Help-seeking for psychological problems in late adolescence

Abstract

Adolescent responses to psychological problems were examined using a five wave longitudinal design over a 12 month period. A total of 715 adolescents were followed at three monthly intervals from just prior to finishing high school through their first year out of school. Of the total sample, 53.1 percent complied with all five waves of data collection. Compliers were more likely to be girls and those with a greater interest in mental health. These Australian adolescents were shown to confide their psychological problems overwhelmingly to friends, with about 70 percent seeking help from friends at each wave. This compared with 30 percent who sought help from their family, and only 5-10 percent who turned to professional sources of help. The peer group was shown to be the primary source of emotional support. The prevalence of minor psychiatric morbidity was very high, with 20 to 30 percent of the sample suffering from psychological distress at any time. This was comparable with other studies of adolescent mental health, confirming that late adolescence and finishing school was a period of considerable distress. Symptoms of minor affective disorder were more common in girls than boys, also consistent with other findings. Although psychological symptoms were an important predictor of help­ seeking, such behavior was shown to have multiple predictors. A range of variables from the social-psychological approach to illness behavior were hypothesised to increase vulnerability to psychological problems and thereby encourage help­ seeking behavior. The major proposition of illness behavior research, that factors other than symptoms influence illness behavior, was strongly supported. Emotional vulnerability factors were shown to vary in their predictive value over the different help-seeking contexts. Help-seeking from friends, family and professionals were found to be distinct domains with different facilitators and inhibitors. Turning to friends for support was predicted by being female, perceived psychological distress, private self-consciousness and fear of the stigma attached to psychological illness. These factors both facilitated help-seeking from friends and inhibited it in those with symptoms. Seeking help from the peer group, of the help­ seeking behaviors, was most affected by vulnerability factors, but was also shown to be a result of peer group socialisation processes. Family help-seeking was the least affected by vulnerability to psychological problems. Facilitators of family help-seeking were shown to be availability of confiding relationships and being female. Only lacking a confiding relationship inhibited family help-seeking in those who were distressed. Those few adolescents who sought professional help were best predicted by psychological distress and life events. Professional help was the most disorder and problem driven type of help-seeking. So few young people sought professional help partly because their problems may not have been seen as appropriate for professional intervention. Furthering the usual predictive nature of help-seeking studies, the effectiveness of help-seeking, in terms of subsequent psychological distress, was also examined. A disturbing finding was that none of the three types of help-seeking reduced minor affective symptoms three months later. Seeking help was unrelated to mental health outcome. This was discussed as a consequence of the type of help offered in most help-seeking episodes. A focus on the self and how one feels is maladaptive for many adolescents. Self-focus reinforces and encourages an overconcern with the self, which generally results in the amplification, rather than reduction, of psychological symptoms. With so many adolescents clearly suffering from psychological distress, the needs of these young people did not appear to be being met by either their informal social support networks or professional services. The help-seeking habits of adolescents need to be considered to provide appropriate services. There was a need for peer based services where skills could be learned to reduce the emotional arousal caused by the many psychological problems of adolescence. Show more