Don’t react. Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany, https://doi.org/10.1371/journal.pone.0176730.s004. broad scope, and wide readership – a perfect fit for your research every time. Principles of Social Psychology. For more information about PLOS Subject Areas, click Despite the availability of effective treatment options, researchers continue to find that a significant number of individuals suffering from major depression do not seek professional help. Therefore, the characteristics identified in the literature should be further considered. Having trouble concentrating [31, 35, 46] and suicidal thoughts or ideation [31, 35, 46, 52] were positively related to help-seeking behaviour. For instance, several studies have already been conducted to shed light on depressed men’s lower help-seeking rates (for review see [21]) and on men’s delays in medical and psychological help-seeking (for review see [71]). Additionally, the influence of illness beliefs, treatment beliefs, anticipated stigmatization and perceived need for mental health care on help seeking may be worth investigating. The studies included in this review revealed that men, young and elderly adults, and people of certain ethnicities as well as individuals with a lower educational status with major depression are at risk of not seeking help, and these populations could be addressed in individually tailored interventions to increase help-seeking. Differences between help seeking by ethnic group were assessed in four Canadian and five US datasets. The associations between help seeking and education in individuals with major depression were significantly positive or non-significant in the eleven datasets. [35]), the latter may only be associated with help seeking in certain populations (e.g., in individuals with an external locus of control [e. g. 19]). No, Is the Subject Area "Clinical psychology" applicable to this article? The ‘Behavioral Model of Health Services Use’ suggests that people’s predisposition to use services, factors which enable or impede the use of services and people’s need of care predict and explain health behaviours like use of health services [15]. No, Is the Subject Area "Mental health therapies" applicable to this article? According to the ‘Behavioral Model of Health Service Use’, these contextual characteristics directly influence service utilization and indirectly influence service utilization through individual characteristics [15]. Certain structural or attitude-related barriers to seeking care among individuals in these groups may explain the findings. Click through the PLOS taxonomy to find articles in your field. Based on the current review, it appears that several factors may influence the likelihood that an individual suffering from major depression will seek professional help. Other findings indicate no significant difference in help-seeking behaviour with comorbid substance dependence disorder [17, 38, 44, 63] or alcohol or drug abuse [31]. However, further research on interventions that increase help-seeking intentions and behaviour among individuals suffering from major depression is needed. Altogether, 40 studies based on 26 datasets were included in the systematic review (see Fig 2 for an overview of the search process). The focus on socio-demographic and clinical variables in the reviewed literature is understandable, as the majority of the studies utilized secondary datasets, thus limiting the variables available for analysis. Two researchers (JLM, ALB) searched the MEDLINE, EMBASE and PsycInfo electronic databases in February 2017 (09.02.2017) using key words and a standardized vocabulary (e.g., MeSH) presented in S2 Appendix. Kids who observed simple reciprocal acts of altruism were far more likely to exhibit altruistic actions, whereas friendly but non-altruistic modeled actions did not show the same results. Behaviour is Influenced by a Number of Factors 2. The German Research Foundation had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper. Specifically, severity of depression was positively related to help-seeking in seven of the 16 datasets [31, 39, 40, 46, 47, 60, 61]. However, as these findings were mainly based on retrospective cross-sectional studies, it remains unclear whether individuals affected by more severe depression are more likely to seek help. News stories often focus on grander cases of altruism, such as a man who dives into an icy river to rescue a drowning stranger or a donor who gives thousands of dollars to a local charity. In contrast with the findings from the Ontario study, Lin and Parikh [38] found no significant differences analysing the same dataset. Although the samples were homogenous regarding the formal diagnosis of major depression, the studies differed in terms of the samples’ age, gender and ethnicity as well as the health care systems affecting the participants. The counselor gained trust by using the effective behaviors, but the negative behaviors might have negated that trust. We included studies if they fulfilled all of the inclusion criteria. No, Is the Subject Area "Ethnic epidemiology" applicable to this article? Rethinking natural altruism: Simple reciprocal interactions trigger children's benevolence. Nadler, A., & Halabi, S. (2006). Discover a faster, simpler path to publishing in a high-quality journal. Thousand Oaks, CA: Sage. Behaviour Shows Individual Differences and Similarities 6. Accordingly, it is promising to focus on psychological variables that affect the decision-making process of seeking help to better predict behaviour. Using the ‘Behavioral Model of Health Services Use’, this study systematically reviewed the literature on the characteristics associated with help-seeking behaviour in adults with major depression. Are You Guilty of Participating in the Bystander Effect? Journal of … Furthermore, including this perspective could provide insight into the associations between certain socio-demographic variables and help seeking. What is it that inspires people to give their time, energy, and money for the betterment of others, even when they receive nothing tangible in return Psychologists have suggested a number of different explanations for why altruism exists. Further research investigating the influence of these characteristics on help-seeking behaviour by individuals suffering from major depression in prospective cohorts and research specifically focused on beliefs, social support, organizational factors and perceived need for treatment would address a significant gap in the literature. Additional quantitative studies on this subject have been conducted without referral to Andersen’s model (e.g. Two criteria of 14 from the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies [29] were selected to examine internal validity (Q1 and Q2, S4 Appendix). Socio-demographic and need factors appeared to influence help-seeking behaviour. Data Availability: All relevant data are within the paper and its Supporting Information files. Chen, Crum [36] showed that people suffering from major depression and substance dependence were more likely to seek help than people suffering from major depression only. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, https://doi.org/10.1371/journal.pone.0176730, http://www.nhlbi.nih.gov/health-pro/guidelines/in-develop/cardiovascular-risk-reduction/tools/cohort2014. How Does Self-Determination Theory Explain Motivation? Altruism is the unselfish concern for other people—doing things simply out of a desire to help, not because you feel obligated to out of duty, loyalty, or religious reasons. Gadalla [52] reported that single mothers with adult children had the lowest odds of seeking treatment in comparison to other women. Data synthesis was performed by vote counting because of the heterogeneity of settings, measures, adjustments and the number of investigated variables. Although the former could facilitate help seeking (e.g. There is some evidence that the severity of depression, longer and more depressive episodes and the presence of anxiety disorders are related to higher help-seeking rates. No, Is the Subject Area "Mental health and psychiatry" applicable to this article? The desire for social distance from mentally ill people is known to be an indirect measure of stigmatizing beliefs towards people belonging to this group, and a dissonance between these negative stereotypes and the preferred self can impede help-seeking for mental health problems [23]. PLoS ONE 12(5): Professional judgement about people’s health and need for treatment is represented by evaluated need whereas perceived need includes people’s perspective on their own health [15]. In that review, Gulliver, Griffiths [28] provided some evidence that mental health literacy interventions (e.g., delivering destigmatisation information and/or providing information about help-seeking sources) can be effective in improving help-seeking attitudes. Department of Health Services Research, Carl von Ossietzky University, Oldenburg, Germany. Prosocial behavior: Multilevel perspectives. No, Is the Subject Area "Behavior" applicable to this article? The association between age and help seeking was analysed in 17 different datasets and was mainly computed comparing different age groups. By systematically reviewing observational studies using standardized diagnostic instruments to assess major depression, this review aims to synthesize the results of studies assessing help-seeking behaviour in a homogeneous population. According to Doblyte and Jiménez-Mejías [24] who stressed out the role of hegemonic masculine identity and its influence in limiting men’s help seeking behaviour, educational campaigns for primary care providers can facilitate communication between male patients and GPs. Regardless, accounting for the financing of health care systems it is necessary to interpret these associations [15]. Articles were identified by systematically searching the MEDLINE, EMBASE and PsycInfo databases and relevant reference lists. Society's rules, norms, and expectations can also influence whether or not people engage in altruistic behavior. The norm of reciprocity, for example, is a social expectation in which we feel pressured to help others if they have already done something for us. They estimated that the median untreated rate for depression is 56.3% worldwide [6]. The majority of studies reported no association between income and help-seeking behaviour. For example, black Americans [55], African Americans [18, 37], Mexican Americans [18], and ethnic minorities [40] had lower rates of seeking help compared to whites. Fourth, there was a lack of studies that quantitatively investigated the influence of individuals’ beliefs and perceptions on their help-seeking behaviour. Soc Cogn Affect Neurosci. Therefore, the current review addresses two questions: (1) Which characteristics associated with help-seeking behaviour in adults suffering from major depression are investigated in the literature? Social support was addressed in three datasets. Some of the characteristics are: 1. A., & Schroeder, D. A. Suffering from chronic somatic disorders was significantly associated with higher help-seeking rates in two datasets [17, 44, 52, 65]. To ensure the validity of the diagnoses, a sample or subsample with formally diagnosed major depression disorder or a major depression episode according to the Diagnostic and Statistical Manual of Mental Disorders (DSM), International Statistical Classification of Diseases (ICD) or Research Diagnostic Criteria (RDC) was required (IC 3). Differences in individuals’ help-seeking behaviour between different regions of the US were found in one [32] of two studies [31]. As evidenced by the findings presented in the results section, several factors of the ‘Behavioral Model of Health Service Use’ seem to be not validated through the systematic review. https://doi.org/10.1371/journal.pone.0176730.g001. Sisco MR, Weber EU. Additionally a slighter entrance into care can be achieved. Second, the synthesis of results was limited because of the heterogeneity of the studies. For instance, a qualitative analysis using the Self-Regulation Model found that primary care patients with depression who did not seek treatment believed that the treatment would not be effective, that depression would be short-lived and that it would not affect their daily lives [72]. Contextual characteristics include health organizations and provider-related factors as well as community characteristics [15]. The study called this theory into question, finding that socialization had a serious impact on altruistic actions in one- and two-year-old children. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Studies on the contextual characteristics of help seeking in individuals with major depression have focused on region or different countries. The results from the ‘National Survey of American Life’ (NSAL) showed that although African Americans reported higher rates of seeking help than Caribbean Blacks, this difference was only significant in a sample of adults with severe or very severe symptoms [56] and was not significant in a sample of adults with mild to moderate symptoms [56] or in a subsample of mothers [57]. Latane, B., & Darley, J. M. (1970). No differences were reported between the help-seeking behaviours of people born in Canada and of Canadian migrants [44], except that lower rates of help-seeking were observed in a group of Chinese immigrants compared to a group of Canadians born in Canada [52, 54]. S5 Appendix displays the ratings of methodological quality. Psychiatric comorbidity was assessed in eleven datasets, and somatic comorbidity in seven (S6 Appendix). A better understanding of the process of help-seeking by individuals suffering from major depression and improved knowledge of the factors that influence this process are important for identifying groups at risk of failing to seek adequate professional help and for improving their access to depression care. Kendra Cherry, MS, is an author, educational consultant, and speaker focused on helping students learn about psychology. employment status), enabling factors (e.g. For instance, synthesizing qualitative studies, Doblyte and Jiménez-Mejías [24] identified attitudinal barriers for help seeking among depressed man, ethnic minorities and young adults: They concluded that help seeking is a threat to hegemonic masculinity, that the fear of disclosure and being judged was strongest among young adults and that ethnic minorities were more willing to keep depression within family [24]. No review protocol exists. However, a systematic review of these findings has not been performed. Whatever the reasons behind it, our world would be a much sadder place without altruism. Raven, B. H. (1992). Decision Model of Helping Definition The decision model of helping, introduced in The Unresponsive Bystander by Bibb Latane and John Darley, outlines a process of five steps that will determine whether a bystander will act or not in a helping situation. Using studies on service utilization rates for major depression in community-based surveys, Kohn, Saxena [6] reported that the percentage difference between number of people needing treatment for major depression and number of people seeking professional help ranged between 15.9% (12 month, Florence) [7, 8] and 83.9% (current, UK) [9]. In addition, a longer duration of illness was positively related to help-seeking behaviour in six datasets [31, 34, 35, 40, 46] and was non-significantly related in three datasets [33, 38, 53]. Gender, age, education, ethnicity, marital status, severity of depression, duration and number of depressive episodes, and comorbid anxiety disorders appeared to influence help-seeking behaviour. Why Do We Feel Compelled to Return Favors? For instance, mainly no associations between certain predisposing factors (e.g. Casting themselves as victims can help sociopaths and psychopaths to … Cooper, J. This review found that the associations of help-seeking behaviour with socio-demographic predisposing (e.g., age, gender, ethnicity, education, and family status), enabling (financial situation/income), need (e.g., severity of depression, comorbidity, and duration and number of episodes) and contextual factors were investigated in several studies. Further research investigating the influence of these characteristics on help-seeking behaviour by individuals suffering from major depression in prospective cohorts and research specifically focused on beliefs, social support, organizational factors and perceived need for treatment would address a significant gap in the literature. Regarding the influence of organizational factors on help-seeking behaviour, findings on the availability, accessibility and acceptability of care were available from the CCHS 1.2 [17]. Some studies focused on beliefs (n = 4) (predisposing factors), social support (n = 4), organization (n = 3) (enabling factors), and context (n = 8) (e.g., urban vs. rural, country) and help-seeking behaviour. Qualitative data synthesis was performed to illustrate which influencing factors were investigated and to discuss heterogeneous findings (e.g., adjusted and unadjusted results) from samples in heterogeneous contexts (e.g., countries, health care systems). 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