Help-seeking behavior in healthcare is defined as any action performed by an individual to seek treatment or support for a condition.

Globally, approximately 1 in 8 people live with a mental health disorder. In many countries, such as the USA, they are the most common health conditions diagnosed in the population. Of these, depression is the most prevalent illness, and its incidence continues to rise. Many factors are associated with depression – sex, socioeconomic status, genetics, etc. – so it’s not always clear why rates are increasing.

Depression and many other mental health conditions are very treatable. But, the majority of the population do not seek or significantly delay seeking treatment. There are many reasons behind this, but mainly it can be related to the stigma of receiving treatment.

Stigma around mental health and help-seeking behavior

Perceptions of mental wellbeing have changed significantly over recent decades. Psychology and medicine have come a long way, with many conditions now being well-researched and -understood. This has led to the development of many effective treatments and therapies.

Despite this, there are several forms of stigma surrounding mental health issues, which are preventing people from seeking support or treatment.

Institutional stigma

Those who suffer from mental health-related difficulties are often implored to reach out to others and speak openly. But, in many cases, the policies of governments and institutions can penalize those experiencing such problems.

Generally, institutions are set up to reward certain behaviors and personality traits – for example, drive and resilience. Certain conditions may make fulfilling obligations in work or education very difficult, leading to a potentially negative impression of a sufferer as an employee or student.

Also, depending on the condition, insurance companies may see a sufferer as a ‘high-risk’ customer. As they may believe they’re more likely to pay out on a claim, insurers can refuse to cover said customer or subject them to higher premiums.

Social stigma

Although attitudes towards mental wellbeing have significantly improved, it’s never guaranteed that everyone will understand non-typical behavior. There is still a lot of uncertainty and judgment around mental health disorders; even still, some consider certain disorders to be dangerous. This severely impacts help-seeking behavior for mental health disorders.

For example, although perceptions of conditions like depression and anxiety have improved, disorders such as schizophrenia and alcohol dependence have seen increased stigma in recent years. This can lead to isolation or conflict, with many sufferers experiencing bullying and loneliness due to their conditions. This often exacerbates symptoms and can have serious consequences.

Even better-known conditions like anxiety lead to behaviors that may be tolerated poorly. Despite the extent of our understanding, anxiety is still something that causes a lot of shame for many people.

Self-stigma

With mental health difficulties comes an increased chance of experiencing low self-esteem and self-confidence. Often, we internalize feedback from the world around us. If society is structured to reward ‘normal’ behavior, then anything deviating from this standard can be a great source of guilt and embarrassment.

This can result in feelings of hopelessness and makes it very difficult to take steps forward to a solution. Young people in particular fear that their worth will be diminished by seeking professional help, due to feelings of alienation and concerns about ‘fitting in’.

It is important, then, for research to identify ways to reduce stigma. 

Solutions: How do we encourage help-seeking behavior?

Much of MDPI’s research is dedicated to breaking down barriers to treatment and improving mental health services.

Mental health literacy

One Portuguese study found that stigma decreased as mental health literacy (MHL) – defined as the “knowledge and beliefs about mental disorders which aid their recognition, management and prevention” – increased. The authors identify populations more likely to hold stigmatic attitudes and suggest running targeted campaigns to increase MHL. This will decrease negative attitudes toward mental health sufferers, resulting in increased engagement in mental health services.

Increased access to mental health services

Young men show significantly reduced rates of health-seeking behaviour compared to other populations. Thus, the authors of a study published in MDPI’s International Journal of Environmental Research and Public Health administered a survey to male video gamers, gathering their perspectives on how to increase engagement. It was found that having access to online mental health services was of great interest to the respondents, in conjunction with in-person sessions. Respondents also wanted to ensure that their information was kept confidential and that they could use services anonymously online.

Stress and depression workshops

Another MDPI study outlined the benefits of running large-scale workshops to normalize discussions around mental health. These can be implemented in communities as an early intervention strategy, reaching people from diverse backgrounds who may have otherwise not sought treatment until years later. They are easily accessible and normalize thinking and talking about mental wellbeing. This could encourage attendees to seek further help.

Life skills training

The provision of life skills training sessions to young people experiencing mental health difficulties is also recommended. This entails teaching young people coping mechanisms to deal with stress and negative emotions when they arise. Also, they are encouraged to focus on ‘structural’ factors, such as their living conditions. This can allow them to identify issues in their individual situations and adapt their coping strategies to suit them. The authors also found that students wanted support from teachers and parents, as well as other important adults or professionals in their lives, to talk about their mental wellbeing. Thus, life skills training should include parents and teachers to better support young people and increase rates of help-seeking behavior.

Conclusion

There are many factors hindering seeking support for mental health issues. The majority relate to stigma and a lack of understanding of common conditions and disorders. Educating the public and getting people to talk or think about their problems can help combat the shame around mental health.