Skip to main content
Top
Published in: Social Psychiatry and Psychiatric Epidemiology 12/2007

01-12-2007 | ORIGINAL PAPER

Adult and peer involvement in help-seeking for depression in adolescent population

A two-year follow-up in Finland

Authors: Sari Fröjd, MSc, Prof. Mauri Marttunen, MD, DrMedSci, Prof. Mirjami Pelkonen, PhD, Prof. Bettina von der Pahlen, PhD, Riittakerttu Kaltiala-Heino, MD, DrMedSci, BSc

Published in: Social Psychiatry and Psychiatric Epidemiology | Issue 12/2007

Login to get access

Abstract

Help-seeking among adolescents and adults is often perceived as a process involving only the health care system and the individual suffering from psychiatric symptoms. The present study attempted to create a model of help-seeking also including members of adolescents social networks. A prospective follow-up design included a school-based survey on all ninth grade students (mean age 15.5) during the academic year 2002–2003 in two Finnish towns (N = 3,278; response rate 94%); and a follow-up conducted two years later (N = 2,080; response rate 63%). The respondents were assessed for current depression and help-seeking for depression and other mental health problems each time. In the follow-up they were asked if they felt that they need help for depression and if their mother, father, sibling, peers, boy- or girl-friend or teacher had been worried about changes in their mood or behaviour. The associations of perceived need for help, help-seeking behaviour and concerns of different people, with depression at baseline were studied. Stepwise logistic regression models were computed to find the best predictors for help-seeking for depression. One third of the adolescents meeting R-BDI-13 criteria for depression at baseline still perceived a need for help for depression two years later but only a fifth of them had sought professional help. Depression at baseline was significantly associated with concerns about changes in mental health or behaviour among parents and significant others; and the concerns of mother, peers and teacher were among the best predictors of recent help-seeking for depression. To ensure adequate intervention for depressed adolescents without a social network capable of prompting referral, routine screening for depression should be applied in primary health care services and specialized services for adolescents.
Literature
1.
go back to reference Kessler RC, Avenevoli S, Ries Merikangas K (2001) Mood disorders in children and adolescents: an epidemiologic perspective. Biol Psychiatry 49:1002–1014PubMedCrossRef Kessler RC, Avenevoli S, Ries Merikangas K (2001) Mood disorders in children and adolescents: an epidemiologic perspective. Biol Psychiatry 49:1002–1014PubMedCrossRef
2.
go back to reference Rushton JL, Forcier M, Schectman RM (2002) Epidemiology of depressive symptoms in the national longitudinal study of adolescent health. J Am Acad Child Adolesc Psychiatry 41:199–205PubMedCrossRef Rushton JL, Forcier M, Schectman RM (2002) Epidemiology of depressive symptoms in the national longitudinal study of adolescent health. J Am Acad Child Adolesc Psychiatry 41:199–205PubMedCrossRef
3.
go back to reference Costello EJ, Foley DL, Angold A (2006) 10-year research update review: the epidemiology of child and adolescent psychiatric disorders: II. Developmental epidemiology. J Am Acad Child Adolesc Psychiatry 45:8–25PubMedCrossRef Costello EJ, Foley DL, Angold A (2006) 10-year research update review: the epidemiology of child and adolescent psychiatric disorders: II. Developmental epidemiology. J Am Acad Child Adolesc Psychiatry 45:8–25PubMedCrossRef
4.
go back to reference Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry 62:593–602PubMedCrossRef Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry 62:593–602PubMedCrossRef
5.
go back to reference Lewinsohn PM, Rohde P, Seeley JR, Klein DN, Gotlib IH (2000) Natural course of adolescent major depressive disorder in a community sample: predictors of recurrence in young adults. Am J Psychiatry 157:1584–1591PubMedCrossRef Lewinsohn PM, Rohde P, Seeley JR, Klein DN, Gotlib IH (2000) Natural course of adolescent major depressive disorder in a community sample: predictors of recurrence in young adults. Am J Psychiatry 157:1584–1591PubMedCrossRef
6.
go back to reference Fergusson DM, Woodward LJ (2002) Mental health, educational, and social role outcomes of adolescents with depression. Arch Gen Psychiatry 59:225–231PubMedCrossRef Fergusson DM, Woodward LJ (2002) Mental health, educational, and social role outcomes of adolescents with depression. Arch Gen Psychiatry 59:225–231PubMedCrossRef
7.
go back to reference Dunn V, Goodyer IM (2006) Longitudinal investigation into childhood- and adolescence-onset depression: psychiatric outcome in early adulthood. Br J Psychiatry 188:216–222PubMedCrossRef Dunn V, Goodyer IM (2006) Longitudinal investigation into childhood- and adolescence-onset depression: psychiatric outcome in early adulthood. Br J Psychiatry 188:216–222PubMedCrossRef
8.
go back to reference Leaf PJ, Alegria M, Cohen P, Goodman SH, Horwitz SM, Hoven CW, Narrow WE, Vaden-Kiernan M, Regier DA (1996) Mental health service use in the community and schools: results from the four-community MECA study. Methods for the epidemiology of child and adolescent mental disorders study. J Am Acad Child Adolesc Psychiatry 35:889–897PubMedCrossRef Leaf PJ, Alegria M, Cohen P, Goodman SH, Horwitz SM, Hoven CW, Narrow WE, Vaden-Kiernan M, Regier DA (1996) Mental health service use in the community and schools: results from the four-community MECA study. Methods for the epidemiology of child and adolescent mental disorders study. J Am Acad Child Adolesc Psychiatry 35:889–897PubMedCrossRef
9.
go back to reference Sourander A, Helstelä L, Ristkari T, Ikäheimo K, Helenius H, Piha J (2001) Child and adolescent mental health service use in Finland. Soc Psychiatry Psychiatr Epidemiol 36:294–298PubMedCrossRef Sourander A, Helstelä L, Ristkari T, Ikäheimo K, Helenius H, Piha J (2001) Child and adolescent mental health service use in Finland. Soc Psychiatry Psychiatr Epidemiol 36:294–298PubMedCrossRef
10.
go back to reference Zwaanswijk M, Van der Ende J, Verhaak PF, Bensing JM, Verhulst FC (2003) Factors associated with adolescent mental health service need and utilization. J Am Acad Child Adolesc Psychiatry 42:692–700PubMedCrossRef Zwaanswijk M, Van der Ende J, Verhaak PF, Bensing JM, Verhulst FC (2003) Factors associated with adolescent mental health service need and utilization. J Am Acad Child Adolesc Psychiatry 42:692–700PubMedCrossRef
11.
go back to reference Bergeron E, Poirier LR, Fournier L, Roberge P, Barrette G (2005) Determinants of service use among young Canadians with mental disorders. Can J Psychiatry 50:629–636PubMed Bergeron E, Poirier LR, Fournier L, Roberge P, Barrette G (2005) Determinants of service use among young Canadians with mental disorders. Can J Psychiatry 50:629–636PubMed
12.
go back to reference Flament MF, Cohen D, Choquet M, Jeammet P, Ledoux S (2001) Phenomenology, psychosocial correlates, and treatment seeking in major depression and dysthymia of adolescence. J Am Acad Child Adolesc Psychiatry 40:1070–1078PubMedCrossRef Flament MF, Cohen D, Choquet M, Jeammet P, Ledoux S (2001) Phenomenology, psychosocial correlates, and treatment seeking in major depression and dysthymia of adolescence. J Am Acad Child Adolesc Psychiatry 40:1070–1078PubMedCrossRef
13.
go back to reference Essau CA (2005) Frequency and patterns of mental health services utilization among adolescents with anxiety and depressive disorders. Depress Anxiety 22:130–137PubMedCrossRef Essau CA (2005) Frequency and patterns of mental health services utilization among adolescents with anxiety and depressive disorders. Depress Anxiety 22:130–137PubMedCrossRef
14.
go back to reference Lin E, Parikh SV (1999) Sociodemographic, clinical, and attitudinal characteristics of the untreated depressed in Ontario. J Affect Disord 53:153–162PubMedCrossRef Lin E, Parikh SV (1999) Sociodemographic, clinical, and attitudinal characteristics of the untreated depressed in Ontario. J Affect Disord 53:153–162PubMedCrossRef
15.
go back to reference Meadows G, Burgess P, Fossey E, Harvey C (2000) Perceived need for mental health care, findings from the Australian national survey of mental health and well-being. Psychol Med 30:645–656PubMedCrossRef Meadows G, Burgess P, Fossey E, Harvey C (2000) Perceived need for mental health care, findings from the Australian national survey of mental health and well-being. Psychol Med 30:645–656PubMedCrossRef
16.
go back to reference Menna R, Ruck MD (2004) Adolescent help-seeking behaviour: how can we encourage it? Guid Couns 19:176–183 Menna R, Ruck MD (2004) Adolescent help-seeking behaviour: how can we encourage it? Guid Couns 19:176–183
17.
go back to reference Flisher AJ, Kramer RA, Grosser RC, Alegria M, Bird HR, Bourdon KH, Goodman SH, Greenwald S, Horwitz SM, Moore RE, Narrow WE, Hoven CW (1997) Correlates of unmet need for mental health services by children and adolescents. Psychol Med 27:1145–1154PubMedCrossRef Flisher AJ, Kramer RA, Grosser RC, Alegria M, Bird HR, Bourdon KH, Goodman SH, Greenwald S, Horwitz SM, Moore RE, Narrow WE, Hoven CW (1997) Correlates of unmet need for mental health services by children and adolescents. Psychol Med 27:1145–1154PubMedCrossRef
18.
go back to reference Wisdom JP, Clarke GN, Green CA (2006) What teens want: barriers to seeking care for depression. Admin Policy Ment Health Ment Health Serv Res 33:133–145CrossRef Wisdom JP, Clarke GN, Green CA (2006) What teens want: barriers to seeking care for depression. Admin Policy Ment Health Ment Health Serv Res 33:133–145CrossRef
19.
go back to reference Sourander A, Multimaki P, Santalahti P, Parkkola K, Haavisto A, Helenius H, Nikolakaros G, Piha J, Tamminen T, Moilanen I, Kumpulainen K, Aronen ET, Linna SL, Puura K, Almqvist F (2004) Mental health service use among 18-year-old adolescent boys: a prospective 10-year follow-up study. J Am Acad Child Adolesc Psychiatry 43:1250–1258PubMedCrossRef Sourander A, Multimaki P, Santalahti P, Parkkola K, Haavisto A, Helenius H, Nikolakaros G, Piha J, Tamminen T, Moilanen I, Kumpulainen K, Aronen ET, Linna SL, Puura K, Almqvist F (2004) Mental health service use among 18-year-old adolescent boys: a prospective 10-year follow-up study. J Am Acad Child Adolesc Psychiatry 43:1250–1258PubMedCrossRef
20.
go back to reference Teagle SE (2002) Parental problem recognition and child mental health service use. Ment Health Serv Res 4:257–266PubMedCrossRef Teagle SE (2002) Parental problem recognition and child mental health service use. Ment Health Serv Res 4:257–266PubMedCrossRef
21.
go back to reference Verhulst FC, van der Ende J (1997) Factors associated with child mental health service use in the community. J Am Acad Child Adolesc Psychiatry 36:901PubMedCrossRef Verhulst FC, van der Ende J (1997) Factors associated with child mental health service use in the community. J Am Acad Child Adolesc Psychiatry 36:901PubMedCrossRef
22.
go back to reference Laitinen-Krispijn S, Van der Ende J, Wierdsma AI, Verhulst FC (1999) Predicting adolescent mental health service use in a prospective record-linkage study. J Am Acad Child Adolesc Psychiatry 38:1073–1080PubMedCrossRef Laitinen-Krispijn S, Van der Ende J, Wierdsma AI, Verhulst FC (1999) Predicting adolescent mental health service use in a prospective record-linkage study. J Am Acad Child Adolesc Psychiatry 38:1073–1080PubMedCrossRef
23.
go back to reference Pihlakoski L, Aromaa M, Sourander A, Rautava P, Helenius H, SillanpAA M (2004) Use of and need for professional help for emotional and behavioral problems among preadolescents: a prospective cohort study of 3- to 12-year-old children. J Am Acad Child Adolesc Psychiatry 43:974–983PubMedCrossRef Pihlakoski L, Aromaa M, Sourander A, Rautava P, Helenius H, SillanpAA M (2004) Use of and need for professional help for emotional and behavioral problems among preadolescents: a prospective cohort study of 3- to 12-year-old children. J Am Acad Child Adolesc Psychiatry 43:974–983PubMedCrossRef
24.
go back to reference Cuffe SP, Waller JL, Addy CL, McKeown RE, Jackson KL, Moloo J, Garrison CZ (2001) A longitudinal study of adolescent mental health service use. J Behav Health Serv Res 28:1PubMedCrossRef Cuffe SP, Waller JL, Addy CL, McKeown RE, Jackson KL, Moloo J, Garrison CZ (2001) A longitudinal study of adolescent mental health service use. J Behav Health Serv Res 28:1PubMedCrossRef
25.
go back to reference Ciarrochi J, Wilson CJ, Deane FP, Rickwood D (2003) Do difficulties with emotions inhibit help-seeking in adolescence? The role of age and emotional competence in predicting help-seeking intentions. Counsell Psychol Quart 16:103CrossRef Ciarrochi J, Wilson CJ, Deane FP, Rickwood D (2003) Do difficulties with emotions inhibit help-seeking in adolescence? The role of age and emotional competence in predicting help-seeking intentions. Counsell Psychol Quart 16:103CrossRef
26.
go back to reference Schonert-Reichl KA, Muller JR (1996) Correlates of help-seeking in adolescence. J Youth Adolesc 25:705–731CrossRef Schonert-Reichl KA, Muller JR (1996) Correlates of help-seeking in adolescence. J Youth Adolesc 25:705–731CrossRef
27.
go back to reference Helsen M, Vollebergh W, Meeus W (2000) Social support from parents and friends and emotional problems in adolescence. J Youth Adolesc 29:319–335CrossRef Helsen M, Vollebergh W, Meeus W (2000) Social support from parents and friends and emotional problems in adolescence. J Youth Adolesc 29:319–335CrossRef
28.
go back to reference Frojd S, Marttunen M, Pelkonen M, von der Pahlen B, Kaltiala-Heino R (2006) Perceived financial difficulties and maladjustment outcomes in adolescence. Eur J Pub Health 16:542–548CrossRef Frojd S, Marttunen M, Pelkonen M, von der Pahlen B, Kaltiala-Heino R (2006) Perceived financial difficulties and maladjustment outcomes in adolescence. Eur J Pub Health 16:542–548CrossRef
29.
go back to reference Raitasalo R (1995) Elämänhallinta sosiaalipolitiikan tavoitteena [Coping as the Target of Social Policy] The Social Insurance Institution, Finland, Helsinki: Studies in social security and health 1 Raitasalo R (1995) Elämänhallinta sosiaalipolitiikan tavoitteena [Coping as the Target of Social Policy] The Social Insurance Institution, Finland, Helsinki: Studies in social security and health 1
30.
go back to reference Beck AT, Beck RW (1972) Screening depressed patients in family practice. A rapid technique. Postgrad Med 52:81–85PubMed Beck AT, Beck RW (1972) Screening depressed patients in family practice. A rapid technique. Postgrad Med 52:81–85PubMed
31.
go back to reference Beck AT, Steer RA, Garbin MG (1988) Psychometric properties of the beck depression inventory: twenty-five years of evaluation. Clin Psychol Rev 8:77–100CrossRef Beck AT, Steer RA, Garbin MG (1988) Psychometric properties of the beck depression inventory: twenty-five years of evaluation. Clin Psychol Rev 8:77–100CrossRef
32.
go back to reference Kaltiala-Heino R, Rimpelä M, Rantanen P, Laippala P (1999) Finnish modification of the 13-item beck depression inventory in screening an adolescent population for depressiveness and positive mood. Nord J Psychiatry 53:451–457CrossRef Kaltiala-Heino R, Rimpelä M, Rantanen P, Laippala P (1999) Finnish modification of the 13-item beck depression inventory in screening an adolescent population for depressiveness and positive mood. Nord J Psychiatry 53:451–457CrossRef
33.
go back to reference Aalto-Setälä T, Marttunen M, Tuulio-Henriksson A, Poikolainen K, Lönnqvist J (2002) Psychiatric treatment seeking and psychosocial impairment among young adults with depression. J Affect Disord 70:35PubMedCrossRef Aalto-Setälä T, Marttunen M, Tuulio-Henriksson A, Poikolainen K, Lönnqvist J (2002) Psychiatric treatment seeking and psychosocial impairment among young adults with depression. J Affect Disord 70:35PubMedCrossRef
34.
go back to reference Haarasilta L, Marttunen M, Kaprio J, Aro H (2003) Major depressive episode and health care use among adolescents and young adults. Soc Psychiatry Psychiatr Epidemiol 38:366–372PubMed Haarasilta L, Marttunen M, Kaprio J, Aro H (2003) Major depressive episode and health care use among adolescents and young adults. Soc Psychiatry Psychiatr Epidemiol 38:366–372PubMed
35.
go back to reference Bergeron E, Poirier L, Fournier L, Roberge P, Barrette G (2005) Determinants of service use among young canadians with mental disorders. Can J Psychiatry 50:629–636PubMed Bergeron E, Poirier L, Fournier L, Roberge P, Barrette G (2005) Determinants of service use among young canadians with mental disorders. Can J Psychiatry 50:629–636PubMed
36.
go back to reference Zimmer-Gembeck M, Alexander T, Nystrom R (1997) Adolescents report their need for and use of health care services. J Adolesc Health 21:388–399PubMedCrossRef Zimmer-Gembeck M, Alexander T, Nystrom R (1997) Adolescents report their need for and use of health care services. J Adolesc Health 21:388–399PubMedCrossRef
37.
go back to reference Rabinowitz J, Gross R, Feldman D (1999) Correlates of a perceived need for mental health assistance and differences between those who do and do not seek help. Soc Psych Psych Epidem 34:141CrossRef Rabinowitz J, Gross R, Feldman D (1999) Correlates of a perceived need for mental health assistance and differences between those who do and do not seek help. Soc Psych Psych Epidem 34:141CrossRef
38.
go back to reference Burns JR, Rapee RM (2006) Adolescent mental health literacy: young people’s knowledge of depression and help seeking. J Adolesc 29:225–239PubMedCrossRef Burns JR, Rapee RM (2006) Adolescent mental health literacy: young people’s knowledge of depression and help seeking. J Adolesc 29:225–239PubMedCrossRef
39.
go back to reference Sourander A, Haavisto A, Ronning JA, Multimäki P, Parkkola K, Santalahti P, Nikolakaros G, Helenius H, Moilanen I, Tamminen T, Piha J, Kumpulainen K, Almqvist F (2005) Recognition of psychiatric disorders, and self-perceived problems. A follow-up study from age 8 to age 18. J Child Psychol Psychiatr 46:1124–1134CrossRef Sourander A, Haavisto A, Ronning JA, Multimäki P, Parkkola K, Santalahti P, Nikolakaros G, Helenius H, Moilanen I, Tamminen T, Piha J, Kumpulainen K, Almqvist F (2005) Recognition of psychiatric disorders, and self-perceived problems. A follow-up study from age 8 to age 18. J Child Psychol Psychiatr 46:1124–1134CrossRef
40.
go back to reference Hofstra MB, Van Der Ende J, Verhulst FC (2001) Adolescents’ self-reported problems as predictors of psychopathology in adulthood: 10-year follow-up study. Br J Psychiatry 179:203–209PubMedCrossRef Hofstra MB, Van Der Ende J, Verhulst FC (2001) Adolescents’ self-reported problems as predictors of psychopathology in adulthood: 10-year follow-up study. Br J Psychiatry 179:203–209PubMedCrossRef
Metadata
Title
Adult and peer involvement in help-seeking for depression in adolescent population
A two-year follow-up in Finland
Authors
Sari Fröjd, MSc
Prof. Mauri Marttunen, MD, DrMedSci
Prof. Mirjami Pelkonen, PhD
Prof. Bettina von der Pahlen, PhD
Riittakerttu Kaltiala-Heino, MD, DrMedSci, BSc
Publication date
01-12-2007
Publisher
D. Steinkopff-Verlag
Published in
Social Psychiatry and Psychiatric Epidemiology / Issue 12/2007
Print ISSN: 0933-7954
Electronic ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-007-0254-4

Other articles of this Issue 12/2007

Social Psychiatry and Psychiatric Epidemiology 12/2007 Go to the issue