Determinants of intentions to seek formal mental health help among Palestinian adolescents in Israel.

BACKGROUND: Mental health challenges are widespread among adolescents undergoing significant physical, emotional, social, and academic changes. However, rates of formal help-seeking remain low, particularly among those from ethnic minorities. AIMS: This study investigated the determinants of intentions to seek formal mental health help among Palestinian adolescents in Israel, focusing on mental health literacy (MHL) and trust in formal sources of information. METHODS: A total of 178 adolescents (Mage = 16.24 ± 1.24 years, 61.8% female) completed measures assessing intention for formal help-seeking, psychological distress, MHL, trust in formal sources of information, sociodemographic, and clinical characteristics. RESULTS: Findings revealed low levels of intention to seek formal help and psychological distress, alongside average or above-average levels on all MHL dimensions and trust in formal sources for information. Our analysis identified socioeconomic status (ß = .17, p < .05), psychological distress (ß = .18, p < .05), trust in formal sources of information (ß = .28, p < .001), and two MHL dimensions: knowledge of where to seek information (ß = .25, p < .01) and attitudes that promote recognition or appropriate help-seeking behavior (ß = .16, p < .05) - as the main determinants of intention for formal help-seeking. CONCLUSIONS: This study underscores the critical role of trust in formal sources of information and MHL in seeking formal help among adolescents from ethnic minorities. Interventions aiming to improve access to mental health-related information, address and enhance attitudes, and foster trust in formal professionals and institutions may contribute to an increased tendency for formal mental health help-seeking among this population and others.

Being sick to a cancer patient: pathways of delay in help seeking and diagnosis of cancer in India.

There is evidence that cancer mortality and morbidity could be reduced when the disease is diagnosed and treated at an early stage. The paper examines the pathways of delay of cancer diagnosis in an Indian setting. It draws on a qualitative study conducted among cancer survivors and family members of cancer patients in the city of Bengaluru, South India. The results show that a substantial part of the delay occurred at the stage of initial formal help seeking wherein patient and family-led, disease-related and systemic factors together played a major role. Patient-led factors included trivialisation and normalisation of symptoms as part of general fatigue and aging; unrealistic risk perceptions that linked causality of cancer merely to heredity and behavioural risk factors; fear of being diagnosed as cancer patient; gender related reasons including family's gender performance expectation, lower agency of women to seek help and lower prioratisation of women's health in the household and access related issues including financial constraints and unavailability of specialised hospitals nearby. Disease-related factors included the presence of comorbidity, cancer's mimicking of symptoms of other diseases and absence of distinguishable symptoms at the initial stage for certain types of cancers. The practitioner-led and system-led factors such as trivialisation of symptoms by general practitioners, non cancer-specific referrals, and lack of cancer screening facilities accounted for a major part of delay after the formal help seeking. The paper argues that the mere knowledge of cancer symptoms did not always lead to early diagnosis due to the interplay of these factors. The ongoing cancer prevention and control interventions in India need to be informed of these micro level factors while developing strategies to prevent avoidable delays in cancer diagnosis.

A multilevel model of the help-seeking behaviors among adolescents with mental health problems.

Objective: Mental health problems are highly prevalent among adolescents yet the utilization of mental health services among such a population is very low. This study was conducted to examine mental health problems and related help-seeking behaviors among a Chinese sample of adolescents. Methods: A total of 3,480 students were recruited from four middle- and high schools in Changsha City, Hunan province, and completed an online questionnaire that assessed their general information, mental health problems including depression, anxiety, self-harm, and suicide ideation, as well as their help-seeking behaviors from both formal (including psychological teachers and mental health professionals) and informal sources (including family, friends, and teachers). Results: The participants had a prevalence of 13.7% for depression, 11.5% for anxiety, 9.8% for self-harm, and 9.1% for suicide ideation. Although a high rate of help-seeking behaviors was observed (73.0%), most were concentrated in informal sources (99.3%), while only a small portion of participants resorted to formal sources (13.9%). Being female (OR: 1.45, 95% CI: 1.15-1.83), higher grade (OR: 1.32, 95% CI: 1.01-1.73), school mental health resources not available (OR: 1.39, 95% CI: 1.02-1.88), without suicide ideation (OR: 2.03, 95% CI: 1.42-2.90) were all associated with increased likelihood of formal help-seeking behaviors. On the other hand, complete middle school (OR: 0.36, 95% CI: 0.22-0.59), the middle level of academic ranking (OR: 0.64, 95% CI: 0.42-0.97), and higher father education levels (OR: 0.54-0.56, 95% CI: 0.33-0.90) were all associated with a decreased likelihood of formal help-seeking behaviors. Conclusion: Our results showed a higher prevalence of help-seeking behavior for emotional or psychological problems during the past year. Compared to the high rate of informal help-seeking behaviors, students showed a lower propensity to seek formal help for their mental health problems, which may be explained by individual-level, family-level, and school-level factors. Our findings provide important implications for the development and popularization of targeted, needs-based mental health promotion and education programs in the future.

The Contextual Influences of Police and Social Service Providers on Formal Help-Seeking After Incidents of Intimate Partner Violence.

Police notification and social service acquisition are two forms of formal help-seeking linked to improved outcomes among survivors of intimate partner violence (IPV), including better socio-emotional health, improved physical health, and, importantly, increased safety. The majority of research devoted to the study of formal help-seeking among survivors of IPV focuses on incident- and individual-level factors and their relationship with formal resource utilization. Much less is known about community-level factors. Using a nationally representative sample of incidents of IPV from the National Crime Victimization Survey (2006-2016), this work explores how law enforcement and social service resources in a community are related to police notification and survivor acquisition of a victim service after an incident of IPV, net of incident- and individual-level factors. Logistic regression models indicate that the number of law enforcement personnel per 1,000 residents in a county is positively associated with police notification after an incident of IPV, and it exerts an indirect effect on survivor service acquisition through police notification. Additional analyses reveal that the race/ethnicity of the survivor of IPV is a key demographic in the explanation of this relationship, as incidents of IPV involving White and Hispanic survivors of IPV are more likely to come to the attention of police as the number of law enforcement personnel increases. The reverse is true for incidents involving Black survivors of IPV. No differences across survivor sex emerged. Potential reasons to account for varying effects across race/ethnicity are discussed as well as the importance of additional funding for police and social service agencies to serve survivors of IPV and meet the dual goals of offender accountability and survivor safety and well-being.

Intimate Partner Violence against Women during the COVID-19 Lockdown in Spain.

AIMS: To analyze the temporal and geographical distribution of different indicators for the evolution of intimate partner violence against women (IPV) before, during and after the COVID-19 induced lockdown between March and June 2020 in Spain. METHODS: Descriptive ecological study based on numbers of 016-calls, policy reports, women killed, and protection orders (PO) issued due to IPV across Spain as a whole and by province (2015-2020). We calculated quarterly rates for each indicator. A cluster analysis was performed using 016-call rates and protection orders by province in the second quarters of 2019 and 2020. ANOVAs were calculated for clustering by province, unemployment rates by province, and the current IPV prevalence. RESULTS: During the second quarter of 2020, the highest 016-call rate was recorded (12.19 per 10,000 women aged 15 or over). Policy report rates (16.62), POs (2.81), and fatalities (0.19 per 1,000,000 women aged 15 or over) decreased in the second quarter of 2020. In the third quarter, 016-calls decreased, and policy reports and POs increased. Four clusters were identified, and significant differences in unemployment rates between clusters were observed (F = 3.05, p < 0.05). CONCLUSIONS: The COVID-19 lockdown fostered a change in IPV-affected women's help-seeking behavior. Differences between the volume of contacts made via 016-call and the policy reports generated provide evidence for the existence of barriers to IPV-service access during the lockdown and the period of remote working. More efforts are needed to reorganize services to cope with IPV in non-presential situations. The provinces with the highest 016-call and PO rates were also those with the highest rates of unemployment, a worrying result given the current socioeconomic crisis.

Intimate Partner Violence and Help-Seeking Among Ethiopian Women.

Although intimate partner violence (IPV) is a widespread phenomenon in Ethiopia, the relationship between help-seeking sources and IPV is not well understood. Better understanding of this relationship could play a role in preventing IPV. We used data collected in the 2016 Ethiopia Demographic and Health Survey and limited our study to women who have ever been married, aged 15 to 49 years (n = 4469). Overall, the proportions of women who have ever experienced emotional abuse, physical, or sexual violence were 24%, 23.1%, and 10.1%. Women who sought informal help (family) were 2.42 times more likely (OR = 2.42; CI 1.29-4.55) to have ever experienced emotional abuse than women who did not seek family help. Neither formal nor informal help-seeking significantly associated with physical or sexual violence. The results may indicate difficulties women face in seeking help and cultural and social norms that tolerate IPV as an acceptable part of family life in Ethiopia.

Type and severity of intimate partner violence and formal help-seeking among women in the Philippines

Background@#In the Philippines, 25% of ever-married women reported experiencing some form of violence from their partners but only 10% of them actually sought medical or legal help (NDHS, 2013). The objective of this study was to describe the type and severity of intimate partner violence experienced, and its association with formal help-seeking,among women aged 15-49 years in the Philippines.@*Methodology@#The cross-sectional data used for this study came from the National Demographic and Health Survey of women aged 15-49 years old conducted in 2013. To estimate the association of interest, confounders were identified using the change-in-estimate criterion and were controlled by multiple logistic regression modelling.@*Results@#Among women aged 15-49 years who experienced intimate partner violence, those who experienced all types of abuse had the highest proportion of formal help-seeking (7.3%), while women who experienced only sexual abuse had the lowest (0 out of 67). Controlling for the effect of other variables, women who experienced severe physical abuse were more likely to seek medical or legal assistance compared to those who experienced moderate physical abuse (OR=4.77; 95% Confidence Interval: 1.96 – 11.62).@*Conclusion@#Formal help-seeking rates were low among victims of intimate partner violence in the Philippines. The severity of the abuse experienced is likely an important factor in seeking medical and legal help. These systems should thus be capable of handling severe cases of abuse in order to address the needs of women who seek help. Efforts should be made to increase formal help-seeking among all victims of domestic violence.

Type and severity of intimate partner violence and formal help-seeking among women in the Philippines

Background: In the Philippines, 25% of ever-married women reported experiencing some form of violence fromtheir partner, but only 10% of them actually sought medical or legal help (NDHS, 2013). The objective of thisstudy was to describe the type and severity of intimate partner violence experienced, and its association withformal help-seeking, among women aged 15-49 years in the Philippines.Methods: The cross-sectional data used for this study came from the National Demographic and Health Surveyof women ages 15-49 years old conducted in 2013. To estimate the association of interest, confounders wereidentified using the change-in-estimate criterion and were controlled by multiple logistic regression modelling.Results: Among women aged 15-49 years who experienced intimate partner violence, those who experiencedall types of abuse had the highest proportion of formal help-seeking (7.3%), while women who experienced onlysexual abuse had the lowest (0 out of 67). Controlling for the effect of other variables, women who experiencedsevere physical abuse were more likely to seek medical or legal assistance compared to those who experiencedmoderate physical abuse (OR=4.77; 95% Confidence Interval: 1.96 - 11.62).Conclusion: Formal help-seeking rates were low among victims of intimate partner violence in the Philippines.Severity of abuse experienced is likely an important factor in seeking medical and legal help. These systemsshould thus be capable of handling severe cases of abuse in order to address the needs of women who seekhelp. Efforts should be made to increase formal help-seeking among all victims of domestic violence.

Attachment and Mental Help-Seeking in the Perinatal Period: The Role of Stigma.

This study aimed at (1) examining how women's attachment representations influence their intentions to seek formal help for their emotional problems, either directly or by affecting attitudes towards professional help-seeking (stigma and psychological openness), and (2) examining whether these effects are moderated by the presence of clinically significant psychopathological symptoms. A cross-sectional online survey including 226 women during the perinatal period was conducted. Results showed that, when clinically significant psychopathological symptoms were present, women's more insecure attachment representations were associated with lower intentions to seek professional help, and this influence occurred throughout a decrease in women's indifference to stigma associated with mental healthcare. These results support both the intra and interpersonal nature of the help-seeking process, and highlight the importance of implementing stigma reduction strategies (e.g., awareness campaigns, health professional's non-judgmental questioning of emotional difficulties), particularly in women with clinically significant psychopathological symptoms.

Women's Decisions to Not Seek Formal Help for Partner Violence: A Comparison of Intimate Terrorism and Situational Couple Violence.

This study examined the help-seeking decisions of low-income women (n = 389) in two types of physically violent heterosexual relationships-intimate terrorism (i.e., physical violence used within a general pattern of coercive control) and situationally violent (i.e., physical violence that is not part of a general pattern of coercive control). Intimate terrorism victims were significantly more likely than situational couple violence victims to cite fear as a reason for not seeking help from the police, medical centers, and counselors/agencies. In contrast, situational couple violence victims more often said that they did not need help. Regression analyses also indicate that additional violence-related factors predict women's help-seeking. Findings emphasize the importance of distinguishing between types of male partner violence and recognizing women's exertions of personal choice and perceptions of dangerousness when examining their decisions about seeking help from service providers.