Predictors of Mental Health Service Use by Young Adults: A Systematic Review

Abstract

Objective: The purpose of this review was to systematically evaluate the available heterogeneous research examining determinants of mental health service use among young adults.Methods: Nine electronic databases were searched to identify quantitative studies examining sociodemographic and psychological variables predictive of or associated with mental health service use. Included studies were examined against the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Effect size estimates in the form of odds ratios were calculated and classified according to predisposing, enabling, and need factors, consistent with Andersen's behavioral model of health care.Results: Eighteen studies met all of the inclusion criteria (N=96,297 participants). Studies generally followed the STROBE recommendations for external validity, although limitations in internal validity were noted. Prior service contact and being homosexual or bisexual, female, or Caucasian were predisposing factors significantly associated with mental health service use. Social support was the single enabling factor identified, although this finding was based on limited data. In relation to need, young adults who reported higher perceived need for professional help or more mental health difficulties were more likely to have utilized services.Conclusions: This review identified subgroups of young adults who are less likely to access mental health support. Future research should focus on developing psychoeducational interventions targeted at young men and racial-ethnic minority groups, in addition to informing young adults of the success of mental health counseling in the absence of a diagnosis.

Filipino help-seeking for mental health problems and associated barriers and facilitators: a systematic review

“…Prominent facilitator themes in help-seeking In terms of enablers of psychological help-seeking, only a few facilitators were mentioned in the studies, which supported findings in other studies asserting that factors that promote help-seeking are less often emphasized [42,51].…”

“…The presence of friends and family can discourage Filipinos from seeking professional help because their social support serves as protective factor that buffer one’s experience of distress [ 77 , 78 ]. Consequently, individuals are less likely to use professional services [ 42 , 79 ]. On the contrary, other studies have found that the presence of friends and family who have positive attitudes towards formal help-seeking can promote the utilization of mental health services [ 8 , 80 ].…”

“…The actual help-seeking behavior of both local and overseas Filipinos recorded at 10.72% (n = 461) is lower than the 19% of the general population in the US [36] and 16% in the United Kingdom (UK) [37], and even far below the global prevalence rate of 30% of people with mental illness receiving treatment [38]. This finding is also comparable with the low prevalence rate of mental health service use among the Chinese population in Hong Kong [39] and in Australia [35], Vietnamese immigrants in Canada [30], East Asian migrants in North America [41] and other ethnic minorities [42] but is in sharp contrast with the increased use of professional help among West African migrants in The Netherlands [43]. Most of the studies identified informal help through family and friends as the most widely utilized source of support, while professional service providers were only used as a last resort.…”

Factors associated with health service utilisation for common mental disorders: a systematic review

“…Other related reviews have been restricted to young adults [ 98 ] or to one country only [ 99 ]. While the results reported here are broadly consistent with the findings of these reviews, this study extends previous research by (a) comparing results across settings; (b) including only population-based studies to ensure the generalisability of findings; (c) examining a set of symptoms that typically present together in community settings, making the results a stronger basis for informing interventions at the population level; and (d) separating service utilisation by adults from that of children or adolescents, since in many countries services are delivered separately for these two groups, and decisions regarding treatment-seeking may follow different paths for minors (defined here as those aged under 18).…”

Predicting disclosure and help-seeking in university students with psychosocial problems based on stigma and attitudes towards disclosure and help-seeking

“…However, later studies suggested that traditionally emphasized barriers such as stigma 'clearly are not the entire story' and that it is possible that stigma takes more subtle forms, like self-stigma within university, which asks for a closer look in future research [16,19]. More recent studies demonstrated that not stigma, but intention to seek help was the most influential predictor of the utilization of mental health services [17,36]. Although our results do not support this finding directly, they did point in the same direction: help-seeking was predicted by attitudes to disclose, which are preceded by intentions.…”