Top

BMC Psychiatry

Published in:

Open Access 01-12-2017 | Research article

Helping intentions of undergraduates towards their depressed peers: a cross-sectional study in Sri Lanka

Authors: Santushi D. Amarasuriya, Nicola J. Reavley, Alyssia Rossetto, Anthony F. Jorm

Published in: BMC Psychiatry | Issue 1/2017

Abstract

Background

Despite showing high rates of depression, university students prefer to seek assistance for their depression from informal sources, such as their friends, rather than seeking professional assistance. Therefore, the helping behaviours of those who provide informal help to these students need examination. This study examines the helping intentions of undergraduates in Sri Lanka towards their depressed peers and the correlates of their helping intentions.

Method

The undergraduates were presented with a vignette of a hypothetical depressed undergraduate. A total of 4442 undergraduates responded to an open-ended question about how the person in the vignette should be helped if this person was someone they knew well. Their responses were coded in reference to established mental health first aid guidelines. Logistic and linear regression models were used to examine the predictors of their helping intentions.

Results

The undergraduates’ most common helping intentions were to listen/talk and support their peer. Only around a third considered the need for professional help. The overall quality of their helping intentions was poor, but better among those who recognised the problem as depression and those who had less stigmatising attitudes. There was some evidence that certain helping intentions of the undergraduates which were person-oriented or social network-related were better among females, those in higher years of study and among certain non-medical student groups. Intentions to encourage professional help were better among those who recognised the problem, but poorer among those with personal experiences of this problem and among those who perceived this problem to be a weakness and not a sickness.

Conclusions

Although the undergraduates may attempt to support their distressed peers, they may not show appropriate helping actions and may not encourage the use of professional assistance. Hence, they need to be educated on how best to respond to their distressed peers. Those with higher levels of stigma and inability to recognise the problem may be at greater risk of showing poorer helping responses towards their distressed peers.

Available only for authorised users

Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. J Psychiatr Res. 2013;47(3):391–400. doi:10.1016/j.jpsychires.2012.11.015.CrossRefPubMed

Peltzer K, Pengpid S. Depressive symptoms and social demographic, stress and health risk behaviour among university students in 26 low-, middle- and high-income countries. Int J Psychiatry Clin Pract. 2015;19(4):259–65. doi:10.3109/13651501.2015.1082598.CrossRefPubMed

Garlow SJ, Rosenberg J, Moore JD, Haas AP, Koestner B, Hendin H, et al. Depression, desperation, and suicidal ideation in college students: results from the American Foundation for Suicide Prevention College Screening Project at Emory University. Depress Anxiety. 2008;25(6):482–8. doi:10.1002/da.20321.CrossRefPubMed

Givens JL, Tjia J. Depressed medical students’ use of mental health services and barriers to use. Acad Med. 2002;77(9):918–21. doi:10.1097/00001888-200209000-00024.CrossRefPubMed

Blanco C, Okuda M, Wright C, Hasin DS, Grant BF, Liu SM, et al. Mental health of college students and their non-college-attending peers: results from the national epidemiologic study on alcohol and related conditions. Arch Gen Psychiatry. 2008;65(12):1429–37. doi:10.1001/archpsyc.65.12.1429.CrossRefPubMedPubMedCentral

Bilican FI. Help-seeking attitudes and behaviors regarding mental health among Turkish college students. Int J Ment Health. 2013;42(2–3):43–59. doi:10.2753/IMH0020-7411420203.CrossRef

Eisenberg D, Hunt J, Speer N, Zivin K. Mental health service utilization among college students in the United States. J Nerv Ment Dis. 2011;199(5):301–8. doi:10.1097/NMD.0b013e3182175123.CrossRefPubMed

Tomoda A, Mori K, Kimura M, Takahashi T, Kitamura T. One-year prevalence and incidence of depression among first-year university students in Japan: a preliminary study. Psychiatry Clin Neurosci. 2000;54(5):583–8. doi:10.1046/j.1440-1819.2000.00757.x.CrossRefPubMed

Michael KD, Huelsman TJ, Gerard C, Gilligan TM, Gustafson MR. Depression among college students: trends in prevalence and treatment seeking. Couns Clin Psychol J. 2006;3(2):60–70.

10.

Zaid ZA, Chan SC, Ho JJ. Emotional disorders among medical students in a Malaysian private medical school. Singapore Med J. 2007;48(10):895–9.PubMed

11.

Rong Y, Luscombe GM, Davenport TA, Huang Y, Glozier N, Hickie IB. Recognition and treatment of depression: a comparison of Australian and Chinese medical students. Soc Psychiatry Psychiatr Epidemiol. 2009;44(8):636–42. doi:10.1007/s00127-008-0471-5.CrossRefPubMed

12.

Reavley NJ, McCann TV, Jorm AF. Mental health literacy in higher education students. Early Interv Psychiatry. 2012;6(1):45–52. doi:10.1111/j.1751-7893.2011.00314.x.CrossRefPubMed

13.

Deane FP, Wilson CJ, Ciarrochi J. Suicidal ideation and help-negation: not just hopelessness or prior help. J Clin Psychol. 2001;57(7):901–14. doi:10.1002/jclp.1058.CrossRefPubMed

14.

Martin JM. Stigma and student mental health in higher education. Higher Educ Res Dev. 2010;29(3):259–74. doi:10.1080/07294360903470969.CrossRef

15.

Arria AM, Winick ER, Garnier-Dykstra LM, Vincent KB, Caldeira KM, Wilcox HC, et al. Help seeking and mental health service utilization among college students with a history of suicide ideation. Psychiatr Serv. 2011;62(12):1510–3. doi:10.1176/appi.ps.005562010.CrossRefPubMedPubMedCentral

16.

Vogel DL, Wade NG, Wester SR, Larson L, Hackler AH. Seeking help from a mental health professional: the influence of one’s social network. J Clin Psychol. 2007;63(3):233–45. doi:10.1002/jclp.20345.CrossRefPubMed

17.

Downs MF, Eisenberg D. Help seeking and treatment use among suicidal college students. J Am Coll Health. 2012;60(2):104–14. doi:10.1080/07448481.2011.619611.CrossRefPubMed

18.

Quinn N, Wilson A, Macintyre G, Tinklin T. "People look at you differently": students’ experience of mental health support within higher education. Br J Guid Counc. 2009;37(4):405–18. doi:10.1080/03069880903161385.CrossRef

19.

Stiffman AR, Pescosolido B, Cabassa LJ. Building a model to understand youth service access: the Gateway Provider Model. Ment Health Serv Res. 2004;6(4):189–98. doi:10.1023/B:MHSR.0000044745.09952.33.CrossRefPubMedPubMedCentral

20.

Jorm AF, Wright A, Morgan AJ. Beliefs about appropriate first aid for young people with mental disorders: findings from an Australian national survey of youth and parents. Early Interv Psychiatry. 2007;1(1):61–70. doi:10.1111/j.1751-7893.2007.00012.x.CrossRefPubMed

21.

Jorm AF, Morgan AJ, Wright A. First aid strategies that are helpful to young people developing a mental disorder: Beliefs of health professionals compared to young people and parents. BMC Psychiatry. 2008;8(42). doi: 10.1186/1471-244X-8-42.

22.

Langlands RL, Jorm AF, Kelly CM, Kitchener BA. First aid for depression: a Delphi consensus study with consumers, carers and clinicians. J Affect Disord. 2008;105(1–3):157–65. doi:10.1016/j.jad.2007.05.004.CrossRefPubMed

23.

Jorm AF. Mental health literacy: empowering the community to take action for better mental health. Am Psychol. 2012;67(3):231–43. doi:10.1037/a0025957.CrossRefPubMed

24.

Vidourek RA, King KA, Nabors LA, Lynch A, Merianos A. College students’ perceived confidence in mental health help-seeking. Int J Ment Health Promot. 2014;16(2):83–90. doi:10.1080/14623730.2014.892257.CrossRef

25.

King KA, Vidourek RA, Strader JL. University students’ perceived self-efficacy in identifying suicidal warning signs and helping suicidal friends find campus intervention resources. Suicide Life Threat Behav. 2008;38(5):608–17. doi:10.1521/suli.2008.38.5.608.CrossRefPubMed

26.

Mishara BL. College students’ experiences with suicide and reactions to suicidal verbalizations: a model for prevention. J Commun Psychol. 1982;10(2):142–50. doi: 10.1002/1520-6629(198204)10:2<142::AID-JCOP2290100207>3.0.CO;2-U.CrossRef

27.

Dunham K. Young adults’ support strategies when peers disclose suicidal intent. Suicide Life Threat Behav. 2004;34(1):56–65. doi:10.1521/suli.34.1.56.27773.CrossRefPubMed

28.

Cheng DR, Poon F, Nguyen TT, Woodman RJ, Parker JD. Stigma and perception of psychological distress and depression in Australian-trained medical students: results from an inter-state medical school survey. Psychiatry Res. 2013;209(3):684–90. doi:10.1016/j.psychres.2013.03.003.CrossRefPubMed

29.

Reavley NJ, McCann TV, Jorm AF. Actions taken to deal with mental health problems in Australian higher education students. Early Interv Psychiatry. 2012;6(2):159–65. doi:10.1111/j.1751-7893.2011.00294.x.CrossRefPubMed

30.

Sharkin BS, Plageman PM, Mangold SL. College student response to peers in distress: an exploratory study. J College Stud Dev. 2003;44(5):691–8. doi:10.1353/csd.2003.0059.CrossRef

31.

Leahy C. Peer responses to psychologically distressed tertiary students: The detection of distress and the helping behaviours of student colleagues from medicine, compared to psychology, law and mechanical engineering students [Doctoral dissertation]. Adelaide: The University of Adelaide; 2009.

32.

Davies EB, Wardlaw J, Morriss R, Glazebrook C. An experimental study exploring the impact of vignette gender on the quality of university students’ mental health first aid for peers with symptoms of depression. BMC Public Health. 2016;16(187). doi:10.1186/s12889-016-2887-2.

33.

Lawrence MT, Ureda JR. Student recognition of and response to suicidal peers. Suicide Life Threat Behav. 1990;20(2):164–76. doi:10.1111/j.1943-278X.1990.tb00099.x.PubMed

34.

Amarasuriya SD, Jorm AF, Reavley NJ. Prevalence of depression and its correlates among undergraduates in Sri Lanka. Asian J Psychiatry. 2015;15:32–7. doi:10.1016/j.ajp.2015.04.012.CrossRef

35.

Amarasuriya SD, Jorm AF, Reavley NJ. Depression literacy of undergraduates in a non-western developing context: The case of Sri Lanka. BMC Res Notes. 2015;8(593). doi:10.1186/s13104-015-1589-7.

36.

Bruckner TA, Scheffler RM, Shen G, Yoon J, Chisholm D, Morris J, et al. The mental health workforce gap in low- and middle-income countries: A needs-based approach. Bull World Health Organ. 2011;89(3):184–94. doi:10.2471/BLT.10.082784.CrossRefPubMed

37.

Jenkins R, Mendis J, Cooray S, Cooray M. Integration of mental health into primary care in Sri Lanka. Ment Health Fam Med. 2012;9(1):15–24.PubMedPubMedCentral

38.

Ranasinghe P, Mendis J, Hanwella R. Community psychiatry service in Sri Lanka: a successful model. Sri Lanka J Psychiatry. 2011;2(1):3–5. doi:10.4038/sljpsyc.v2i1.3157.CrossRef

39.

Olsson DP, Kennedy MG. Mental health literacy among young people in a small US town: recognition of disorders and hypothetical helping responses. Early Interv Psychiatry. 2010;4(4):291–8. doi:10.1111/j.1751-7893.2010.00196.x.CrossRefPubMed

40.

Yap MBH, Reavley NJ, Jorm AF. Intentions and helpfulness beliefs about first aid responses for young people with mental disorders: findings from two Australian national surveys of youth. J Affect Disord. 2012;136:430–42. doi:10.1016/j.jad.2011.11.006.CrossRefPubMed

41.

Yap MBH, Wright A, Jorm AF. First aid actions taken by young people for mental health problems in a close friend or family member: findings from an Australian national survey of youth. Psychiatry Res. 2011;188(1):123–8. doi:10.1016/j.psychres.2011.01.014.CrossRefPubMed

42.

Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211. doi:10.1016/0749-5978(91)90020-T.CrossRef

43.

Yap MBH, Jorm AF. Young people’s mental health first aid intentions and beliefs prospectively predict their actions: findings from an Australian National Survey of Youth. Psychiatry Res. 2012;196(2–3):315–9. doi:10.1016/j.psychres.2011.10.004.CrossRefPubMed

44.

Rossetto A, Jorm AF, Reavley NJ. Predictors of adults’ helping intentions and behaviours towards a person with a mental illness: a six-month follow-up study. Psychiatry Res. 2016;240:170–6. doi:10.1016/j.psychres.2016.04.037.CrossRefPubMed

45.

Langlands RL, Jorm AF, Kelly CM, Kitchener BA. First aid recommendations for psychosis: using the Delphi method to gain consensus between mental health consumers, carers, and clinicians. Schizophr Bull. 2008;34(3):435–43. doi:10.1093/schbul/sbm099.CrossRefPubMed

46.

Kelly CM, Jorm AF, Kitchener BA. Development of mental health first aid guidelines for panic attacks: a Delphi study. BMC Psychiatry. 2009;9(49). doi:10.1186/1471-244X-9-49.

47.

Kelly CM, Jorm AF, Kitchener BA. Development of mental health first aid guidelines on how a member of the public can support a person affected by a traumatic event: a Delphi study. BMC Psychiatry. 2010;10:49–63. doi:10.1186/1471-244X-10-49.CrossRefPubMedPubMedCentral

48.

Kitchener BA, Jorm AF, Kelly CM. Mental health first aid manual. 2nd ed. Melbourne: Orygen Youth Health Research Centre, University of Melbourne; 2010.

49.

Jorm AF, Kitchener BA. Noting a landmark achievement: Mental Health First Aid Training reaches 1% of Australian adults. Aust N Z J Psychiatry. 2011;45(10):808–13. doi:10.3109/00048674.2011.594785.CrossRefPubMed

50.

Kelly CM, Jorm AF, Rodgers B. Adolescents’ responses to peers with depression or conduct disorder. Aust N Z J Psychiatry. 2006;40(1):63–6. doi:10.1111/j.1440-1614.2006.01744.x.CrossRefPubMed

51.

Yoshioka K, Reavley NJ, Rossetto A, Jorm AF. Beliefs about first aid for mental disorders: results from a mental health literacy survey of Japanese high school students. Int J Cult Ment Health. 2015;8(2):223–30. doi:10.1080/17542863.2014.931980.CrossRef

52.

Jorm AF, Blewitt K, Griffiths K, Kitchener B, Parslow R. Mental health first aid responses of the public: results from an Australian national survey. BMC Psychiatry. 2005;5(9). doi:10.1186/1471-244X-5-9.

53.

Kelly CM, Mithen JM, Fischer JA, Kitchener BA, Jorm AF, Lowe A, et al. Youth mental health first aid: a description of the program and an initial evaluation. Int J Ment Health Syst. 2011;5(1):4–12. doi:10.1186/1752-4458-5-4.CrossRefPubMedPubMedCentral

54.

Mason RJ, Hart LM, Rossetto A, Jorm AF. Quality and predictors of adolescents’ first aid intentions and actions towards a peer with a mental health problem. Psychiatry Res. 2015;228(1):31–8. doi:10.1016/j.psychres.2015.03.036.CrossRefPubMed

55.

Rossetto A, Jorm AF, Reavley NJ. Quality of helping behaviours of members of the public towards a person with a mental illness: a descriptive analysis of data from an Australian national survey. Ann Gen Psychiatry. 2014;13(2). doi:10.1186/1744-859X-13-2.

56.

Subedi P, Changwei L, Gurung A, Bizune D, Dogbey MC, Johnson CC, et al. Mental health first aid training for the Bhutanese refugee community in the United States. Int J Ment Health Syst. 2015;9(1):1–7. doi:10.1186/s13033-015-0012-z.CrossRef

57.

Rossetto A, Jorm AF, Reavley NJ. Examining predictors of help giving toward people with a mental illness: results from a National Survey of Australian adults. SAGE Open. 2014;4(2):1–11. doi:10.1177/2158244014537502.CrossRef

58.

Yap MBH, Jorm AF. The influence of stigma on first aid actions taken by young people for mental health problems in a close friend or family member: findings from an Australian national survey of youth. J Affect Disord. 2011;134(1–3):473–7. doi:10.1016/j.jad.2011.05.039.CrossRefPubMed

59.

Amarasuriya SD, Jorm AF, Reavley NJ, Mackinnon AJ. Stigmatising attitudes of undergraduates towards their peers with depression: a cross-sectional study in Sri Lanka. BMC Psychiatry. 2015;15(129). doi:10.1186/s12888-015-0523-9.

60.

Kroenke K, Spitzer RL. The PHQ-9: a new depression diagnostic and severity measure. Psychiatr Ann. 2002;32(9):509–21. doi:10.3928/0048-5713-20020901-06.CrossRef

61.

Amarasuriya SD, Jorm AF, Reavley NJ. Quantifying and predicting depression literacy of undergraduates: a cross sectional study in Sri Lanka. BMC Psychiatry. 2015;15(269). doi:10.1186/s12888-015-0658-8.

62.

Burleson BR. The experience and effects of emotional support: what the study of cultural and gender differences can tell us about close relationships, emotion, and interpersonal communication. Pers Relationsh. 2003;10(1):1–23. doi:10.1111/1475-6811.00033.CrossRef

63.

Shulruf B, Hattie J, Dixon R. Development of a new measurement tool for individualism and collectivism. J Psychoeduc Assess. 2007;25(4):385–401. doi:10.1177/0734282906298992.CrossRef

64.

MacGeorge EL, Feng B, Thompson ER. “Good” and “bad” advice: How to advice more effectively. In: Motley MT, editor. Studies in applied interpersonal communication. Thousand Oaks: SAGE Publications, Inc; 2008. p. 145–64.

65.

Feng B. Testing an integrated model of advice giving in supportive interactions. Hum Commun Res. 2009;35(1):115–29. doi:10.1111/j.1468-2958.2008.01340.x.CrossRef

66.

Knipe DW, Metcalfe C, Fernando R, Pearson M, Konradsen F, Eddleston M et al. Suicide in Sri Lanka 1975-2012: age, period and cohort analysis of police and hospital data. BMC Public Health. 2014;14(839). doi:10.1186/1471-2458-14-839

67.

MacGeorge EL, Gillihan SJ, Samter W, Clark RA. Skill deficit or differential motivation? Testing alternative explanations for gender differences in the provision of emotional support. Commun Res. 2003;30(3):272–303. doi:10.1177/0093650203252407.CrossRef

68.

Mueller MA, Waas GA. College students’ perceptions of suicide: the role of empathy on attitudes, evaluation, and responsiveness. Death Stud. 2002;26(4):325–41. doi:10.1080/074811802753594709.CrossRefPubMed

69.

Roberts LW, Hardee JT, Franchini G, Stidley CA, Siegler M. Medical students as patients: a pilot study of their health care needs, practices, and concerns. Acad Med. 1996;71(11):1225–32. doi:10.1097/00001888-199611000-00019.CrossRefPubMed

70.

Chew-Graham CA, Rogers A, Yassin N. ‘I wouldn’t want it on my CV or their records’: medical students’ experiences of help-seeking for mental health problems. Med Educ. 2003;37(10):873–80. doi:10.1046/j.1365-2923.2003.01627.x.CrossRefPubMed

71.

Thistlethwaite J, Quirk F, Evans R. Medical students seeking medical help: a qualitative study. Med Teach. 2010;32(2):164–6. doi:10.3109/01421590903434177.CrossRefPubMed

72.

Kitchener BA, Jorm AF. Mental health first aid training for the public: evaluation of effects on knowledge, attitudes and helping behavior. BMC Psychiatry. 2002;2(10). doi:10.1186/1471-244X-2-10.

73.

Kitchener BA, Jorm AF. Mental health first aid training in a workplace setting: a randomized controlled trial. BMC Psychiatry. 2004;4(23). doi:10.1186/1471-244X-4-23.

74.

Jorm AF, Kitchener BA, O’Kearney R, Dear KBG. Mental health first aid training of the public in a rural area: a cluster randomized trial. BMC Psychiatry. 2004;4(33). doi:10.1186/1471-244X-4-33.

75.

Bond KS, Jorm AF, Kitchener BA, Reavley NJ. Mental health first aid training for Australian medical and nursing students: an evaluation study. BMC Psychol. 2015;3(11). doi:10.1186/s40359-015-0069-0.

76.

Chen H, Cohen P, Chen S. How big is a big odds ratio? Interpreting the magnitudes of odds ratios in epidemiological studies. Commun Stat-Simul C. 2010;39(4):860–4. doi:10.1080/03610911003650383.CrossRef

77.

Fritz CO, Morris PE, Richler JJ. Effect size estimates: current use, calculations, and interpretation. J Experimental Psychol. 2012;141(1):2–18. doi:10.1037/a0024338.CrossRef

78.

University Grants Commission Sri Lanka. Sri Lanka University Statistics 2013. 2013. http://www.ugc.ac.lk/en/publications/1418-sri-lanka-university-statistics-2013.html. Accessed 30 Dec 2014.

Title: Helping intentions of undergraduates towards their depressed peers: a cross-sectional study in Sri Lanka
Authors: Santushi D. Amarasuriya
Nicola J. Reavley
Alyssia Rossetto
Anthony F. Jorm
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-017-1192-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Helping intentions of undergraduates towards their depressed peers: a cross-sectional study in Sri Lanka

Abstract

Background

Method

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Method

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2017

Selective impairment of decision making under ambiguity in alexithymia

Personality traits and suicide attempts with and without psychiatric disorders: analysis of impulsivity and neuroticism

Insomnia, psychiatric disorders and suicidal ideation in a National Representative Sample of active Canadian Forces members

Correlations between physical activity and neurocognitive domain functions in patients with schizophrenia: a cross-sectional study

Possible factors influencing the duration of hospital stay in patients with psychiatric disorders attempting suicide by jumping

In-patient costs of agitation and containment in a mental health catchment area