Who is seeking whom? A person-centred approach to help-seeking in adults with currently untreated mental health problems via latent class analysis

Soc Psychiatry Psychiatr Epidemiol. 2018 Aug;53(8):773-783. doi: 10.1007/s00127-018-1537-7. Epub 2018 Jun 6.

Abstract

Purpose: Global surveys point to a gap in mental health service utilisation. However, contacting more than one source of professional help may influence the estimates of utilisation. Currently, few studies statistically differentiate between different sources of help based on patient characteristics.

Methods: We assessed sociodemographic and psychosocial data in a convenience sample of 188 adults with mental health problems (Mage = 50.34 years; SD = 16.19; 71% female), who reported their help-seeking behaviour during the next 6 months. We analysed their behaviour via latent class analysis and compared baseline characteristics between classes.

Results: We found four latent classes: "mental health professionals" (MHP; 9.0%), "multiple sources" (4.3%), "primary care" (35.6%), and "non-seekers" (51.1%). All classes had moderate to high probabilities of seeking help from friends or family. Primary care utilisers were more often in a cohabiting partnership; MHP utilisers were more experienced in mental health treatment and reported lower well-being and more depressive symptoms than non-seekers. By trend, non-seekers were younger, and both non-seekers and primary care utilisers reported fewer depressive and somatic symptoms than utilisers of multiple sources and MHP.

Conclusions: In our analysis, MHP utilisation was even lower (9.0%) than in previous studies. However, MHP utilisers appeared to suffer from more serious conditions than other latent classes. As informal sources such as family and friends were present in all latent classes, help-seeking behaviour seems to transcend traditional MHP-focused approaches. Further research is necessary to investigate tenability and trajectories of different latent classes of help-seeking in larger and representative samples with longer follow-ups.

Keywords: Community mental health; Depression; Health service research; Mental health; Psychiatric services.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Depression
  • Female
  • Friends
  • Health Services Accessibility*
  • Humans
  • Latent Class Analysis*
  • Male
  • Mental Disorders / diagnosis*
  • Mental Disorders / therapy*
  • Mental Health
  • Mental Health Services / organization & administration*
  • Middle Aged
  • Patient Acceptance of Health Care
  • Patient-Centered Care*
  • Primary Health Care / organization & administration
  • Probability
  • Social Class
  • Surveys and Questionnaires
  • Young Adult