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Background. Help-seeking is a concept of growing interest in the context of psychosis and the move towards early intervention and community-based service models. Despite a preponderance of first episode studies in this field, help-seeking is also of clinical relevance to adults with more chronic psychosis in the face of spiralling patterns of relapse and diminished recovery. Recent research into attachment theory opens up new avenues for exploring aspects of relating in psychosis, including help-seeking in mental health service contexts. Methods. A systematic review of attachment and psychosis was carried out to critically assess the strength and nature of empirical support for this theory within a clinical context. A social-constructivist based grounded theory study of help-seeking and chronic psychosis was conducted amongst nine individuals in a long term rehabilitation service. This aimed to develop an experiential account and grounded theory of the processes shaping help-seeking for this clinical group. Study findings were reviewed against existing constructs of attachment style, service attachment, recovery style and beliefs about psychosis. Results. A grounded theory emerged from the study emphasising the importance of three domains; ‘beliefs about the self’, ‘beliefs about others’ and ‘service experience’, in dynamically shaping views to help-seeking and receiving, for those with chronic psychosis. Attachment theory and recovery coping style were seen as compatible with this model. Conclusions. Individuals with chronic psychosis may continue to experience difficulties with help-seeking and service engagement, even within supported service settings. An appreciation of the interpersonal significance of service interactions, and improved understanding in this area, may help services better anticipate, respond to and adjust their models of engaging for this important clinical group.

published_or_final_version / Social Work / Master / Master of Social Work

INTRODUCTION Since the expansion of the EU, several hundred thousand people from Eastern European countries have migrated to the UK, the majority of whom are Polish. Although no studies examining utilisation of mental health services by Polish workers in the UK could be found, research suggests that their knowledge of how to access health services is low, while rates of emergency psychiatric treatment are relatively high. The broader migrant literature suggests that migrants can perceive a cultural mismatch between themselves and services, find it difficult to access services due to logistical barriers, and often prefer to seek help from other sources. The current study sought to explore Polish migrants' responses to distress, with a focus on views about accessing psychological services. METHODS A cultural psychology framework using Charmaz's social constructionist method of grounded theory was adopted in the design of the research. Field work was conducted within the Polish community, and semi-structured interviews took place with Polish community members and key informants. Utilising data from a range of sources allowed for triangulation of the data, and credibility was further enhanced by member checking. Data were analysed using guidelines outlined by Charmaz supported by NVivo software. RESULTS AND DISCUSSION Participants' responses to distress were congruent with their sense of identity and the norms of the social groups with which they identified. Polish cultural values emphasising family closeness, traditional gender roles and discomfort with difference influenced participants' help-seeking strategies. The majority of participants preferred to seek help from a close inner circle of family and friends, at least in the first instance. Participants from working class rural backgrounds appeared to adhere more strongly to traditional values and often saw psychological services as irrelevant to them, whereas seeing a therapist was viewed as fashionable for those from urban, middle-class social groups. Disappointment with Scottish primary care services led to reluctance to approach the NHS for help with emotional difficulties, while those who were satisfied with their treatment were open to this possibility. Private services were preferred in Poland, which could result in preferences for seeking help from private Polish therapists in Scotland. This may also allow problems to be contained within the broader Polish community in line with Polish cultural values. CONCLUSIONS Clinical psychology services in Scotland may not be well-placed to meet the needs of Polish migrant workers. NHS services should attempt to be more responsive to the needs of migrant groups in order that they are not discouraged from seeking help if required. Furthermore, it may be helpful to find ways of working with other organisations which migrants feel more comfortable approaching.

Over half of all lifetime mental health disorders emerge during early adulthood and is associated with many adverse outcomes including: lower educational achievement, substance misuse and premature death. Despite the prevalence and burden of mental health problems, young adults with mental health needs are the least likely to seek professional help. This study aimed to gain a better understanding of help-seeking among young adults aged 18-25 and aimed to identify the factors that can delay or prevent access to mental health support. Quantitative and qualitative data was collected from young adults in the community using an anonymous online survey. The results of the study showed that approximately a third of participants did not seek any help for an emotional or mental health difficulty and of those who sought help the majority had accessed help from their friends or their GP. Intention to seek professional help was significantly association with satisfaction from services and perceived stigma, however psychological distress revealed a non-significant relationship. Thematic analysis revealed that stigmatising beliefs, perceiving the problem as not serious, a preference for self-reliance and difficulty in accessing help or communicating concerns were common barrier themes. Facilitator themes highlighted the importance of having a flexible and confidential service. The clinical implications of the results are discussed as well as consideration for future research.

Thesis (Ph. D.)--University of Rhode Island, 2005. / Typescript. Includes bibliographical references (leaves 171-187).

Thesis (M. Soc. Sc.)--University of Hong Kong, 2003.

The purpose of this study was to determine how cognitive, demographic, and motivational factors can be used to understand help-seeking behavior in college students. Specifically, the study examined engagement in Supplemental Instruction (SI) of undergraduate students at Texas A&M University. An additional purpose of the study was to determine the efficacy of SI. The sample for the study was 2,407 undergraduate students who were enrolled in eight randomly selected courses at Texas A&M University in the spring 2004 semester. Students enrolled in multiple course sections were eliminated from the study. The revised sample consisted of 2,297 students. Data collected for all students in the sample included student demographic information, SI attendance and participation, and final course grades. Students were also requested to complete an on-line survey instrument containing a modified version of the Motivated Strategies for Learning Questionnaire (MSLQ) and questions related to parent education and household income. Ultimately, 1,003 students from the revised sample submitted surveysfor a response rate of 43.7%. Based on attendance data and participation ratings, students were classified into three engagement groups for subsequent data analysis: high engagement, low engagement, and non-SI. The following were among the major findings from the study: ?? Hispanic students were significantly more engaged in SI than their White peers. ?? Engagement in SI was inversely related to grade level classification. ?? SI participants had significantly lower mean SAT math and verbal scores than students who did not attend SI. ?? The motivational variables as a set had a statistically significant relationship with SI engagement. ?? Extrinsic motivation, organization, academic self-efficacy, control beliefs, help-seeking, and peer learning were the motivational scales which best predicted SI engagement. ?? Students who were highly engaged in SI had significantly higher mean final course grades than either non-participants or low engagement students even controlling for differences in SAT scores, cumulative grade point average, and motivation. The study helps provide some insight into the dynamics of academic help-seeking. It also contributes to the growing body of evidence which shows that SI is an effective intervention for improving student success in traditionally difficult courses.

Thesis (Ph. D.)--University of Texas at Austin, 2002. / Supervisor: Frank Wicker. Vita. Includes bibliographical references. Also available from UMI.

Major depression is a prevalent and harmful illness in the United States. About 7% of Americans experience depressive symptoms each year. Leaving depression untreated can result in poor general health and increased susceptibility to severe health risks such as suicide. Although there exists a variety of effective treatment methods for depression, the National Health and Nutrition Survey 2005-2006 reports that less than 30% of depressed individuals will be seen by a mental health care professional. It is essential that current efforts work toward encouraging depressed persons to seek treatment. A number of health promotion campaigns for mental health have tried reaching depressed individuals with little success. Created through a series of projects conducted with depressed men and women, Faces of Depression is a messaging strategy campaign that may prove highly effective with this audience. The campaign utilized video and computer program media in health clinic waiting areas to encourage patients with depressive symptoms to seek help from a primary care physician. These forms of media often capture attention; however, they also require many resources that may not be readily available at a health clinic. The purpose of the present study was to determine whether a cost-sensitive poster version of the Faces of Depression campaign would be an effective alternative to the original media. Undergraduate students completed an online survey concerning their willingness to discuss depression with a physician and their reactions to the health poster. Some had previously sought help from a mental health professional (33%), yet few had received treatment for depression (11%). However, 48% of the participants met the criteria for having current depressive symptoms. Although scores for the posters’ visual elements were low, the idea of the poster in a health clinic waiting area was well received by those currently depressed and non-depressed. Moreover, non-depressed persons were likely to indicate that they would seek help in response to the poster if experiencing depressive symptoms. The study is limited by poster design elements. Amendments to these aesthetic details would likely increase poster effectiveness. Future research should ensure that health promotion materials target those currently experiencing symptoms, especially men. / text