Value-related attitudes towards mental health problems and help-seeking barriers: a sequential mixed-methods design investigating participants with reported depressive episodes in rural Northern Germany with and without treatment experience
Abstract Background Seeking help for severe depressive symptoms remains a major obstacle for particular groups within the general population. Value-related attitudes might contribute to this treatment gap, particularly in rural regions with a low density of psychiatric-psychotherapeutic services. We...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12888-024-05521-9 |
| _version_ | 1797273671625080832 |
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| author | Karsten Valerius Linnéa von Eitzen Mirjam Göbel Heike Ohlbrecht Neeltje van den Berg Henry Völzke Hans J. Grabe Georg Schomerus Sven Speerforck |
| author_facet | Karsten Valerius Linnéa von Eitzen Mirjam Göbel Heike Ohlbrecht Neeltje van den Berg Henry Völzke Hans J. Grabe Georg Schomerus Sven Speerforck |
| author_sort | Karsten Valerius |
| collection | DOAJ |
| description | Abstract Background Seeking help for severe depressive symptoms remains a major obstacle for particular groups within the general population. Value-related attitudes might contribute to this treatment gap, particularly in rural regions with a low density of psychiatric-psychotherapeutic services. We aimed to investigate narratives of socialization, value systems, and barriers of help-seeking to better understand social milieus at increased risk for underuse of psychiatric-psychotherapeutic services in a rural area in East Germany. This could complement the explanatory power of classical socio-demographic determinants and provide guidance for possible interventions. Method Based on results of an analysis of a population-based German cohort study (SHIP-TREND-1), 20 individual semi-structured interviews were conducted with participants who met criteria for having been moderately or severely depressed at least once in their life. Qualitative analyses of interview data were guided by grounded theory methodology. Results Participants with severe symptoms of depression were more frequent among non-responders of this study. We identified key aspects that influence help-seeking for mental health problems and seem to be characteristic for rural regions: family doctors serve as initial contact points for mental health problems and are considered as alternatives for mental health professionals; norms of traditional masculinity such as being more rational than emotional, needing to endure hardships, embodying strength, and being independent were frequently mentioned as inhibiting help-seeking by middle-aged men; anticipated adverse side-effects of therapy such as worsening of symptoms; a frequently expressed desire for less pathologically perceived treatment options. Conclusions Our results suggest that barriers regarding help-seeking in rural regions are multifaceted and seem to be influenced by traditional norms of masculinity. We believe it is critical to strengthen existing and already utilized services such as family doctors and to implement and evaluate tailored interventions targeting the needs of the rural milieu. |
| first_indexed | 2024-03-07T14:47:41Z |
| format | Article |
| id | doaj.art-736a9589da4e46af881dc01620b6f18f |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-03-07T14:47:41Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-736a9589da4e46af881dc01620b6f18f2024-03-05T19:54:06ZengBMCBMC Psychiatry1471-244X2024-02-0124111710.1186/s12888-024-05521-9Value-related attitudes towards mental health problems and help-seeking barriers: a sequential mixed-methods design investigating participants with reported depressive episodes in rural Northern Germany with and without treatment experienceKarsten Valerius0Linnéa von Eitzen1Mirjam Göbel2Heike Ohlbrecht3Neeltje van den Berg4Henry Völzke5Hans J. Grabe6Georg Schomerus7Sven Speerforck8Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig UniversityDepartment of Psychiatry and Psychotherapy, Medical Faculty, Leipzig UniversityDepartment of Psychiatry and Psychotherapy, Medical Faculty, Leipzig UniversityDepartment for Social Sciences, Otto-von-Guericke UniversityInstitute for Community Medicine, University Medicine GreifswaldInstitute for Community Medicine, University Medicine GreifswaldDepartment of Psychiatry and Psychotherapy, University Medicine GreifswaldDepartment of Psychiatry and Psychotherapy, Medical Faculty, Leipzig UniversityDepartment of Psychiatry and Psychotherapy, Medical Faculty, Leipzig UniversityAbstract Background Seeking help for severe depressive symptoms remains a major obstacle for particular groups within the general population. Value-related attitudes might contribute to this treatment gap, particularly in rural regions with a low density of psychiatric-psychotherapeutic services. We aimed to investigate narratives of socialization, value systems, and barriers of help-seeking to better understand social milieus at increased risk for underuse of psychiatric-psychotherapeutic services in a rural area in East Germany. This could complement the explanatory power of classical socio-demographic determinants and provide guidance for possible interventions. Method Based on results of an analysis of a population-based German cohort study (SHIP-TREND-1), 20 individual semi-structured interviews were conducted with participants who met criteria for having been moderately or severely depressed at least once in their life. Qualitative analyses of interview data were guided by grounded theory methodology. Results Participants with severe symptoms of depression were more frequent among non-responders of this study. We identified key aspects that influence help-seeking for mental health problems and seem to be characteristic for rural regions: family doctors serve as initial contact points for mental health problems and are considered as alternatives for mental health professionals; norms of traditional masculinity such as being more rational than emotional, needing to endure hardships, embodying strength, and being independent were frequently mentioned as inhibiting help-seeking by middle-aged men; anticipated adverse side-effects of therapy such as worsening of symptoms; a frequently expressed desire for less pathologically perceived treatment options. Conclusions Our results suggest that barriers regarding help-seeking in rural regions are multifaceted and seem to be influenced by traditional norms of masculinity. We believe it is critical to strengthen existing and already utilized services such as family doctors and to implement and evaluate tailored interventions targeting the needs of the rural milieu.https://doi.org/10.1186/s12888-024-05521-9Help-seekingBarriersMental healthDepressionRuralSocial milieu |
| spellingShingle | Karsten Valerius Linnéa von Eitzen Mirjam Göbel Heike Ohlbrecht Neeltje van den Berg Henry Völzke Hans J. Grabe Georg Schomerus Sven Speerforck Value-related attitudes towards mental health problems and help-seeking barriers: a sequential mixed-methods design investigating participants with reported depressive episodes in rural Northern Germany with and without treatment experience BMC Psychiatry Help-seeking Barriers Mental health Depression Rural Social milieu |
| title | Value-related attitudes towards mental health problems and help-seeking barriers: a sequential mixed-methods design investigating participants with reported depressive episodes in rural Northern Germany with and without treatment experience |
| title_full | Value-related attitudes towards mental health problems and help-seeking barriers: a sequential mixed-methods design investigating participants with reported depressive episodes in rural Northern Germany with and without treatment experience |
| title_fullStr | Value-related attitudes towards mental health problems and help-seeking barriers: a sequential mixed-methods design investigating participants with reported depressive episodes in rural Northern Germany with and without treatment experience |
| title_full_unstemmed | Value-related attitudes towards mental health problems and help-seeking barriers: a sequential mixed-methods design investigating participants with reported depressive episodes in rural Northern Germany with and without treatment experience |
| title_short | Value-related attitudes towards mental health problems and help-seeking barriers: a sequential mixed-methods design investigating participants with reported depressive episodes in rural Northern Germany with and without treatment experience |
| title_sort | value related attitudes towards mental health problems and help seeking barriers a sequential mixed methods design investigating participants with reported depressive episodes in rural northern germany with and without treatment experience |
| topic | Help-seeking Barriers Mental health Depression Rural Social milieu |
| url | https://doi.org/10.1186/s12888-024-05521-9 |
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