Top

BMC Psychiatry

Published in:

Open Access 01-12-2018 | Research article

Predicting intentions to seek help for depression among undergraduates in Sri Lanka

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

Published in: BMC Psychiatry | Issue 1/2018

Abstract

Background

Studies have found that although there are high rates of depression among university students, their help-seeking practices are poor. It is important to identify students who are less likely to seek the necessary help, to encourage better help-seeking among them. This study, which was conducted among undergraduates in Sri Lanka, examined the associations between personal characteristics of the undergraduates and their intentions to seek help for depression.

Methods

This was a cross-sectional study in which 4461 undergraduates (Male: n = 1358, 30.4%, Female: n = 3099, 69.5%; Mean age = 22.18; SD = 1.47) indicated their intentions to seek help if personally affected by depression, which was described in a hypothetical vignette about a peer experiencing depression symptomatology. The predictors of the undergraduates’ help-seeking intentions, including their sociodemographic characteristics, prior exposure to and recognition of the problem, and their stigma towards those with depression were examined using binary logistic regression analyses models.

Results

The undergraduates’ ability to recognise the problem was one of the strongest predictors of their intentions to seek professional help. Those with higher levels of stigma were less likely to seek both professional and informal help. While females were less likely to consider professional help, they were more likely to consider the help of informal help-providers and to consider religious strategies. Medical undergraduates and those who had sought help for personal experiences of the problem were also more likely to consider informal help. However, all these associations resulted in small effect sizes, except for those between recognition of the problem and the undergraduates’ intentions to seek professional help, where medium to very large effect sizes were observed in the case of some the associations examined.

Conclusions

Improvement of problem-recognition may be a key strategy for improving help-seeking among these undergraduates. Reduction of stigma may also be associated with better depression-related help-seeking of undergraduates. Females and medical undergraduates need to be educated about the importance of seeking appropriate types of help, and their informal social networks must be educated about how best to help them.

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. https://doi.org/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. https://doi.org/10.3109/13651501.2015.1082598.CrossRefPubMed

Hickie IB, Davenport TA, Luscombe GM, Rong Y, Hickie ML, Bell MI. The assessment of depression awareness and help-seeking behaviour: experiences with the international depression literacy survey. BMC Psychiatry. 2007;7(48) https://doi.org/10.1186/1471-244X-7-48.

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. https://doi.org/10.1007/s00127-008-0471-5.CrossRefPubMed

Smith CL, Shochet IM. The impact of mental health literacy on help-seeking intentions: results of a pilot study with first year psychology students. Int J Men Health Promot. 2011;13(2):14–20. https://doi.org/10.1080/14623730.2011.9715652.CrossRef

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

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

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

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) https://doi.org/10.1186/s13104-015-1589-7.

10.

Abeyasinghe DRR, Tennakoon S, Rajapakse TN. The development and validation of the Peradeniya depression scale (PDS)—a culturally relevant tool for screening of depression in Sri Lanka. J Affect Disord. 2012;142(1–3):143–9. https://doi.org/10.1016/j.jad.2012.04.019.CrossRefPubMed

11.

de Silva VA, Ekanayake S, Hanwella R. Validity of the Sinhala version of the Centre for Epidemiological Studies Depression Scale (CES-D) in out-patients. Ceylon Med J. 2014;59(1):8–12. https://doi.org/10.4038/cmj.v59i1.6732.CrossRefPubMed

12.

Sumathipala A, Siribaddana S, Hewege S, Sumathipala K, Prince M, Mann A. Understanding the explanatory model of the patient on their medically unexplained symptoms and its implication on treatment development research: a Sri Lanka study. BMC Psychiatry. 2008;8:54. https://doi.org/10.1186/1471-244X-8-54.CrossRefPubMedPubMedCentral

13.

Ediriweera HW, Fernando SM, Pai NB. Mental health literacy survey among Sri Lankan carers of patients with schizophrenia and depression. Asian J Psychiatry. 2012;5(3):246–50. https://doi.org/10.1016/j.ajp.2012.02.016.CrossRef

14.

Hollifield M, Hewage C, Gunawardena CN, Kodituwakku P, Bopagoda K, Weerarathnege K. Symptoms and coping in Sri Lanka 20–21 months after the 2004 tsunami. Br J Psychiatry. 2008;192(1):39–44. https://doi.org/10.1192/bjp.bp.107.038422.CrossRefPubMed

15.

Somasundaram D, Thivakaran T, Bhugra D. Possession states in northern Sri Lanka. Psychopathology. 2008;41(4):245–53. https://doi.org/10.1159/000125558.CrossRefPubMed

16.

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):189–198. https://doi.org/10.1023/B:MHSR.0000044745.09952.33.

17.

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):184–194. https://doi.org/10.2471/BLT.10.082784.

18.

Stigma HMJ. Help seeking related to depression: a study of nursing students. J Psychosoc Nurs Ment Health Serv. 2004;42(2):42–51.

19.

Seyfi F, Poudel KC, Junko Y, Keiko O, Masamine J. Intention to seek professional psychological help among college students in Turkey: influence of help-seeking attitudes. BMC Res Notes. 2013;6:519. https://doi.org/10.1186/1756-0500-6-519.CrossRefPubMedPubMedCentral

20.

Zochil ML, Thorsteinsson EB. Exploring poor sleep, mental health, and help-seeking intention in university students. Aust J Psychol. 2017; https://doi.org/10.1111/ajpy.12160.

21.

Erkan S, Ozbay Y, Cihangir-Cankaya Z. Terzi Ş. The prediction of university students' willingness to seek counseling. Educ Sci: Theory Pract. 2012;12(1):35–42.

22.

Yap MBH, Reavley NJ, Jorm AF. The associations between psychiatric label use and young people's help-seeking preferences: results from an Australian national survey. Epidemiol Psychiatr Sci. 2014;23(1):51–9. https://doi.org/10.1017/S2045796013000073.CrossRefPubMed

23.

Chan W, Batterham P, Christensen H, Galletly C. Suicide literacy, suicide stigma and help-seeking intentions in Australian medical students. Australas Psychiatry. 2014;22(2):132–9. https://doi.org/10.1177/1039856214522528.CrossRefPubMed

24.

Wilson CJ, Rickwood D, Deane FP. Depressive symptoms and help-seeking intentions in young people. Clin Psychol. 2007;11(3):98–107. https://doi.org/10.1080/13284200701870954.CrossRef

25.

Kenny R, Dooley B, Fitzgerald A. How psychological resources mediate and perceived social support moderates the relationship between depressive symptoms and help-seeking intentions in college students. Br J Guid Counc 2016;44(4):402–413. https://doi.org/10.1080/03069885.2016.1190445.

26.

Yap MBH, Wright A, Jorm AF. The influence of stigma on young people's help-seeking intentions and beliefs about the helpfulness of various sources of help. Soc Psychiatry Psychiatr Epidemiol. 2011;46(12):1257–65. https://doi.org/10.1007/s00127-010-0300-5.CrossRefPubMed

27.

Lally J, O'Conghaile A, Quigley S, Bainbridge E, McDonald C. Stigma of mental illness and help-seeking intention in university students. Psychiatrist. 2013;37(8):253. https://doi.org/10.1192/pb.bp.112.041483.CrossRef

28.

Fernando SM, Deane FP, McLeod HJ. The delaying effect of stigma on mental health help-seeking in Sri Lanka. Asia-Pac Psychiatry. 2017;(1). https://doi.org/10.1111/appy.12255.

29.

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

30.

Griffiths KM, Christensen H, Jorm AF, Evans K, Groves C. Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression: randomised controlled trial. Br J Psychiatry. 2004;185(4):342–9. https://doi.org/10.1192/bjp.185.4.342. CrossRefPubMed

31.

Link BG, Phelan JC, Bresnahan M, Stueve A, Pescosolido BA. Public conceptions of mental illness: labels, causes, dangerousness, and social distance. Am J Pub Health 1999;89(9):1328–1333. https://doi.org/10.2105/AJPH.89.9.1328.

32.

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). https://doi.org/10.1186/s12888-015-0523-9.

33.

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 Comput. 2010;39(4):860–4. https://doi.org/10.1080/03610911003650383.CrossRef

34.

Rosenthal JA. Qualitative descriptors of strength of association and effect size. J Soc Serv Res. 1996;21(4):37–59. https://doi.org/10.1300/J079v21n04_02.CrossRef

35.

Mackinnon A. The inter-quartile odds ratio: a suggestion for the presentation of results from continous predictors in logistic regression. Int J Methods Psychiatr Res. 1992;2:233–5.

36.

Nagelkerke NJD. A note on a general definition of the coefficient of determination. Biometrika. 1991;(3):691. https://doi.org/10.2307/2337038.

37.

Morgan AJ, Jorm AF. Self-help interventions for depressive disorders and depressive symptoms: a systematic review. Ann General Psychiatry. 2008;7:13. https://doi.org/10.1186/1744-859x-7-13.CrossRef

38.

Yousaf O, Popat A, Hunter MS. An investigation of masculinity attitudes, gender, and attitudes toward psychological help-seeking. Psychol Men & Masc. 2015;16(2):234–7. https://doi.org/10.1037/a0036241.CrossRef

39.

Pattyn E, Verhaeghe M, B P. The gender gap in mental health service use. Soc Psychiatry Psychiatr Epidemiol. 2015;50(7):1089–95. https://doi.org/10.1007/s00127-015-1038-x.CrossRefPubMed

40.

Addis ME, Mahalik JR. Men, masculinity, and the contexts of help seeking. Am Psychol. 2003;58(1):5–14. https://doi.org/10.1037/0003-066X.58.1.5.CrossRefPubMed

41.

Chang H. Help-seeking for stressful events among chinese college students in Taiwan: roles of gender, prior history of counseling, and help-seeking attitudes. J Coll Stud Dev 2008;49(1):41–51. https://doi.org/10.1353/csd.2008.0003.

42.

Nam SK, Chu HJ, Lee MK, Lee JH, Kim N, Lee SM. A meta-analysis of gender differences in attitudes toward seeking professional psychological help. J Am Coll Heal. 2010;59(2):110–6. https://doi.org/10.1080/07448481.2010.483714.CrossRef

43.

Ashton WA, Fuehrer A. Effects of gender and gender role identification of participant and type of social support resource on support seeking. Sex Roles. 1993;28(7/8):461–76. https://doi.org/10.1007/BF00289608. CrossRef

44.

Flaherty J, Richman J. Gender differences in the perception and utilization of social support: theoretical perspectives and an empirical test. Soc Sci Med. 1989;28(12):1221–8. https://doi.org/10.1016/0277-9536(89)90340-7.CrossRefPubMed

45.

Ptacek JT, Smith RE, Gender ZJ. Appraisal, and coping: a longitudinal analysis. J Pers. 1992;60(4):747–70. https://doi.org/10.1111/1467-6494.ep9212283735. CrossRef

46.

Gold JA, Johnson B, Leydon G, Rohrbaugh RM, Wilkins KM. Mental health self-care in medical students: a comprehensive look at help-seeking. Acad Psychiatry. 2015;39(1):37–46. https://doi.org/10.1007/s40596-014-0202-z.CrossRefPubMed

47.

Dyrbye LN, Eacker A, Durning SJ, Brazeau C, Moutier C, Massie FS et al. The impact of stigma and personal experiences on the help-seeking behaviors of medical students with burnout. Acad Med 2015;90(7):961–969. https://doi.org/10.1097/ACM.0000000000000655.

48.

Dahlin ME, Burnout RB. Psychiatric morbidity among medical students entering clinical training: a three year prospective questionnaire and interview-based study. BMC Med Educ. 2007;7(6) https://doi.org/10.1186/1472-6920-7-6.

49.

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

50.

Brimstone R, Thistlethwaite JE, Quirk F. Behaviour of medical students in seeking mental and physical health care: exploration and comparison with psychology students. Med Educ. 2007;41(1):74–83. https://doi.org/10.1111/j.1365-2929.2006.02649.x.CrossRefPubMed

51.

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. https://doi.org/10.1046/j.1365-2923.2003.01627.x.CrossRefPubMed

52.

Amarasuriya SD, Jorm AF, Perceptions RNJ. Intentions relating to seeking help for depression among medical undergraduates in Sri Lanka: a cross-sectional comparison with non-medical undergraduates. BMC Med Educ. 2015;15(162) https://doi.org/10.1186/s12909-015-0453-8.

Title: Predicting intentions to seek help for depression among undergraduates in Sri Lanka
Authors: Santushi D. Amarasuriya
Anthony F. Jorm
Nicola J. Reavley
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Psychiatry / Issue 1/2018
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-018-1700-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Predicting intentions to seek help for depression among undergraduates in Sri Lanka

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2018

The impact of immigration detention on mental health: a systematic review

Salivary cortisol in post-traumatic stress disorder: a systematic review and meta-analysis

Improving risk prediction accuracy for new soldiers in the U.S. Army by adding self-report survey data to administrative data

Personality dimensions emerging during adolescence and young adulthood are underpinned by a single latent trait indexing impairment in social functioning

Hyperprolactinemia and insulin resistance in drug naive patients with early onset first episode psychosis

Does presence of metabolic syndrome impact anxiety and depressive disorder screening results in middle aged and elderly individuals? A population based study