Suchergebnisse

We examined male partners' influence on the decision to seek medical help for infertility using the National Study of Fertility Barriers. Building upon an existing help‐seeking framework, we incorporated characteristics of both partners from 219 heterosexual couples who had ever perceived a fertility problem. In logistic regression analyses, we found an association between couple‐level attitudes and medical help‐seeking even when other predisposing and enabling conditions existed. Overall, the findings highlight that both partners contribute to the infertility help‐seeking process, and that different factors may play a role in different stages of help‐seeking. Studies of infertility help‐seeking need to be more inclusive of the context that these decisions are embedded within to better understand service use.

Background – Northern Ireland (NI) veterans are a particularly hard to reach population. The Troubles' legacy has caused many to self-marginalise, therefore, it is difficult to understand or support them as a population. NI as a nation has particularly poor rates of mental health, that is linked back to living with exacerbated, conflict-related trauma. There is a great likelihood that NI veterans have a large unmet mental health need, which is partly driven by elevated traumatic exposure, poor support services and a reluctance to seek support. This thesis set out to explore the relationship between trauma, mental health, alcohol and help-seeking for NI veterans. Method – The thesis adopted a sequential (quant, qual), integrated mixed methods approach. Ecological systems theory was used to frame and consider the findings across each study. Secondary NIVHWS data of 609 participants was used for the quant portion. The qual element consisted of primary data collection and IPA analysis from six participants. Quant - latent class analyses (LCA) was applied to endorsements of 16 trauma types and, separately, to six measures of mental health. LCA was assessing classes of comorbidity. Multivariate modelling was used to explore two relationships: the link between trauma class and mental health class; the link between mental health class and help-seeking. Other variables were included during modelling such as age, whether they were NI home-serve and attitudes towards help-seeking. Qual - a series of open-ended interviews were conducted with NI veteran residents, where questions focused on experience. Findings – The LCA of trauma exposure produced three classes; all classes had particularly high rates of conflict/combat related trauma. The mental health LCA elicited four classes, indicating nuance within the NI veteran community. Almost 40% had comorbid mental health and excessive alcohol use was associated with every class, suggesting risky drinking is not necessarily linked to poor mental health. Trauma class did not predict mental health class, which could have been due to uneven latent class sizes. Mental health class did predict help-seeking. The NI population tended to prefer medication over therapy. The interview data found two superordinate themes of "a lack of…" and "an abundance of…", which were not polar as the sub-themes related to different concepts. The sub-themes found that NI veterans 'lack' mental health literacy/awareness, have poor expectation of official support and a low sense of inward-facing appreciation. NI veterans had 'abundant' exposure to a range of extreme environments, many examples of navigating and challenging systemic 'rules' and a great deal of local support engagement. Ecological systems theory found that trauma, mental health and help-seeking was heavily impacted by systematic factors, with negative and positive influence sitting within different 'systems'. Exo and macro systems leaned towards the negative whereas micro and meso had positive associations. Conclusion – NI veteran mental health and alcohol behaviour is dynamic. Poor mental health may not have local causes whereas excessive alcohol is more likely a reflection of NI and military culture. Support services are lacking in quantity and quality for NI veterans. The avoidance of therapy is driven by the wish to remain hidden and the need for non-self-disclosure, to avoid a trauma thereat. Yet many have engaged support seeking out of functional impairment and need. There was considerable anger towards those who officially arrange and administrate veteran support which has been partly buffered by the many local veteran support organisations. The utility of local support may be linked to taking a more 'person centred' approach. Several unique contributions were made via this thesis in respect of methods adopted and findings produced. The overall message was that more local support is needed but engaging with a self-marginalised population, to create and deliver appropriate assistance, is challenging.

Disruptive behaviour problems in early childhood are found to be associated with many negative long-term outcomes, such as antisocial behaviour, adolescent delinquency, and substance abuse (Kellam, Werthamer-Larsson & Dolan (1991), as cited in Butler, 2005:1). Even after adolescence this arises, for, as Vogel (2008:16) states the 'frequency of behavioural problems or challenging behaviour among the youth of today often predicts the size of our future prison population'. These findings clearly highlight the importance of early identification of behavioural problems, adequate preventative intervention (Butler, 2005:1) and the necessity for early intervention to prevent their continuity, since behaviour problems are found to worsen without treatment (Loeber, 1982, cited in Butler, 2005:1). The goal of this study is to gain an understanding of disruptive behaviour in primary school learners. To achieve this goal, the objectives of this are to explore the nature of child disruptive behaviour problems; to explore parents and teachers' problem perception of child disruptive behaviour; to explore the problem threshold of parents and teachers toward child disruptive behaviour; and to explore their help-seeking behaviour. The study's aim, therefore, is to better understand and gain more insight in child disruptive behaviour problems before a threshold is reached by parents and teachers and help is sought from social service professionals. The study uses an exploratory qualitative research design to gain insight into child disruptive behaviour problems, problem perceptions and help-seeking behaviour in the Southern Cape Karoo District in the Western Cape. Child disruptive behaviour patterns were analysed along a three-point continuum (from less severe - 'preventative'; to moderate - 'early intervention'; and most severe - 'statutory') based, on problem perceptions of parents, teachers and social service professionals. In addition, the present study examines parents and teachers' problem thresholds to identify help-seeking behaviour and sources. A purposive sampling technique was used to select the participants according to appropriation and availability. Parents and teachers were contacted to participate voluntarily in the research from schools in the area - Acacia Primary School, Baartmansfontein Primary School, Buffelsriver Private Primary School and Matjiesfontein Primary School. The social service professionals who participated consisted of social workers, social auxiliary workers and police officials from the Department of Social Development, Child Welfare SA and the South African Police Service. The study consisted of a broad range of child ages and parental ages. Parent participants also included biological and foster parents. Data was gathered by means of a semi-structured interview schedule administered during 24 individual interviews. The schedule is based on information obtained from the literature review relevant to the models and theories selected. Previous research done by Jessica Hankinson in 2009 in America on child psychopathology, parental problem perception, and help-seeking behaviours was used as a reference for creating the data collection tool, since she also focused on child behavioural problems and used similar models in the theories. This tool was created in such a way as to be relevant to the South African context. The findings confirmed the serious nature of child disruptive behaviour amongst primary school learners, including abusive behaviour, assault, bullying, fighting, swearing, theft, criminal involvement, substance abuse, truancy and school dropouts. The participants were found to be able to perceive their child's problem behaviour and to perceive themselves to be competent parents in dealing with disruptive behaviour. Child disruptive behaviour was found to have a significant effect on classroom learning. Despite legislation banning this, the participants still resort to punitive corrective measures. Stigma related to professional services and the privacy of the family are found to be very relevant in help-seeking efforts. This lead to the conclusion that child disruptive behaviour may become a normal and acceptable phenomenon, and thus leads to late reporting - and social services being contacted only as a last resort. The most important recommendation resulting from the study indicates that there is a need for prevention and early intervention services for child disruptive behaviour. This should address the escalation of the behaviour that later results in the need for statutory services. The study further indicates that various sectors (social workers, teachers, community structures and the departments) need to collaborate and form partnerships in order to enhance the early reporting of children in need and the accessibility and availability of services rendered in rural areas. This could enhance the early identification, reporting and service delivery in order to find problem resolutions.

Mental illness stigma has been identified by national policy makers as an important barrier to help seeking for mental health. Using a random sample of 5,555 students from a diverse set of 13 universities, we conducted one of the first empirical studies of the association of help-seeking behavior with both perceived public stigma and people's own stigmatizing attitudes (personal stigma). There were three main findings: (a) Perceived public stigma was considerably higher than personal stigma; (b) personal stigma was higher among students with any of the following characteristics: male, younger, Asian, international, more religious, or from a poor family; and (c) personal stigma was significantly and negatively associated with measures of help seeking (perceived need and use of psychotropic medication, therapy, and nonclinical sources of support), whereas perceived stigma was not significantly associated with help seeking. These findings can help inform efforts to reduce the role of stigma as a barrier to help seeking.

Abstract. Background: Evidence suggests that the majority of people with suicidality do not seek help. Little systematic evaluation of factors influencing professional help-seeking has been done. Aims: To systematically evaluate the factors that influence professional help-seeking for suicidality. Method: Published quantitative and qualitative studies in Medline and PsycInfo databases were reviewed following PRISMA. Results: In all, 55 relevant studies were identified. Of these, 15 studies examined professional help-seeking intentions for perceived suicidal ideation, among people with or without suicidality; 21 studies examined professional help-seeking behavior among people with suicidality; and 19 studies examined suicidal decedents' health services use. Several potential important barriers were identified including high self-reliance, lack of perceived need for treatment, and stigmatizing attitudes toward suicide, toward mental health issues, and toward seeking professional treatment. The presence of suicidality and mental health issues was found to generally decrease help-seeking intentions for perceived suicidal ideation while facilitating actual service use. Social support and informal support from family and friends also played an important role in professional help-seeking. Limitations: Although the majority of the included studies were of sound quality, some of the factors identified in the review were assessed in relatively few studies, and most of the included studies were conducted in industrialized countries. Conclusion: Further quantitative and qualitative studies examining the potential important factors in broader community samples, especially in developing countries, are needed.

Socio-demographic and cultural factors have been reported to shape help-seeking behavior. However, not much effort has been made to determine the effects of these factors on help-seeking among rural populations. A telephone survey using random-digit dialing was used to explore socio-demographic characteristics and ethnic differences in the types of professionals sought for unexplained somatic and emotional problems ( N = 1161) in rural eastern North Carolina. Ethnic differences in comfort with participating in support groups were also examined. The effect of a large natural disaster, Hurricane Floyd and subsequent flooding, on help-seeking choices and comfort with support groups was also assessed. Results showed that the rural population makes a sharp distinction between somatic symptoms and stress-related symptoms. This distinction seemed more pronounced for European-Americans than for African-Americans. In general African-Americans selected help-seeking from clergy more often than European-Americans, although for unexplained somatic symptoms this difference was fostered by Hurricane Floyd with its flooding. African-Americans showed markedly increased comfort with support groups after the hurricane, while European-Americans showed no changes in comfort with support groups as a function of the hurricane. The effects of Hurricane Floyd on African-Americans are interpreted as reflecting an increased salience of community support for African-Americans, significantly through the Baptist Church. Training of clergy should include recognition of stress-related somatic and emotional symptoms and the potential for an important referral role, especially following disasters.

We sought to characterize the help-seeking behavior of Asian Americans living in a Southeastern community in the U.S. by examining different types of services sought, help-seeking preferences, and how demographic characteristics and mental health problems (including domestic violence) predicted these behaviors. 610 Asian Americans (mean age = 39.43 years; 59.6% female; 75% immigrants) completed an anonymous, community survey that included measures of different types of help-seeking behaviors and preferences, mental health symptoms, and exposure to domestic violence. The two most-frequently help-seeking behaviors included seeking advice from friends, family members, or relatives (66.7%), and visiting a medical doctor (46.4%). In logistic regression models, older age, sex, immigrant status and symptomatic depression predicted different types of help-seeking behaviors and preferences. Neither domestic violence experience or symptomatic anxiety significantly predicted help-seeking.

Background: Unemployment and mental ill health often contribute to each other and lead to social exclusion with negative consequences for individuals and society. Yet, unemployed people with mental health problems often do not seek care. Aims: The aim of this study was to assess predictors of help-seeking among unemployed people with mental health problems. Methods: At baseline, 301 unemployed participants with mental health problems reported potential predictors of help-seeking in terms of mental health literacy, perceived barriers to care, self-concept as having a mental illness and current mental health service use. At 6-month follow-up, 240 participants reported whether or not they had started new mental health treatment since baseline. Results: Adjusted for symptoms, sociodemographic and work-related variables, help-seeking was predicted by previous mental health service use and by fewer non-stigma-related barriers, not by stigma-related barriers. Conclusion: Implications for interventions to increase help-seeking among this vulnerable group are discussed.

AbstractIn many ways, male farmers can be considered to be a vulnerable group in relation to mental health, experiencing high rates of suicide, psychological distress and low use of health services. This study highlights important connections between rurality, farming and masculinities in the context of men's mental health. In‐depth interviews with 32 male farmers from Quebec, Canada were completed focusing on stress and coping strategies. Findings include informal and formal strategies. Many participants had previous positive experience of formal help and would be willing to use such help again and to recommend it to others in need. Those without such experience are sceptical about services but recognise the courage it requires to seek help. Pride and lack of knowledge about services are the main barriers to help‐seeking, but it can be legitimated in certain contexts, such as divorce or other psychosocial crisis, and by alignment with particular male ideals. Role models at national or local levels can also help farmers prioritise their own and their family's wellbeing over stigmas and rigid, traditional masculine ideals. Furthermore, gender‐based strengths and recommendations for practice are also discussed.

AbstractAlthough therapy, relationship education, and online relationship resources may help alleviate relational distress, many adolescents and adults eschew help. Deciding to seek help for relationship concerns involves mental processes that reflect behavioral intentions and information‐seeking behaviors. The present paper examines the prevalence of adolescents' (N = 183) intentions and behaviors to seek relationship help, and investigates determinants of such decisions. Results indicate that only readiness to change was consistently associated with help‐seeking decisions. In contrast, other factors varied, with relationship status associated only with future intentions, and family difficulties associated only with behaviors to seek relational assistance. Programs may benefit from considering methods of disseminating information and encouraging adolescents to reflect upon reasons for considering making changes.