Background
The burden and prevalence of mental disorders
Reluctance to seek help
Proposed reasons for not seeking help
Aims and scope of this study
Methods
Databases & Search methodology
Study Selection
Coding of Studies
Analysis strategy
Results
1. Study characteristics
Year and location of studies
Methodologies employed
Sample and participant characteristics
Sample size
Participant age
Gender
Settings and target groups
Mental health status of participants
2. Perceived barriers and facilitators
Analysis of qualitative studies
# | Barrier theme | Number of studies |
---|---|---|
1 | Public, perceived and self-stigmatising attitudes to mental illness | 10 |
2 | Confidentiality and trust | 6 |
3 | Difficulty identifying the symptoms of mental illness | 5 |
4 | Concern about the characteristics of the provider | 5 |
5 | Reliance on self, do not want help | 5 |
6 | Knowledge about mental health services | 4 |
7 | Fear or stress about the act of help-seeking or the source of help itself | 4 |
8 | Lack of accessibility, e.g., time, transport, cost | 4 |
9 | Difficulty or an unwillingness to express emotion | 3 |
10 | Do not want to burden someone else | 2 |
11 | Prefer other sources of help (e.g., family, friends) | 2 |
12 | Worry about effect on career | 1 |
13 | Others not recognising the need for help or not having the skills to cope | 1 |
# | Facilitator theme | Number of studies |
---|---|---|
1 | Positive past experiences with help-seeking | 3 |
2 | Social support or encouragement from others | 2 |
3 | Confidentiality and trust in the provider | 2 |
4 | Positive relationships with service staff | 2 |
5 | Education and awareness | 1 |
6 | Perceiving the problem as serious | 1 |
7 | Ease of expressing emotion and openness | 1 |
8 | Positive attitudes towards seeking help | 1 |
Analysis of quantitative studies
Author | Top rated barriers |
---|---|
Sheffield (2004) [35] |
School counsellor
|
1. Prefer to handle myself (45%) (self-reliance) | |
2. Don't think they can help (27%) (no one can help) | |
Doctor
| |
1. Too expensive (25%) (cost) | |
2. Prefer to handle myself (23%) (self-reliance) | |
Psychologist/Psychiatrist
| |
1. Too expensive (50%) (cost) | |
2. Don't know where to find (28%) (knowledge) | |
Dubow (1990) [26] | 1. I felt that no person or helping service could help (55%) (no one can help) |
2. The problem was too personal to tell anyone (53%) (stigma/comfort) | |
West (1991) [37] | 1. I do not like to tell a stranger about personal things (29.4%) (stigma/comfort) |
2. I am afraid counsellor will pass information about me to other people (18.3%) (confidentiality) | |
Kuhl, (1997) [32] | 1. If I had a problem I would solve it by myself (3.87) (self-reliance) |
2. I think I should work out my own problems (3.79) (self-reliance) | |
Wilson (2008) [38] | 1. I feel comfortable talking to a GP (general practitioner) who I don't know (1.65) (stigma/comfort) |
2. I'm not embarrassed to talk about my problems (1.51) (stigma/comfort) | |
Eisenberg (2007) [27] | 1. Stress is normal in graduate school (51%) (self-reliance) |
2. Have not had any need (45%) (no perceived need) | |
Brimstone (2007) [24] | 1. Worries about either knowing the doctor/counsellor or having to have future dealings with the counsellor/psychologist or general practitioner at university health care centre (stigma/comfort) |
2. Worries about either knowing the doctor/counsellor or having to have future dealings with the counsellor/psychologist or general practitioner at non-university health care centre (stigma/comfort) |