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Effectiveness of interventions to promote help-seeking for mental health problems: systematic review and meta-analysis

Published online by Cambridge University Press:  01 June 2018

Ziyan Xu ,
Fangfang Huang ,
Markus Kösters ,
Tobias Staiger ,
Thomas Becker ,
Graham Thornicroft  and
Nicolas Rüsch
Ziyan Xu
Affiliation:
Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
Fangfang Huang
Affiliation:
Medical College, Henan University of Science and Technology, Henan, China
Markus Kösters
Affiliation:
Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
Tobias Staiger
Affiliation:
Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
Thomas Becker
Affiliation:
Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
Graham Thornicroft
Affiliation:
Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
Nicolas Rüsch*
Affiliation:
Department of Psychiatry II, University of Ulm and BKH Günzburg, Ulm, Germany
*
Author for correspondence: Nicolas Rüsch, E-mail: nicolas.ruesch@uni-ulm.de
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Abstract

Help-seeking is important to access appropriate care and improve mental health. However, individuals often delay or avoid seeking help for mental health problems. Interventions to improve help-seeking have been developed, but their effectiveness is unclear. A systematic review and meta-analysis were therefore conducted to examine the effectiveness of mental health related help-seeking interventions. Nine databases in English, German and Chinese were searched for randomised and non-randomised controlled trials. Effect sizes were calculated for attitudes, intentions and behaviours to seek formal, informal and self-help. Ninety-eight studies with 69 208 participants were included. Interventions yielded significant short-term benefits in terms of formal help-seeking, self-help, as well as mental health literacy and personal stigma. There were also positive long-term effects on formal help-seeking behaviours. The most common intervention types were strategies to increase mental health literacy, destigmatisation (both had positive short-term effects on formal help-seeking behaviours) as well as motivational enhancement (with positive long-term effects on formal help-seeking behaviours). Interventions improved formal help-seeking behaviours if delivered to people with or at risk of mental health problems, but not among children, adolescents or the general public. There was no evidence that interventions increased the use of informal help. Few studies were conducted in low- and middle-income countries (LMICs). This study provides evidence for the effectiveness of help-seeking interventions in terms of improving attitudes, intentions and behaviours to seek formal help for mental health problems among adults. Future research should develop effective interventions to improve informal help-seeking, for specific target groups and in LMICs settings.

Keywords

Help-seekingmental healthmental health literacyservice usestigma
Type
Review Article
Information
Psychological Medicine , Volume 48 , Issue 16 , December 2018 , pp. 2658 - 2667
Copyright
Copyright © Cambridge University Press 2018 

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Footnotes

*

These authors contributed equally to this paper.

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