Corry 0 1 3
Gerard Leavey 0 1 3
0 Gerard Leavey
1 Patrick Harper
2 Natalie Divin
3 Bamford Centre for Mental Health and Wellbeing , Coleraine Campus, Cromore Road, Coleraine BT52 1SA, Northern Ireland , UK
Despite increasing numbers of adolescents experiencing poor mental wellbeing, adolescents are often reluctant to seek help for mental health problems. In response, there is increasing interest in the development of evidence-based interventions to increase help-seeking behavior. However, the evidence base may lack validity if help-seeking measures used in adolescent research contain age-inappropriate language or content such as seeking help from a spouse; no previous review has assessed this. A review of adolescent mental health help-seeking research was conducted to identify help-seeking measures used, assess their psychometric properties and linguistic appropriateness in adolescent populations, and organize measures by facet of help-seeking for ease of future use. We found 14 help-seeking measures used in adolescent research, but only 17/72 (24%) studies found used one of the identified measures. Help-seeking measures identified were categorized into one of four help-seeking facets: attitudes toward help-seeking, intentions to seek help, treatment fears regarding help-seeking, and barriers to help-seeking. The content and language of measures were deemed appropriate for all but one help-seeking measure. Recommendations for future research include greater utilization of identified measures, particularly in researching help-seeking behavior in different cultures, subcultures and between stages of adolescence.
Adolescence; Youth; Wellbeing; Help-seeking; Measures; Psychometrics
Introduction
Increasing numbers of young people experience poor mental
health
(Meltzer et al. 2003)
, with 20–25% of mental health
disorders being diagnosed in adolescence and emerging
adulthood
(Gore et al. 2011)
. It is recommended for those
suffering from poor mental health to communicate their
difficulties to others as a method of seeking assistance and
further treatment options; this is known as mental health
help-seeking
(Rickwood et al. 2012)
. These difficulties
may be communicated to informal sources of help such as
family members, or formal sources such as mental health
practitioners. While the prevalence of poor mental health
is increasing in young people, mental health help-seeking
remains low: only one-third of adolescents meeting
diagnostic criteria for a mental health diagnosis seek professional
help
(Green et al. 2005; World Federation for Mental Health
2009)
. Adolescents suffering from serious and debilitating
mental health difficulties may still avoid seeking help or
considerably delay getting appropriate help
(Biddle et al. 2006;
Goodman et al. 2002)
. Failing to seek help or delaying the
help-seeking process can lead to adverse health outcomes
such as substance abuse, engaging in risky sexual behavior,
lower quality of adult life and premature death
(Anderson
and Lowen 2010; Brindis et al. 2002, 2007; Laski 2015)
.
Current research suggests that when adolescents engage
in help-seeking, they are more comfortable doing so from
informal sources such as parents
(Rickwood et al. 2005)
.
While parents can be a valuable resource for initiating the
referral process for formal help-seeking
(Langeveld et al.
2010)
, parental referrals occur disproportionately in families
with a higher socioeconomic status
(Benjet et al. 2016)
. This
finding places economically vulnerable adolescents at risk
as they are otherwise unwilling to speak with formal sources
of help
(Leavey et al. 2011)
. Investigations into why
adolescents may be unwilling to engage in formal help-seeking
have uncovered barriers such as fears of unfriendly
clinicians, the fear of receiving a “stigmatizing” mental health
diagnosis, and the fear of being treated “like a child” by
clinicians
(Rickwood et al. 2007; Zachrisson et al. 2006; Corry
and Leavey 2017)
. Barriers to informal help-seeking have
also been identified such as fearing negative judgment from
friends and family
(Gulliver et al. 2010)
. The fear of
negative judgment from others is heightened in certain cultures
(Chen et al. 2014)
, with parents of Moroccan and Turkish
adolescents fearing judgment from the community if their
child sought help
(Flink et al. 2013)
. In order to improve
help-seeking behavior in adolescents, it is imperative to
understand why such help-seeking barriers exist and how
they can be broken down.
There is a growing policy interest in developing early
intervention programs to break down barriers to adolescent
help-seeking
(Biddle et al. 2006; Rickwood et al. 2007;
Rothì and Leavey 2006)
. In order to develop effective
interventions to encourage help-seeking, the research base must
be examined to achieve (...truncated)