One of the biggest
barriers we face as youth service workers and health professionals
is that young people simply do not feel comfortable accessing
mental health support when they need it. ABS data shows that 80% of
males and nearly 70% of females with mental health disorders aged
16-24 do not seek help from professional services1. Accessing professional help has
been shown to be an important protective factor against suicidal
behaviour2. It is vital for us
to find ways to get young people to the help that they need to
overcome mental health difficulties.
Join the discussion
In the ReachOut Pro professionals network, our objective is to
work with health professionals in all fields to find ways to get
young people to the help they need, and to support professionals to
be able to help young people who present with mental health
difficulties. By sharing your opinions, your experience,
and your insights, you can help other professionals find ways to
make help-seeking more accessible to young people.
Join the discussion by sharing your observations and questions
via the comments section at the bottom of this page.
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What is the help-seeking
process?
What barriers are preventing young
people from seeking help?
What are effective facilitators
of help-seeking?
Join the discussion - Share your
experience
Background
What is the help-seeking process?
In one of the few comprehensive studies into help-seeking
behaviour in Australia, Rickwood et. Al. (2005)2 define help seeking in four
stages:
Awareness and appraisal of
problems
I.e. the ability to recognise
symptoms, and that you have a problem that may require intervention
from someone else.
Expression of symptoms and
need for support
I.e. this awareness must be able to
be articulated or expressed in words that can be understood by
others, and the help-seeker must feel comfortable to do so.
Availability of sources of
help
I.e. sources of help and support in
dealing with the problem need to be available and accessible, and
the help-seeker must have an understanding of where / how to get
that support.
Willingness to seek out and
disclose to sources
I.e. the help-seeker must be willing
and able to disclose their inner state to the source of help.
For us to help young people get to the help they need, we need
to find ways to help them recognise that they have a mental health
problem that they can't overcome on their own, to have the ability
to express what they are feeling, to know where they can get help,
and to be willing to seek out that help.
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What
barriers are preventing young people from seeking help?
Many studies have been done into the key barriers to help
seeking. A detailed literature review was published in 2010 by
Guillver et al.3, which
reviewed 15 qualitative and 7 quantitative studies of young
people's experiences of help-seeking for anxiety or depression. Key
themes in the barriers young people identified to help-seeking
were:
Stigma and embarrassment
The most frequently reported of all the barriers. Public,
perceived and self-stigmatising attitudes to mental illness create
an embarrassment and fear of identifying with a mental illness or
seeking help about it. Also prominent among young people was a
general concern about what others, including the source of help,
might think of them if they were to seek help.
"Because you can't see it, it's not real. Unless I'm in
physical pain, there's no reason to go seek help." -
ReachOut.com focus group participant
Problems recognising symptoms (poor mental health
literacy)
It was frequently reported that young people simply don't know
how to identify when the difficulties they are facing are beyond
the normal threshold of storm and stress. One study reported that
young people were aware of their distress, but continuously altered
their definition of what was "normal" distress to avoid seeking
help.
"Stress is normal…" - Eisenberg (2007), in Gulliver et
al.3
Preference for self-reliance
A consistent factor in both qualitative and quantitative
research was the trend that young people prefer to rely on
themselves, rather than seeking outside help for the problems they
were facing. To seek help from someone else is often seen as an
indicator of weakness, or not being capable of dealing with normal
life problems.
Confidentiality and trust
A major concern for many young people was a lack of trust with
respect to the potential source of help. Fears of a breach of
confidentiality leading to exposure, distrust of the credibility or
authenticity of providers, perceptions of judgmental attitudes, and
a lack of familiarity were all identified as aspects of this
barrier.
Hopelessness
Additionally, Rickwood et al.2 suggested that the feeling or
perception of hopelessness was a strong contributor to the help
negation effect (a consistent pattern where the higher someone's
levels of distress, the less likely they are to access
support).
"I felt that no person or helping service could help."
- Dubow (1990), in Gulliver et al.3
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What are effective facilitators of
help-seeking?
In the review of existing literature, Gulliver et al.3 found research that looked at what
facilitates help-seeking behaviour was far less comprehensive. Some
of the key factors which had been reported in the previous studies
were:
Positive past experiences
Three studies investigating facilitating factors reported
positive past experiences of help-seeking or support as a
significant influence on help-seeking. This could also include
increased mental health literacy and service knowledge from earlier
help-seeking.
Social support and encouragement from
others
Influences such as parents who are supportive and open to
professional support as a factor in good health and wellbeing, or
friends who have had positive experiences, were positive influences
on help-seeking. Interestingly, young people were observed to be
more likely to seek or recommend help for a friend, than to seek
help themselves.
Emotional confidence / mental health
literacy
Rickwood et al.2 found that
one of the most important factors in help-seeking was young people
having the ability and confidence to identify and articulate their
emotions, and their ability to recognise and understand the
symptoms of a mental health difficulty.
Back to top | Comment
What's your experience?
The research shows us key trends in the way young people seek
help, and the reason's why they don't, but the real challenge is
taking this down to the level on which we engage with young people.
Share your experiences and insights to help other health
professionals to break down these barriers to help seeking.
What's the hardest barrier
you've come up against when supporting young people around mental
health?
What has made it easier for
young people to access support?
How do you broach the topic of
mental health with young people?
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