Investigating institutional abuse survivors’ help-seeking attitudes with the Inventory of Attitudes towards Seeking Mental Health Services

Abstract

Background: Although effective treatments exist, many trauma survivors delay or avoid professional help. Attitudes towards help-seeking are associated with intentions to and actual treatment use, but were neglected in research on trauma survivors so far. Objective: This study aimed to investigate the reliability, construct validity, and predictive power of the Inventory of Attitudes towards Seeking Mental Health Services (IASMHS) and to investigate attitudes of adult institutional abuse survivors. Method: A total of 220 adult survivors of institutional abuse were interviewed using IASMHS, the PTSD Checklist for DSM-5 (PCL-5), the Childhood Trauma Questionnaire Short-Form (CTQ-SF), the Life Events Checklist (LEC-5), and the depression-subscale of the Brief Symptom Inventory (BSI-18). They were further asked about their current mental health service use. We assessed the fit of different models of IASMHS with confirmatory factor analyses and predicted current mental health service use with a binominal logistic regression model. Results: The three-factor structure of IASMHS provided the best fit. One of the three scales (help-seeking propensity), the PTSD-intrusion scale, and the depression scale significantly contributed to the prediction of current mental health service use. Single items of the psychological openness scale loaded weakly on the according factor. Our sample showed a similar IASMHS profile compared to other samples with mental health problems. Conclusion: Overall, IASMHS appears to be a useful instrument to assess attitudes towards seeking mental health services in trauma survivors. It can be used to investigate help-seeking attitudes and its correlates to better understand and facilitate survivors’ treatment use.

Inventory of Attitudes toward Seeking Mental Health Services: Psychometric Properties among Adolescents

“…The IASMHS was subjected to EFA, validating a three-factor structure, comprised of the following dimensions: help-seeking propensity, indifference to stigma and psychological openness. These results not only corroborated the original study of the inventory (Mackenzie et al 2004) but also the Portuguese study (Fonseca et al 2017) as well as numerous other international studies (e.g., Hyland et al 2014;Kantor et al 2017;Tieu et al 2018).…”

“…The reduction of the scale to 20 items has already been observed in other studies (Tieu et al 2018;Tuliao et al 2019). Regarding the items with limitations, it is observed that these seem to be constant in the literature (Kantor et al 2017;Tieu et al 2018;Tuliao et al 2019) since items 1, 4, 7 and/or 14 have frequently been shown to be problematic and item 23 has often revealed factor loading problems.…”

“…Help-seeking propensity, along with PTSD-intrusions and depression, contributed to the prediction of current use of mental health services. The inventory revealed satisfactory reliability (total scale: α = 0.84; psychological openness: α = 0.67; help-seeking propensity: α = 0.80; indifference to stigma: α = 0.77) (Kantor et al 2017).…”

“…In Austria, the tool was used to examine 220 adult survivors of institutional abuse (40.0% female; M age = 57.9; SD = 9.55) (Kantor et al 2017). The three-factor model was again revealed as most appropriate; however, some items of the psychological openness dimension loaded weakly on their expected factors (items 1, 4, 7, and 14) and item 23 loaded poorly on its expected factor (indifference to stigma).…”

The potential impact of an anti-stigma intervention on mental health help-seeking attitudes among university students

“…The IASMHS was selected as it was designed to be a multifactorial, theoretically-based attitude inventory grounded in the TPB. The three-factor model of the IASMHS was validated in two studies which employed different samples [ 30 , 31 ] but has not been validated in Singapore. The internal consistency of the Psychological Openness, Help-seeking Propensity, and Indifference to Stigma subscales at pre-intervention were moderate to high, with Cronbach α values of 0.67, 0.70, and 0.81 respectively, comparable to that found among college students in Taiwan [ 32 ].…”