Lost in space - an exploration of help-seeking among young people with mental health problems: a constructivist grounded theory study

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Abstract

Background

Mental health problems among young people is a worldwide public health concern. There has been an increase in mental health problems among young people in the Nordic countries in the last 25 years, particularly in Sweden. Despite this increase, international research has repeatedly shown that young people do not access or receive support when encountering mental health problems. The purpose of this study was to explore the process of help-seeking for professional support among young people with mental health problems.

Methods

The study used qualitative constructivist Grounded Theory and open-ended interviews. Thirteen young people between 15 and 23, recruited from two local support clinics, were interviewed.

Results

Lost in space emerged as the core category, capturing aspects of both the experience of self and mental health problems as well as the process of seeking and acquiring help from professional support systems. The study identified several prominent barriers for seeking and acquiring professional help for mental health problems. The young people expressed a lack of knowledge on mental health issues and support services and substantial efforts were made to try to cope with problems on one’s own. Lost in space involved Drifting - trying to make sense of own experiences and struggling to cope with problems, Navigating - searching for help through multiple attempts and contacts and Docking - finding support with something/somebody that feels right.

Conclusions

The theoretical model sheds light on how young people with mental health problems were met with fragmented support services. Society needs to provide encompassing, youth-friendly and flexible support services, so that attempts at help-seeking are not missed.

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Most cited references 23

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Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication.

Ronald C Kessler, Patricia Berglund, Philip Wang … (2005)

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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Subjective health complaints in older adolescents are related to perceived stress, anxiety and gender – a cross-sectional school study in Northern Sweden

Maria Wiklund, Eva-Britt Malmgren-Olsson, Ann Öhman … (2012)

Background Negative trends in adolescent mental and subjective health are a challenge to public health work in Sweden and worldwide. Self-reported mental and subjective health complaints such as pain, sleeping problems, anxiety, and various stress-related problems seem to have increased over time among older adolescents, especially girls. The aim of this study has therefore been to investigate perceived stress, mental and subjective health complaints among older adolescents in Northern Sweden. Methods Data were derived from a cross-sectional school-based survey with a sample consisting of 16–18 year olds (n = 1027), boys and girls, in the first two years of upper secondary school, from different vocational and academic programmes in three public upper secondary schools in a university town in northern Sweden. Prevalence of perceived stress, subjective health complaints, general self-rated health, anxiety, and depression were measured using a questionnaire, including the Hospital Anxiety and Depression Scale (HADS). Results A large proportion of both girls and boys reported health complaints and perceived stress. There was a clear gender difference: two to three times as many girls as boys reported subjective health complaints, such as headache, tiredness and sleeping difficulties and musculoskeletal pain, as well as sadness and anxiety. High pressure and demands from school were experienced by 63.6% of girls and 38.5% of boys. Perceived stress in the form of pressure and demands correlated strongly with reported health complaints (r = 0.71) and anxiety (r = 0.71). Conclusions The results indicate that mental and subjective health complaints are prevalent during adolescence, especially in girls, and furthermore, that perceived stress and demands may be important explanatory factors. Future studies should pay attention to the balance between gender-related demands, perceived control and social support, particularly in the school environment, in order to prevent negative strain and stress-related ill-health. The gender gap in subjective adolescent health needs to be further explored.

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Help-seeking behaviour: a concept analysis.

Geraldine McCarthy, Nicola Cornally (2011)

The concept 'help-seeking behaviour' has gained popularity in recent years as an important vehicle for exploring and understanding patient delay and prompt action across a variety of health conditions. The term is used interchangeably with health seeking and is described as part of both illness behaviour and health behaviour. Concept clarification is required to aid nurses and other health-care professionals understanding of the attributes of help-seeking behaviour and to guide theory development, practice and research. The Walker and Avant method of concept analysis was used to guide the analysis. Help-seeking behaviour was shown to be a complex decision-making process instigated by a problem that challenges personal abilities. According to the literature, the process is characterized by the following attributes: problem focused, intentional action and interpersonal interaction. Help-seeking behaviour for a health problem can therefore be defined as a problem focused, planned behaviour, involving interpersonal interaction with a selected health-care professional. © 2011 Blackwell Publishing Asia Pty Ltd.

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Author and article information

Contributors

Katrin Häggström Westberg:

ORCID: http://orcid.org/0000-0002-1324-558X

Katrin.haggstrom.westberg@affecta.nu

Jens M. Nygren: jens.nygren@hh.se

Maria Nyholm: maria.nyholm@hh.se

Ing-Marie Carlsson: ing-marie.carlsson@hh.se

Petra Svedberg: petra.svedberg@hh.se

Journal

Journal ID (nlm-ta): Arch Public Health

Journal ID (iso-abbrev): Arch Public Health

Title: Archives of Public Health

Publisher: BioMed Central (London )

ISSN (Print): 0778-7367

ISSN (Electronic): 2049-3258

Publication date (Electronic): 7 October 2020

Publication date PMC-release: 7 October 2020

Publication date Collection: 2020

Volume: 78

Electronic Location Identifier: 93

Affiliations

[1 ]GRID grid.73638.39, ISNI 0000 0000 9852 2034, School of Health and Welfare, University of Halmstad, ; 301 18 Halmstad, Sweden

[2 ]Affecta Pscyhiatric Clinic, Sperlingsgatan 5, 302 48 Halmstad, Sweden

Author information

Katrin Häggström Westberg http://orcid.org/0000-0002-1324-558X

Article

Publisher ID: 471

DOI: 10.1186/s13690-020-00471-6

PMC ID: 7542338

PubMed ID: 33042539

SO-VID: a312c1c0-d913-42e5-b802-55ac6ebacc9f

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 1 May 2020

Date accepted : 15 September 2020

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100009777, Region Halland;

Award ID: 68995

Award ID: 723861

Award Recipient : Katrin Häggström Westberg

Funded by: Swedish partnership for mental health (NSPH)

Funded by: Swedish society of nursing

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ScienceOpen disciplines: Public health

Keywords: sweden,mental health,young people,help-seeking,support services,grounded theory

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ScienceOpen disciplines: Public health

Keywords: sweden, mental health, young people, help-seeking, support services, grounded theory

Lost in space - an exploration of help-seeking among young people with mental health problems: a constructivist grounded theory study

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Special series on COVID-19 and Mental Health

Most cited references 23

Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication.

Subjective health complaints in older adolescents are related to perceived stress, anxiety and gender – a cross-sectional school study in Northern Sweden

Help-seeking behaviour: a concept analysis.

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