Stigma of Seeking Help

À l’image des hommes en général, les professionnels de l’urgence (policiers, ambulanciers, pompiers, militaires), lorsque confrontés à des difficultés de nature psychosociale, hésitent à formuler une demande d’aide vers les services professionnels. Les superviseurs, dans les organisations employant ces professionnels, occupent des fonctions privilégiées pour intervenir auprès de ces personnes afin de les orienter vers les ressources appropriées.

Nous nous sommes demandé si une intervention éducative de groupe portant sur la demande d’aide chez les hommes et sur quelques techniques de base en relation d’aide peut permettre d’outiller des superviseurs de professions d’urgence pour mieux intervenir auprès d’un subordonné. À cette fin, l’intervention Urgence Masculinité a été mise sur pied et évaluée. Cette intervention éducative de groupe, d’une durée d’une journée, a été réalisée à six reprises et a permis de rejoindre un total de 43 superviseurs chez les pompiers, les militaires et les policiers.

L’évaluation indique que l’intervention a permis aux participants de se sentir plus outillés pour identifier les problèmes chez leurs subordonnés, pour entrer en relation d’aide auprès de ces derniers et pour les orienter vers les ressources adéquates. De plus, les participants rapportent majoritairement avoir acquis de nouvelles connaissances et habiletés et se disent satisfaits de l’intervention. L’évaluation indique, par contre, que certains participants présentent toujours des besoins concernant l’identification d’un employé vivant des problèmes psychosociaux. Il a, de plus, été impossible de former un groupe de superviseurs ambulanciers, ce qui constitue une limite importante de ce projet.

Cet article concerne la validation française de l’Inventory of Attitudes Toward Seeking Mental Health Services (Inventaire d’attitudes envers le recours aux services de santé mentale; IARSSM). Cet outil a pour objectif de mesurer les croyances et les attitudes exprimées à l’égard de la recherche d’aide psychologique professionnelle. Il se présente sous la forme d’un inventaire de 24 affirmations — inspirées de la théorie du comportement planifié — qui rendent compte de l’ouverture psychologique, de l’indifférenceà la stigmatisation sociale et de la propension à l’action. L’objectif de la présente recherche a été de traduire en français l’échelle, puis de tester, notamment, sa validité factorielle. Après application d’une procédure de traduction et de rétro-traduction, l’IARSSM a été rempli par 702 Français. Les réponses ont été traitées par analyse factorielle confirmatoire. Les résultats confirment la structure tri-factorielle théorique et attestent sa supériorité par rapport à une structure unifactorielle. En outre, la présence de corrélations avec des critères externes confirme la validité de l’échelle, et la consistance interne de ses sous-échelles est satisfaisante.

While some instruments may be developed for a discrete research study, others could have significant utility as a tool for researchers and practitioners if they are found to be both culturally and psychometrically reliable measures. The
persistence of religion as a central component of daily life for many African-Americans provides a rich opportunity for researchers to develop tools that can be used broadly by clinicians and clergy. Research expediency and cultural
neutrality cannot be the hallmarks of measurement instrument design. If the goal of research is to gain awareness of existing viewpoints and desired outcomes among a particular population, it is important to tailor that tool to collect the views and outcomes to the population under study. The results of this study show that the ATRHSS is a reliable measure that can accomplish this goal.

Introduction: In Australia, rural adolescents still face barriers to obtaining professional psychological help due to poor availability and accessibility of services in rural areas when delay in seeking help for mental health problems can lead to poorer treatment outcomes. The aims of this study were to: investigate the preferences and intentions of rural Australian youth towards seeking help for mental health problems; determine predictors of help-seeking intention among rural adolescents; and verify results from previous qualitative research on the barriers to help-seeking in a rural context.

Method: Participants were 201 adolescents recruited from 8 rural schools in the state of Victoria, Australia. Participants ranged inage from 11 to 18 years. Using the Accessibility and Remoteness Index of Australia (ARIA+), approximately 149 participants were classified as currently living in an inner regional area of Victoria, whereas 52 participants lived in an outer regional area. Participants completed an open-ended survey of help-seeking intention.

Results: Overall, 55.7% of the sample indicated that they would seek help for a mental health problem. The majority of participants, regardless of subgroup, indicated that they would seek help for a mental health problem from a school counsellor as their first choice. Gender differences were observed such that males had a higher preference for seeking help from a psychologist than females. Furthermore, older adolescents were more likely to prefer seeking help from a GP than younger participants. A multivariate analysis of help-seeking intentions revealed that ARIA was the only predictor of help-seeking intention; however, when extreme scores of depression and anxiety were also taken into account, these also predicted help-seeking intention. A content analysis of the barriers to help-seeking nominated by participants revealed that perceived limited availability of professional services in towns, perceived social proximity and fear of rural gossip, and difficulties associated with travelling to obtain help were the most significant concerns for these youth.

Conclusions: These findings verify previous research on help-seeking among rural youth and reinforce that these young peopleface additional barriers to help-seeking by virtue of living in a rural environment. The availability of services for rural youth needs to be improved, as do young people’s knowledge of service availability and access (especially travel options). It must be taken into account that rural adolescents of different ages and sex may differ in their help-seeking preferences. Finally, mental health promotion work with rural youth should consider the influence of rural culture on help-seeking intentions.

Little research has been undertaken into the barriers facing rural adolescents seeking help and support for mental health problems. This study presented students from rural secondary schools in Victoria with hypothetical scenarios of an adolescent living in a rural area with a mental disorder and posed questions in order to create group discussion. The results revealed a range of perceived barriers to helpseeking that could be considered unique to rural settings. However, adolescents also expressed positive attitudes and identified a range of professional help sources available to them. The findings support recent moves towards providing school-based mental health services to young people in rural areas.

The objectives of this article are to expand and comment upon a recent review in Australian Psychologist of the literature in relation to mental health problems in rural contexts by Jackson et al. (2007). In the present article we review recently published qualitative research on the help-seeking attitudes and experiences of rural Australian adolescents. While we agree on the utility of the Macintyre, Ellaway, and Cummins (2002) conceptual framework based on notions of health and place, we note that this framework specifically emphasises the importance of the collective dimension. We present a broader perspective on health and place than Jackson et al. (2007) by incorporating social geographic research. We argue that rural mental health research has been hampered by a simplistic view of social stigma of mental illness and that a more thorough conceptualisation of the phenomenon is needed. Finally, we make some further recommendations based on a broader perspective of mental health in rural contexts: one that incorporates an in-depth understanding of the help-seeking attitudes and experiences of rural adolescents as well as an appreciation of the collective social functioning of rural communities.

Objective: This study aims to explore Australian rural adolescents’ experiences of accessing help for a mental health problem in the context of their rural communities.

Design and setting: A qualitative research design was used whereby university students who had sought help for a mental health problem during their adolescence were interviewed about their experiences. Interviews were conducted face-to-face at the university.

Main outcome measures: A semi-structured interview schedule was designed around the study’s main research questions. Audio-taped interviews were transcribed and thematically coded using a constant comparative method.

Participants: Participants were first-year undergraduate psychology students between the ages of 17 and 21 years who sought help for a mental health issue during their adolescence and who at that time resided in a rural area.

Results: Participants highlighted various barriers to seeking help for mental health problems in the context of a rural community, including: social visibility, lack of anonymity, a culture of self-reliance, and social stigma of mental illness. Participants’ access to help was primarily school-based, and participants expressed a preference for supportive counselling over structured interventions. Characteristics of school-based helpers that made them approachable included: ‘caring’, ‘nonjudgemental’, ‘genuine’, ‘young’, and able to maintain confidentiality.

Conclusions: The findings support previous research that reveals barriers to help seeking for mental health problems that are unique to the culture of rural communities. The study raises questions about the merit of delivery of primary mental health care to young people via GPs alone and suggests that school-based counsellors be considered as the first step in a young person’s access to mental health care.

The mental health of adolescents living in rural Australia has received little research attention.  In this article, the extant literature on rural adolescent mental health in Australia is reviewed.  Given the lack of literature on this topic, the review is centered on a vignette presented at the beginning of the article.  The case represented by the vignette is that of a young Australian growing up in a rural area.  The issues raised - including the nature of mental health issues for rural adolescents and barriers to seeking profession help - are then discussed in terms of the available literature.  The article concludes with a future focus for research efforts in the area of rural adolescent mental health.