Determinants of help-seeking behavior in depression: a cross-sectional study.

BACKGROUND: Although evidence-based and effective treatments are available for people with depression, a substantial number does not seek or receive help. Therefore, it is important to gain a better understanding of the reasons why people do or do not seek help. This study examined what predisposing and need factors are associated with help-seeking among people with major depression. METHODS: A cross-sectional study was conducted in 102 subjects with major depression. Respondents were recruited from the general population in collaboration with three Municipal Health Services (GGD) across different regions in the Netherlands. Inclusion criteria were: being aged 18 years or older, a high score on a screening instrument for depression (K10 > 20), and a diagnosis of major depression established through the Composite International Diagnostic Interview (CIDI 2.1). RESULTS: Of the total sample, 65 % (n = 66) had received help in the past six months. Results showed that respondents with a longer duration of symptoms and those with lower personal stigma were more likely to seek help. Other determinants were not significantly related to help-seeking. CONCLUSIONS: Longer duration of symptoms was found to be an important determinant of help-seeking among people with depression. It is concerning that stigma was related to less help-seeking. Knowledge and understanding of depression should be promoted in society, hopefully leading to reduced stigma and increased help-seeking.

Reasons and determinants of help-seeking in people with a subclinical depression.

BACKGROUND: Subclinical depression is common. Although interventions have proven to be effective, participation rates are low. This study first aimed to get more insight in help-seeking and reasons for (not) seeking care. The second aim was to identify characteristics that distinguish people who receive help, those with an unmet need, or no perceived need for care. METHODS: Respondents with a subclinical depression (n=162) were recruited from the general population. They were eligible for participation if they were aged 18 years or older, scored 20 or higher on the K10 screening instrument for depression, and did not meet the criteria for major depression. RESULTS: Of all participants, 27% received help, 33% had an unmet need, and 40% had no perceived need for care. Participants with no perceived need reported not to experience symptoms, were able to solve problems on their own, and could mobilize their own support. They were characterized by lower scores on neuroticism and an older age than those who received care. LIMITATIONS: The response rate in this study was relatively low which may have caused a selection bias. CONCLUSION: Not all people with subclinical depression may need help for their symptoms, some are able to deal with problems on their own. However, others experience a need for care but do not receive any. Gaining insight into potential barriers for help seeking and receiving in people with an unmet need is important so appropriate measures can be taken to ensure that those who need care get the help they want.