The purpose of the current study was to combine the factors previously determined to be related to African American help seeking into a single path model and, using structural equation modeling (SEM), determine the relative influence of each factor in the attitudes toward seeking mental health services (see Figure 2.2) among a community sample of African American adults from several metropolitan areas in the US. As such, SEM was utilized to compare the relative fit of two opposing models within this sample, one where a path from economic barriers to help-seeking attitudes was estimated freely and one where that path was constrained. Many have argued that for African Americans, economic constraints are barriers to seeking help. While existing literature fails to consistently support this contention, the current study does suggest that social status does carry significant weight in predicting attitudes toward seeking mental health services. Acculturation was not as strong of a predictor. Limitations , including the use of an abbreviated help-seeking scale, were discussed. In addition, implications for African Americans seeking services were also discussed.

The purpose of this study was to determine the extent to which women seeking services of a shelter for battered women in the Southwestern United States were similar to the existing picture of battered women. Supplemental questions were asked concerning the effects of substance abuse, marital status, and child abuse. Information was gathered from records of a sample of 100 women who sought shelter between September 1984 and August 1987. Results were compared with previous studies by Gayford (1975), Giles-Sims (1983), and Walker. Results suggested women in this study were similar to battered women who had been studied previously. No significant relationship was found between the use of drugs and/or alcohol and the type of abuse a woman experienced, between marital status and employment status, nor between the occurrence of child abuse and a woman's willingness to involve the police. Implications and recommendations for future research were presented.

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OBJECTIVE: The current study explored the applicability of the social norms approach to a new domain of study: psychological help-seeking. A number of questions that must be answered to determine whether the social norms model can be applied effectively to the help-seeking domain guided the study. METHOD: Data were collected from freshmen at five colleges and universities in the Mid-Atlantic region (N = 3021) during freshman orientation week. The study used a cross sectional design to examine personal attitudes and behaviors related to help-seeking as well as perceptions about others’ attitudes and behaviors related to help-seeking. RESULTS: Most participants reported that they were willing to seek help and viewed seeking help as a personal strength rather than personal weakness. However, discrepancies between “reality” and perception indicate that most freshmen in this sample misperceived reality. Most participants underestimated the extent to which peers are accepting of seeking psychological help and most participants were not accurate in their perceptions of peer help seeking behaviors. This misperception significantly influenced personal willingness to seek help. CONCLUSIONS: The data indicate that the social norms method of intervention is applicable to the domain of help seeking and efforts to reduce stigma. Implications, next steps for future research, and limitations of the current study are discussed.

This study was conducted with fourteen participants who lived in a rural Virginia community. The focus of the study was exploration of the nature of the experience of depression and of help-seeking for depression in one rural woman and in her community social network. The need for exploration of the community social network was influenced by the DeFacto Services Model of Rural Mental Health, which emphasized the influence of community factors in making decisions to seek mental health care. Findings of the study included the following themes, which related to the nature of depression: 1) linkage of experiential depression to diagnostic criteria; 2) overcoming depression using willpower; 3) connection of depression to abuse and violence, and 4) masking the inner world of depression. The following themes related to the nature of help-seeking emerged from the data: 1) family role in help-seeking; 2) insider/outsider status impact on help-seeking; 3) role of family and work functioning in help-seeking, and 4) role of informal and formal networks in help-seeking. Tentative conclusions were reached based on the findings that suggest depression and help-seeking may be experienced in distinctive ways by rural dwelling women in this particular community. Further research was suggested as a way of understanding more about how rural women seek help for depression within the context of their own community social networks.

Thesis advisor: Judith Shindul-Rothschild PhD, MSN, RN / The issue of mental health awareness has been a familiar topic of concern in recent years, due to increasing incidence of suicide, PTSD, anxiety disorders, and other behavioral illnesses. Patient populations impacted by mental illness are diverse and research has focused on the recognition of symptoms and the treatment. Less research has investigated the barriers that hinder access to mental health services and the early identification of individuals who need mental health assistance. The specific aim of this study is to evaluate how the stigma of mental illness, both perceived and personal, may affect the willingness of college students to obtain behavioral health care. Based upon the findings, recommendations for improving access to mental health services on a college campus will be proposed. / Thesis (BS) — Boston College, 2017. / Discipline: Nursing.

There is no research on the assessment or treatment of help-seeking behaviors for individuals with acquired brain injury (ABI). The current study evaluated the efficacy of a group treatment protocol, NICE (Noticing you have a problem, Identifying the information you need for help, Compensatory strategies, Evaluating progress), to train help-seeking for adults with ABI when lost. Theoretical and treatment components from two empirically validated interventions that target social problem solving and social competence were adapted to develop the NICE group treatment protocol. A single subject modified variant of a nonconcurrent and multiple probe multiple baseline across participant cohort design was used to examine sensitivity to treatment effects for seven persons with ABI. The overall findings suggest that the NICE group treatment has potential to improve help-seeking when wayfinding. This dissertation supports further investigation of the NICE group treatment to train help-seeking skills.

Introduction: This multiphase qualitative study explored the understanding of middle-aged women’s sexuality and sexual difficulties and the way they address these difficulties. Nurses’ and midwives’ role in sexuality-related care was also explored. The need to address the subject was triggered by the multidimensional nature of female sexuality that could not be limited to one single definition; the medicalisation of female sexual problems that is based on the standards of sexual function and dysfunction; the scarcity of research that reflects on women’s subjective views on sexuality and sexual difficulties and the way they address these difficulties. This is particularly crucial at the middle-age where women undergo hormonal and psychosocial changes that may affect their sexual life. Methods: Interviews and focus group discussions were used to capture the narratives of 52 middle-aged women of 40-55 years in phases one and two of the study. They were chosen purposively by education and menopausal status from clinical and non-clinical settings regardless of their marital status and sexual orientation. Additionnally, a sample of 11 nurses and midwives working in the hospital and primary healthcare centres participated in two focus group discussions. Results: Women’s narratives led to a comprehensive understanding of sexuality and sexual problems and the implications for help-seeking. Findings showed how women’s interpretation of sexuality resonates within bio-psychosocial and cultural perspectives driven by double standards and inhibiting sexual socialisation. Women’s sexuality is ‘muted’, conflicting between frustrating experiences, personal expectations and the perception of sexual selves as affected by the middle-age and social myths. Yet, sexuality is central to women’s life where they tend to play a sacrificing role and gain agency. Their sexual difficulties are multifaceted mirroring their inhibitions, relational conflicts, husbands’ sexual problems and contextual burdens. Women would firstly rely on their husbands to discuss together their common sexual issues as nobody can understand their needs more than both of them. In parallel, the gynaecologist is reportedly the first one they consult as they are familiar with him/her. Yet, some do not know who else to turn to for help. Women highlighted many personal, relational and contextual barriers to help-seeking focusing on their husbands’ negative attitude. They also criticised the services offered and the lack of resources. Within this context and in focus group discussions, 11 nurses and midwives reflected on their attitude and behaviour towards sexuality-related care. They had opposing views concerning their involvment in the assessment of patients’ sexual health and identified many barriers to having an effective role in the field. Discussion and implications: This study has a unique contribution in voicing women’s views and concerns as sexuality is underreported and poorly researched in Lebanon. Women’s narratives shed light on many aspects of their sexuality, sexual difficulties and the facilitators and barriers to help-seeking focusing on the role of nurses and midwives in this field. This comprehensive perspective that is contextually based has implications on education, clinical practice and research. It is particularly important to provide middle-aged Lebanese women with a culturally sensitive professional assistance to satisfy their sexual life. In addition, the publication of two papers from the study enriches knowledge in the field. It is of note that in this study sexuality and sexual life are interchangeably used. Nevertheless, sexuality has a broader meaning and encompasses all the thoughts, fantasies, desires, beliefs, attitudes, values, behaviour, practices, roles and relationships (WHO, 2006), whereas sexual life is more related to sexual relationships and activities (Segen's Medical Dictionary, 2012).

Within the United States, African Americans account for 13% of the entire population, making them the second largest minority group. A notable concern is the rate at which African Americans fail to utilize both medical and mental health services. Researchers have long examined possible factors, such as stigmas, barriers, and accessibility, as reasons why African Americans underutilize psychological help. Overlooked is the potential influence of adverse childhood experiences (ACE). The term ACE encompasses ten major domains, ranging from emotional abuse to parental divorce/separation, all of which have been found to negatively influence individuals’ well-being. As such, this study examined the association between African American women’s adverse childhood experiences and help seeking attitudes. Data for this study were gathered from 64 African American female college students. Adverse childhood experiences were measured with the Traumatic Experiences Checklist (TEC) and help seeking attitudes were assessed with the Attitudes Toward Seeking Professional Psychological Help-Short Form (ATSPPH-SF). Results demonstrated scores reflecting childhood traumatic events for violence, death, and legal involvement were negatively related to attitudes toward help seeking. The results of this study highlight the need for continued research regarding ACE for African American women in college settings. Specific implications for this study include outreach development in university counseling centers focused on the association between childhood trauma, violence/legal involvement, and intersectionality. Programming of this nature may provide a critical link to increase this population’s utilization of mental health services. Keywords: African American women, ACE, help seeking

This study seeks to understand the perceptions of African American parents on preventive family therapy and their help-seeking behaviors. Specifically, this study aims to identify the factors that influence African American families in engaging in preventive family therapy and the barriers to accessing treatment. The data was collected through two group interviews that consisted of a total of 11 African American parents residing in Riverside County and San Bernardino County. The findings indicate that: (a) African American parents sought therapy primarily for crisis; (b) Alternatives to therapy were viewed as being just as effective; (c) Barriers to treatment include institutional fear, lack of diversity, and stigmatization; and (d) African Americans held positive views of therapy and individuals who received treatment. These findings highlight the perceptions of an underserved community that is disproportionately represented in child welfare and provides practitioners with strategies to develop effective interventions. Recommendations for future social work practice, policy, and research include continued community outreach and mental health awareness campaigns, partnership with faith-based organizations in developing youth mentoring programs, and the need for research centered on current and former African American child welfare clients.