De-restricted 15/11/2013

Mental health challenges among Canadian post-secondary students have been on a steep upward trend in recent years, exacerbated by the COVID-19 pandemic. Yet, many students do not reach out to the mental health services available to them. To lessen or remove actual and perceived barriers, research has been exploring how to predict their intentions to seek help for their personal mental health challenges. Much of this work applies the widely used Theory of Planned Behaviour (TPB; Fishbein & Ajzen, 1980) which posits that behavioural intentions are best predicted by attitudes toward the behaviour; perceived normative expectations; and perceived behavioural control. Though the theory also posits that beliefs underlie and are formative of these three predictors, studies have largely neglected their measurement. This is problematic as it deviates from the TPB and frustrates efforts toward the development of interventions to enhance behaviours towards seeking help for mental health challenges. If they are to be effective, such interventions must be directed at changing salient beliefs. This research addresses this gap through a mixed-method sequential design. It provides a unique and valuable contribution to scholarship and practice by identifying and examining the role of students’ attitudinal, normative, and control beliefs with respect to their intentions to seek help. This is examined separately and together with the more traditionally studied direct predictors of attitudes, subjective norms, and perceived behavioural control (i.e., the formative constructs defined by the beliefs). Students relied on six salient beliefs concerning their intentions to seek mental health help: two behavioural, two normative, and two control beliefs. Student attitudes, subjective norms, and PBC mediated the links between salient beliefs and intentions, with PBC being the strongest predictor of intentions to help-seek. The findings help inform interventions to change the beliefs most associated with low intentions to get mental health support. / Thesis / Doctor of Philosophy (PhD) / This dissertation aims to advance the understanding of student intentions or—lack thereof—to seek mental health help following the onset of COVID-19. Salient beliefs that underlie student attitudes, subjective norms and perceived behavioural control are examined, using a Theory of Planned Behaviour approach. The research provides valuable theoretical and practical contribution. It identifies the beliefs held by post-secondary students post COVID-19, which can inform interventions intended to increase mental health service use. In Phase 1 of this study, students’ salient beliefs were examined through survey and interview methods. In Phase 2, I assessed these beliefs as direct predictors of their attitudes, subjective norms, perceived behaviour control, and as indirect predictors of mental health help-seeking intentions. Six beliefs were identified as relevant to student intentions to seek help, and findings lend support for the applied and scholarly value of the TPB to this area of study.

Intimate partner violence (IPV) is experienced by millions of women in the U.S. every year. As the population of Hispanic women continues to grow, there is more attention to the unique experience of these women and the factors that disproportionately affect this population when they experience IPV. The objective of this study was to identify the help-seeking behaviors and barriers to help-seeking in Hispanic survivors of IPV. The last published systematic review on this topic was in 2011, showing a gap in our understanding of the prevalent barriers affecting these Hispanic women over the last decade. To assess the current knowledge on this topic, a systematic literature review was conducted using the University of Central Florida's PRIMO database to find research on help-seeking among Hispanic women from 2009-2021. From this search, 113 studies were identified and 28 met the inclusion criteria for review based on if the study was peer-reviewed, Hispanic women are the main or sub-focal sample of the study, and help-seeking or barriers to help-seeking were identified. Results showed that Hispanic women use an array of help-seeking strategies (e.g., friends, family, police, social workers), and multiple barriers to help-seeking were identified such as language barriers and cultural standards. The information from this study can be used to assist Hispanic women seeking help after experiencing IPV.

Psykisk ohälsa är ett växande problem bland ungdomar i Sverige. Ungdomsmottagningar ären av de instanser som ungdomar kan vända sig till för att få hjälp och stöd gällande blandannat psykisk ohälsa. Bemötande i sig har en stor påverkan på den hjälpsökande och kan varaavgörande för huruvida denne är benägen att söka hjälp senare i livet. Forskning visar attunga personer som har erfarenheter av negativt bemötande av att söka hjälp tar med sig denerfarenheten genom livet det och kan leda till att den unge inte söker hjälp igen. Studiensempiri har sin grund i sex semistrukturerade intervjuer med ungdomar som tidigare sökt hjälpför psykisk ohälsa på Ungdomsmottagningen. Det empiriska materialet visade att det fannsdelade erfarenheter gällande bemötandet på Ungdomsmottagningen. Av de respondenter somupplevde kontakten som positiv har många uppgett att personalen var lyhörd, tog derasproblematik på allvar och kunde individanpassa stödet. De var också mer benägna att sökahjälp senare i livet jämfört med de respondenter som upplevt kontakten som negativ.Respondenterna som upplevde kontakten som negativ berättade att de kände ett behov av attöverdriva sina symtom, att de inte togs på allvar och att de saknade inflytande i stödet somerbjöds. Resultatet analyserades med hjälp av begreppen stigma, kommunikationsteori ochmakt. / Mental illness is a growing problem amongst adolescents in Sweden. Ungdomsmottagningenis one of the instances that young people can turn to in order to receive help and support with,amongst other things, their mental health concerns. The interaction with staff has a big impacton whether or not they are willing to seek help later in life. Research shows that adolescentswith negative experiences of the interaction with professionals are especially vulnerable tonot seeking help again later in life. This study is based on six semi-structured interviews withadolescents who have received help and support via Ungdomsmottagningen. The empiricaldata shows that there are different experiences about the treatment received atUngdomsmottagningen. The participants who described the interaction as positive, alsodescribed the staff as being perceptive, and that they acknowledged the youths problems anddescriptions. These participants were also more prone to seek support later compared tothose who had a bad experience. Among the interviewed who had a bad experience with thestaff interaction mentioned that they felt a need to exaggerate their symptoms, that they werenot taken seriously and had a lack of influence in the care they received. The results wereanalyzed using theories such as stigma, communication theory and power.

Background: The Syrian refugee crisis is one of the most significant humanitarian crises of our time and has resulted in over 6.5 million displaced individuals worldwide. Syrian refugees are a vulnerable population and are at considerably higher risk for mental health disorders including depression, anxiety, and post-traumatic stress disorder. However, despite the high prevalence, there is insufficient utilization of mental health services among Syrian refugees resettled in high-income countries. To help address this gap this study aims to investigate mental health conceptualization, coping, and help-seeking among Syrian refugee parents resettled in Canada to build a comprehensive understanding of the factors influencing perception and the decisions to seek help, thus adding to the knowledge base for refugee mental health and generating insight to help inform policy and program decisions for Syrian refugees resettled in Canada. Methods: Data was collected using semi-structured interviews with Syrian refugee parents (N=31) who have been permanently resettled in Canada. Interviews were conducted in Arabic and transcribed verbatim and were subsequently translated into English. Thematic analysis was used to analyze the data. Results Significant interlinkages were observed between the factors that influence mental health conceptualization, coping, and help-seeking. Our findings suggest that many refugees perceive mental health concerns as part of daily life and do not believe it requires professional intervention. This along with personal, cultural, and religious context have strong implications for help-seeking behaviour. Moreover, the availability of culturally sensitive services has the potential to increase service utilization. Knowledge of how individuals conceptualize mental health and cope can be leveraged to design more impactful mental health services for Syrian refugees. Conclusion: The factors influencing mental health conceptualization, coping, and help-seeking are deeply interconnected and must be considered holistically to improve policies and programming to increase the uptake of mental health services. / Thesis / Master of Health Sciences (MSc)

Mental health stigma among military service members has been recognized as a significant barrier to mental health treatment as researchers (Greenberg, Langston, & Gould, 2007; Greene-Shortridge, Britt, & Castro, 2007; Hoge et al., 2004; Pietrzak, Johnson, Goldstein, Malley, & Southwick, 2009) have concluded that military service members are reluctant to engage in help seeking behaviors to avoid negative labeling in the form of stereotyping. Additionally, links have been made between leadership and stigma, acknowledging that military service members are more likely to seek mental health treatment if they perceive that their leadership is supportive (Britt, Wright, & Moore, 2012; Hoge et al., 2004; Wright et al., 2009). Each of the aforementioned authors has advocated for an increased attention on those military service members with mental health issues by offering new programs and providing leadership support. The military has attempted to address both of these suggestions with the introduction of resilience training and increased screening for mental health issues. Unfortunately, despite such interventions, prevalence rates for diagnoses such as PTSD remain at high levels. A reason for this may be due to a lack of attention to the origins of the messages that future leaders receive regarding mental health. The purpose of this study was to investigate the thoughts, feelings, and beliefs of US Army ROTC students and the possible presence of mental health stigma at their level of military involvement (i.e. pre-commission). The author sought to understand how biases against mental health are formed at one of the earliest points of cultural indoctrination within the military structure. This dissertation will contain an overview of the identified mental health beliefs of US Army ROTC students at a large southern university. How these beliefs relate to mental health stigma and help seeking behaviors will also be explored.

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