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      Seeking help for depression from family and friends: A qualitative analysis of perceived advantages and disadvantages

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      BMC Psychiatry
      BioMed Central

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          Abstract

          Background

          People with depression often seek help from family and friends and public health campaigns frequently encourage such help seeking behaviours. However, there has been little systematically collected empirical data concerning the effects of such informal help seeking. The current study sought to investigate the views of consumers about the advantages and disadvantages of seeking support from family and friends for depression.

          Methods

          Participants were the subset of 417 respondents to a survey, sent to 7000 randomly selected members of an Australian electoral community, who indicated that they had sought help for depression from family or friends. One item on the survey asked participants to indicate the advantages or disadvantages of seeking help from family or friends. A coding system was developed based on a content analysis of the responses to the item. Each of the responses was then coded by two raters.

          Results

          Respondents identified both advantages and disadvantages of seeking support from friends. The most commonly cited advantage was social support (n = 282) including emotional support (n = 154), informational support (n = 93), companionship support (n = 36) and instrumental support (n = 23). Other advantages related to family's or friend's background knowledge of the person and their circumstances (n = 72), the opportunity to offload the burden associated with depression (n = 62), the personal attributes of family and friends (n = 49), their accessibility (n = 36), and the opportunity to educate family and friends and increase their awareness about the respondent's depression (n = 30). The most commonly cited disadvantages were stigma (n = 53), inappropriate support (n = 45), the family member's lack of knowledge, training and expertise (n = 32) and the adverse impact of the help seeking on the family/friend (n = 20) and the relationship (n = 18).

          Conclusions

          Family and friends are well placed to provide support which consumers perceive to be positive and which can assist them in obtaining formal mental health treatment. However, the input of some family members may be unhelpful or toxic. There may be benefits in undertaking community education and destigmatisation programs which target carers.

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          Most cited references24

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          Stress, social support, and the buffering hypothesis.

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            Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression: randomised controlled trial.

            Little is known about the efficacy of educational interventions for reducing the stigma associated with depression. To investigate the effects on stigma of two internet depression sites. A sample of 525 individuals with elevated scores on a depression assessment scale were randomly allocated to a depression information website (BluePages), a cognitive-behavioural skills training website (MoodGYM) or an attention control condition. Personal stigma (personal stigmatising attitudes to depression) and perceived stigma (perception of what most other people believe) were assessed before and after the intervention. Relative to the control, the internet sites significantly reduced personal stigma, although the effects were small. BluePages had no effect on perceived stigma and MoodGYM was associated with an increase in perceived stigma relative to the control. Changes in stigma were not mediated by changes in depression, depression literacy or cognitive-behavioural therapy literacy. The internet warrants further investigation as a means of delivering stigma reduction programmes for depression.
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              Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication.

              An understudied crucial step in the help-seeking process is making prompt initial contact with a treatment provider after first onset of a mental disorder. To provide data on patterns and predictors of failure and delay in making initial treatment contact after first onset of a mental disorder in the United States from the recently completed National Comorbidity Survey Replication. Nationally representative face-to-face household survey carried out between February 2001 and April 2003. A total of 9282 respondents aged 18 years and older. Lifetime DSM-IV disorders were assessed with the World Mental Health (WMH) Survey Initiative version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI), a fully structured interview designed to be administered by trained lay interviewers. Information about age of first professional treatment contact for each lifetime DSM-IV/WMH-CIDI disorder assessed in the survey was collected and compared with age at onset of the disorder to study typical duration of delay. Cumulative lifetime probability curves show that the vast majority of people with lifetime disorders eventually make treatment contact, although more so for mood (88.1%-94.2%) disorders than for anxiety (27.3%-95.3%), impulse control (33.9%-51.8%), or substance (52.7%-76.9%) disorders. Delay among those who eventually make treatment contact ranges from 6 to 8 years for mood disorders and 9 to 23 years for anxiety disorders. Failure to make initial treatment contact and delay among those who eventually make treatment contact are both associated with early age of onset, being in an older cohort, and a number of socio-demographic characteristics (male, married, poorly educated, racial/ethnic minority). Failure to make prompt initial treatment contact is a pervasive aspect of unmet need for mental health care in the United States. Interventions to speed initial treatment contact are likely to reduce the burdens and hazards of untreated mental disorder.
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                Author and article information

                Journal
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central
                1471-244X
                2011
                15 December 2011
                : 11
                : 196
                Affiliations
                [1 ]Centre for Mental Health Research, The Australian National University, Acton, Canberra, ACT, 0200, Australia
                [2 ]Directorate of Mental Health, Department of Defence, CP2-7-043A, Canberra, ACT, 0200, Australia
                Article
                1471-244X-11-196
                10.1186/1471-244X-11-196
                3271042
                22171567
                05225a6f-6bcd-4b45-9924-feac18ead3bd
                Copyright ©2011 Griffiths et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 October 2010
                : 15 December 2011
                Categories
                Research Article

                Clinical Psychology & Psychiatry
                Clinical Psychology & Psychiatry

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