Attitudes and beliefs about mental health among African American older adults suffering from depression

Depression among older adults is a major public health concern leading to increased disability and mortality. Less than 3% of older adults utilize professional mental health services for the treatment of depression, less than any other adult age group. And despite similar rates of depression, African Americans are significantly less likely to seek, engage and be retained in professional mental health services than their white counterparts. Cultural differences in the way depression symptoms are manifested, defined, interpreted and labeled may in part explain some of these racial differences in help-seeking behaviors. Focus group methodology was utilized to identify and explore attitudes and beliefs about depression and mental health treatment utilization among 42 older African Americans who had recently suffered a major depressive episode. Thematic analysis of identified six overarching themes: (a) perceptions of depression, (b) the African American experience, (c) seeking treatment as a last resort, (d) myths about treatment, (e) stigma associated with seeking treatment and (f) culturally appropriate coping strategies. We discuss implications for practice, education and research.     

“What brings you here today?” The role of self-assessment in help-seeking for age-related hearing loss

Why do persons with age-related hearing problems typically wait years from the time hearing difficulties are noticed until hearing health care is sought? This article presents findings of a grounded theory study exploring perspectives of older women on help-seeking for hearing problems. Findings indicate that participants engaged in protracted self-assessment of their hearing before, during, and after seeking help for hearing problems. Many factors were found to facilitate or delay help-seeking; some factors may do both at different times. These factors combine to produce a “push–pull” effect that moves persons iteratively toward and away from help-seeking. A preliminary model of self-assessing is presented including three themes identified as significant in self-assessing: contrasting/comparing, cost vs. benefit, and control. The findings may have relevance beyond the study of hearing loss to the more general investigation of help-seeking for chronic health conditions in aging.     

Personality and Gender as Predictors of Online Counseling Use

ABSTRACT

Extraversion, neuroticism, and gender as predictors of online counseling help-seeking behavior were investigated. A total of 176 college student participants, 30 men and 146 women, were given the NEO-PIR and ATSPPH-S that assessed, respectively, their personalities and attitudes toward seeking professional psychological help through different modes: traditional face-to-face counseling, video-conferencing, e-mail, instant text message, and microphone. Results were analyzed using MANOVA and MANCOVA. Subjects were grouped by scores on personality variables: low, medium, and high. Findings suggest that attitudes toward different modes of seeking counseling were associated primarily with gender and extraversion but not with neuroticism.     

Bridging help-seeking options to Vietnamese Americans with parent–child conflict and depressive symptoms

To help practitioners bridge services to their clients who face family problems, this research aims to identify help-seeking behaviors among Vietnamese Americans who have experienced parent–child conflict and depression. The 2008 Asian Survey found that 46.3% of 572 Vietnamese Americans experienced parent–child conflict and 30.2% reported depressive symptoms. Having parent–child conflicts or depressive symptoms did not predict help-seeking from mental health professionals. Logistic regression results show that having parent–child conflict would increase the likelihood by 81.7% of a thinking that the problem will be naturally resolved; having depressive symptoms would increase the likelihood of seeking help from herbalists by 1.718 times and from medical doctors by 39.7%. Service strategies should include offering educational programs by multidisciplinary professionals with a focus on the natural aspect of building parent–child bonding.     

Motivators for Seeking Gambling-Related Treatment Among Ontario Problem Gamblers

A random digit dialing telephone survey was used to interview 8,467 adults in Ontario, Canada. The NODS-CLiP was used to identify a representative sample of 730 gamblers (54.3% male, mean age 45.3 years) with possible past year gambling problems in order to explore factors that might affect disordered gamblers’ motivators for seeking gambling-related help. A final sample of 526 gamblers provided useable data on possible reasons for and barriers to seeking help, awareness of services, self-perception of gambling problems and experience with help-seeking. Financial and relationship issues were the most frequently volunteered motivators. However, over two-thirds of the respondents could not think of a reason for seeking help. Gamblers who had self-admitted or more severe problems, who knew how to get help, who were employed and had more education, and who identified possible barriers to seeking help were more likely to suggest motivators, especially financial ones. More research is recommended on gamblers’ trajectory towards recognition of a gambling problem, the process of overcoming specific barriers to treatment, and the role of social advantage (e.g., education and employment), in order to devise educational campaigns that will encourage earlier help-seeking among disordered gamblers.     

Sexual Prejudice Among Barbadian University Students

The level of sexual prejudice on university campuses has implications for the health and well-being of gay and lesbian students, and research on sexual prejudice in the Eastern Caribbean is extremely limited. This study assesses the individual attitudes of 251 Barbadian students toward lesbian and gay people using two psychometric inventories. It also examines differences in attitudes as a function of demographic variables including gender, religiosity, and personal acquaintance with lesbian or gay people. The Barbadian students evidenced diverse attitudes, with the average student displaying a moderate amount of sexual prejudice toward lesbian and gay people. Religiosity predicted more negative attitudes toward both lesbians and gay men. Being male predicted more sexual prejudice against gay men, but not against lesbians. Finally, personal acquaintance with a gay or lesbian person did not have a statistically significant relationship with sexual prejudice. This study is among the first of its kind and may serve as a guide to other researchers seeking to further explore attitudes toward lesbian and gay people among Eastern Caribbean students or among Barbadians in general.     

Individual differences in referral for help for severe emotional difficulties in adolescence

Adolescents with emotional distress may find help-seeking an extremely daunting endeavor. However, different adolescent population sectors relate differently to help-seeking for severe emotional difficulties. Gender and ethnic group are among the central factors influencing attitudes towards seeking emotional help. One of the possible mechanisms explaining these cross-group differences is self-esteem. The psychological price of seeking help could be admission of incompetence and feelings of failure, emotions that can be threatening, particularly to adolescents' self-esteem. In the present study, the psychological price of seeking help was manipulated by comparing the ease with which adolescents would self-refer for a severe emotional problem as opposed to referring another for the same problem, and the influence of gender, ethnic group differences and level of self esteem in both situations. The first hypothesis predicting greater ease of referral in the other-referral condition compared to self-referral was confirmed. The second hypothesis predicting general preference of informal help agents than the formal help agents was confirmed. The third hypothesis predicting gender differences such that girls would show higher ease of referral than boys from the different help agents was confirmed. The fourth hypothesis predicting that Jewish-Israeli adolescents would show greater ease of referral than Arab-Israeli adolescents was confirmed. An additional exploratory question examined the interaction between self-esteem and self versus other-referral on ease of referral for help. A significant interaction emerged only for help from the family. Adolescents with low self-esteem showed no differences in self versus other-referral, but adolescents with high self-esteem were more willing to refer others than themselves to seek help. These findings emphasize the importance of a sensitive needs assessment approach in designing mental health service delivery for youth.     

Obstacles to Help-Seeking for Sexual Offenders: Implications for Prevention of Sexual Abuse

ABSTRACT

Persons with potentially harmful sexual interests such as attraction to minors are unlikely to seek or receive treatment before a sexual offense has been committed. The current study explored barriers to help-seeking in a sample of 372 individuals in treatment for sexual offending. Results revealed that the shame and secrecy resulting from stigma associated with pedophilic interests often prevented our respondents from seeking professional counseling, and only about 20% tried to talk to anyone about their sexual interests prior to their arrest. Barriers to seeking and receiving psychological services included concerns about confidentiality, fears of social and legal consequences, personal shame or confusion about the problem, affordability, and challenges finding competent therapists who were adequately equipped to help them. Understanding and ultimately reducing obstacles to help-seeking can improve the quality of life for people with harmful sexual interests and potentially prevent sexual abuse of children or other vulnerable individuals.     

Battered Immigrant Mexican Women's Perspectives Regarding Abuse and Help-Seeking

SUMMARY

A qualitative, pilot study employing in-depth ethno-graphic interviews was conducted to examine perceptions and attitudes towards abuse and the help-seeking behaviors of a sample of ten battered immigrant Mexican women. Findings indicated that participants' attitudes about seeking help were influenced more by cultural factors (e.g., gender-role expectations, famialism) than by psycho-social stres-sors (e.g., immigrant status, financial dependency). Children's welfare played a salient role in women's decisions about seeking help, both as a deterrent and a motivating factor. Women's attitudes about their own abuse were more tolerant than their attitudes about hypothetical situations involving others. Changes in women's attitudes about abuse reflected changes only after some type of intervention had taken place. The majority of the women in the sample had misconceptions or were uninformed about shelters. Suggestions for further research and intervention with this population and a model of internal and external determinants of help-seeking behavior are presented.     

Help Seeking and Treatment Use Among Suicidal College Students

Abstract

Objectives: Many suicidal college students do not receive mental health treatment, and the reasons for this are not fully understood. This study examines how attitudes, beliefs, and social network factors relate to help seeking among suicidal students. Participants: A random sample of 8,487 undergraduate and graduate students from 15 US universities participated. Methods: A Web-based survey administered in spring 2009 examined correlates of mental health service utilization among students reporting serious thoughts of suicide in the previous year (n = 543). Results: Correlates of treatment use included perceived need, beliefs that treatment is effective, contact with service users, lower personal stigma, higher perceived stigma, fewer positive relationships, and sexual minority or Caucasian identity. Conclusions: Help seeking among suicidal students is associated with a range of personal and social network factors. Campus strategies to enhance help seeking should be tailored to address identified facilitators and barriers to treatment use among target populations.     

A Meta-analysis of Gender Differences in Attitudes Toward Seeking Professional Psychological Help

Abstract

Objective: The present study aims to examine gender differences in attitudes toward professional psychological help–seeking behavior and how gender differences could be affected by other cultural factor such as race. Participants: The authors selected studies that involved undergraduate and graduate students as samples, making the total number of participants in this meta-analysis 5,713. Methods: Statistical procedures were administrated by the MIX (Meta-analysis with Interactive eXplanations) program, which does meta-analyses. Results and Conclusions: The results indicated that gender itself was a significant predictor on attitudes toward seeking professional psychological help. In addition, individual's cultural background (eg, Western versus non-Western ethnicity) moderated the gender differences on attitudes toward seeking professional psychological help. Practical implications for mental health professionals in college settings were discussed.     

Predicting help-seeking behavior: The impact of knowing someone close who has sought help

ABSTRACT

Objectives: This study sought to replicate and extend research on social facilitators of college student's help seeking for psychological problems. Participants: We collected data on 420 ethnically diverse college students at a large public university (September 2008–May 2010). Methods: Students completed a cross-sectional online survey. Results: We found that students who were aware of close others' (eg, family, friends) help seeking were two times more likely to have sought formal (eg, psychologist) and informal (eg, clergy) help themselves. Tests of moderation revealed the incremental effect (ie, controlling for help-seeking attitudes, internalizing symptoms, cultural demographics) of close others' formal help seeking was strong and significant for men (R² = 0.112), while it was negligible and nonsignificant for women (R² = .002). Conclusions: We discuss the importance for students—particularly men—to learn about close others' help seeking for facilitating their own help seeking during times of distress.     

Prompting Depression Treatment Seeking among Smokers: A Comparison of Participants from Six Countries in an Internet Stop Smoking RCT

Websites containing information and advice about health are increasingly common and popular. It is important to understand whether the material these sites contain can positively influence individual behavior, and whether populations differ in their response to that material. Participants in an international web-based stop smoking randomized controlled trial (RCT) were screened for major depression; participants whose history and/or depression symptoms were deemed of concern were offered one of two prompts (Strong and Mild) to seek treatment, depending on depression history. Participants from 3 predominantly English-speaking and 3 predominantly Spanish-speaking countries were analyzed. Individuals given a Strong prompt were more likely to seek treatment for depression than those given a weak prompt (16.6% vs. 10.2% of previously untreated individuals reported seeking treatment), controlling for symptom level and other variables. Country-specific differences were observed, with participants from South Africa and Spain departing from the common pattern of Strong prompt leading to higher likelihood of treatment seeking. Older age and female gender, but not symptom level predicted higher likelihood of seeking treatment following a prompt. The results suggest that information provided by the health websites can promote help seeking in affected individuals.     

Professional Help-Seeking for Gambling Problems: Awareness,Barriers and Motivators for Treatment

Despite the negative consequences associated with gambling, few problem gamblers seek professional help. This study aimed to examine awareness of professional sources of help and help-seeking behaviour amongst regular and problem gamblers. Australian gamblers (N = 730) were recruited from the general population, multicultural gambling venues, and gambling helplines and treatment services. Surveys measured awareness of professional help services, help-seeking behaviour and motivators and barriers to seeking help. Gamblers demonstrated low awareness of professional help services. Problem gamblers born in Australia or who were divorced were more likely to seek help. Problem gamblers who were reluctant to seek help due to a desire solve the problem on their own and feeling ashamed for themselves or their family pride were more likely to have overcome these barriers to seek help. However, significant barriers related to denial of problem severity and concerns about the ability to access low cost services that cater for multicultural populations predicted a lower likelihood of having sought help. Public education should aim to de-mystify the treatment process and educate gamblers about symptoms of problem gambling to reduce shame, stigma, and denial and encourage help-seeking. Ongoing education and promotion of help services is required to increase awareness of the resources available, including targeted promotions to increase awareness of relevant services among specific populations.     

Attitudes of African American Adults Toward Treatment in Cases of Child Sexual Abuse

The attitudes of 155 African American adults toward the need for treatment in cases of child sexual abuse were assessed. These attitudes were assessed in relation to the following variables: age, sex, educational level, income, knowledge of short and long term effects, the cirucmstances and the nature of the abuse, and expectations regarding interactions with treatment facilities. In addition, attitudes toward other invervention facilities and agencies were assessed. The results indicated that attitudes toward treatment and intervention agencies had a significant impact on the treatment - seeking attitudes of African Americans that was dependent upon marital status. However, consistent with previous studies, participants generally held favorable attitudes toward mental health services and felt that treatment would yield positive results.     

The effect of charitable giving by celebrities on the personal public relations

This study examined how charitable giving by entertainment celebrities influences celebrity personal public relations. Survey participants showed positive attitudes toward charitable giving. Attitudes toward charitable giving positively influenced celebrity credibility perception. Credibility also influenced attitudes toward the celebrities, which in turn positively influenced the purchase intention of their performance. Also, attitudes toward charitable donations were positively associated with attitudes toward the celebrities. Scholars and practitioners need to note charitable giving as an efficient and strategic personal public relations factor and method.     

Counselors’ and Counseling Students’ Attitudes toward Transgender Persons

Issues related to persons who are transgender have gained large interest in recent years, but discrimination and differential health outcomes for persons who are transgender continue. This article reviewed the 14 existing studies on attitudes toward persons who are transgender, none dealing exclusively with counselors and/or counselors in training. This study involved investigation of those attitudes with a sample of 95 counselors and counselors in training. Findings indicated that counselors tend to have positive attitudes. Greater personal familiarity and multicultural competence as well as being female were associated with more positive attitudes, whereas quantity of diversity training was not related and professional experience was related to more negative attitudes.     

Attitudes toward homosexuality among U.S. residents of Mexican descent

This study examined attitudes toward lesbians and gay men in a sample of northern California residents of Mexican descent (N = 616), using 3‐item versions of the Attitudes Toward Gay Men (ATG) and Attitudes Toward Lesbians (ATL) scales presented simultaneously in Spanish and English. Males’ attitudes toward homosexual men were significantly more negative than females’ attitudes, whereas females expressed relatively negative attitudes toward lesbians. Overall, respondents expressing negative attitudes endorsed more traditional gender attitudes than respondents with positive attitudes, tended to be older and less educated, had more children, were more likely to belong to a fundamentalist religious denomination and to attend religious services frequently, were more conservative politically, and were less likely to have personal contact with gay people. Further analyses revealed that associations between attitudes and education, number of children, personal contact, and religious attendance occurred mainly among respondents who spoke and read English (rather than Spanish) or identified with U.S. culture (rather than Mexican culture).     

Attitudes toward homosexuality among U.S. residents of Mexican descent

This study examined attitudes toward lesbians and gay men in a sample of northern California residents of Mexican descent (N = 616), using 3-item versions of the Attitudes Toward Gay Men (ATG) and Attitudes Toward Lesbians (ATL) scales presented simultaneously in Spanish and English. Males attitudes toward homosexual men were significantly more negative than females attitudes, whereas females expressed relatively negative attitudes toward lesbians. Overall, respondents expressing negative attitudes endorsed more traditional gender attitudes than respondents with positive attitudes, tended to be older and less educated, had more children, were more likely to belong to a fundamentalist religious denomination and to attend religious services frequently, were more conservative politically, and were less likely to have personal contact with gay people. Further analyses revealed that associations between attitudes and education, number of children, personal contact, and religious attendance occurred mainly among respondents who spoke and read English (rather than Spanish) or identified with U.S. culture (rather than Mexican culture).