Help-Seeking Measures and Their Use in Adolescents: A Systematic Review

Adolescent Research Review, Jan 2018

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.

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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)


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Natalie Divin, Patrick Harper, Emma Curran, Dagmar Corry, Gerard Leavey. Help-Seeking Measures and Their Use in Adolescents: A Systematic Review, Adolescent Research Review, 2018, pp. 1-10, DOI: 10.1007/s40894-017-0078-8