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Many people with mental health problems do not seek professional help but their use of other sources of help is unclear. To investigate patterns of lay and professional help-seeking in men and women aged 16–64 years in relation to severity of symptoms and sociodemographic variables. Postal questionnaire survey, including the 12-item General Health Questionnaire (GHQ–12), sent to a stratified random sample ( n =15222) of the population of Somerset.

 

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The response rate was 76%. Only 28% of people with extremely high GHQ–12 scores (⩾8) had sought help from their general practitioner but most (78%) had sought some form of help. Males, young people and people living in affluent areas were the least likely to seek help. Health promotion interventions to encourage appropriate help-seeking behaviour in young people, particularly in men, may lead to improvements in the mental health of this group of the population. People suffering from psychiatric symptoms, even if severe, often do not seek professional help ( Reference Bebbington, Meltzer and Brugha Bebbington et al , 2000). This is a source of concern in view of the availability of effective treatments for many psychological problems ( Reference Meltzer, Bebbington and Brugha Meltzer et al , 2000). The main determinant for seeking help for mental health problems from a health professional is the severity of the symptoms ( Reference Bebbington, Meltzer and Brugha Bebbington et al , 2000). The lay support system can play an important role in helping people with mental health symptoms ( Reference Angermeyer, Matschinger and Riedel-Heller Angermeyer et al , 2001). The initial recognition and response to mental health problems generally takes place in the community ( Reference Horwitz Horwitz, 1978) but there has been little research on the attitudes and behaviour of people with regard to non-professional help-seeking. In this paper our aim was to investigate the patterns of lay and professional help-seeking in people aged 16–64 years in relation to severity of symptoms and socio-demographic variables. METHOD. Survey methods. This analysis is based on a postal questionnaire survey of the prevalence of common mental disorders in Somerset. A computerised random sample of 15 222 adults aged 16–64 years registered with a general practitioner (GP) in Somerset was obtained in January 2001. The sample was stratified by primary care group area ( n =4) and population density ( n =3 groups). The sample size within each stratum was calculated so that we had 80% power to detect a difference of 5% in the prevalence of minor psychiatric morbidity between subgroups at a 5% significance level, assuming a prevalence in the population as a whole of 10% and a response rate of 60%. Subjects were mailed a questionnaire that included the 12-item version of the General Health Questionnaire (GHQ–12, Reference Goldberg Goldberg, 1978) and two questions on help-seeking attitudes and behaviour (see below). Because of the possible stigma associated with mental health, the phrase ‘stress or strain’ was used instead of mental health. Participants were asked ‘Have you discussed with anyone in the past few weeks any concerns about the effect on your health of stress or strain in your life?’ and requested to tick one or more of the following response categories: relatives or friends, counsellor, GP, and other (please specify). The second question asked ‘If you felt that your health might be suffering as a result of stress or strain in your life would you consider consulting any of these people?’. The response categories were the same as used in the first question (see above) and for each possible source of help the participants were asked to select one of the following options: yes, maybe or no. Analysis. The questionnaires were scored using the GHQ–12, a maximum score of 12 indicating a high likelihood of psychiatric illness ( Reference Goldberg and Williams Goldberg & Williams, 1991). A GHQ–12 score of ≥4 was used as the cut-off point to define common mental disorder ( Reference Weich and Lewis Weich & Lewis, 1998, Reference Erens and Primatesta Erens & Primatesta, 1999). High GHQ–12 scores were classified into two severity groups (4–7 and 8–12) and the results were analysed using STATA version 7.0 (Stata Corporation, 2001). Univariable differences between groups were tested using χ 2 tests. Logistic regression analyses were used to examine the association of help-seeking with symptom severity (GHQ–12 score) and socio-demographic variables. Weights were applied to take into account the sampling fractions used to draw the stratified sample. RESULTS. Response rates. In total 10 842 completed questionnaires were returned after two reminders. By excluding 922 people who were unknown at their recorded address, had moved away or had died, the adjusted response rate was 75.8% (10 842/14 300). The response rate was higher in women than in men (79.9% v . 71.7%, P et al , 1988). One in three people (33.5%) had a GHQ–12 score of ≥4. Table 1 Age and gender distribution of the respondents and the high-scorers: mean GHQ—12 scores by gender and age groups. Age (years) No. (%) of respondents No. (%) with GHQ ≥4 1 Mean (s.e.) GHQ score 1 Female 16-24 662 (67.34) 257 (37.74) 3.23 (0.14) 25-34 1035 (73.82) 383 (37.45) 3.12 (0.12) 35-44 1343 (81.99) 485 (36.80) 3.16 (0.11) 45-54 1423 (83.22) 540 (37.50) 3.15 (0.10) 55-64 1286 (88.02) 358 (28.43) 2.50 (0.10) Total female 5749 (79.91) 2023 (35.33) 3.01 (0.05) Male 16-24 627 (59.10) 214 (33.86) 2.86 (0.15) 25-34 843 (63.19) 266 (31.10) 2.69 (0.12) 35-44 1107 (70.60) 386 (34.92) 3.04 (0.11) 45-54 1356 (78.46) 447 (32.87) 2.87 (0.10) 55-64 1160 (81.98) 301 (25.89) 2.31 (0.11) Total male 5093 (71.67) 1614 (31.57) 2.75 (0.05) Overall total 10842 (75.8) 3637 (33.57) 2.89 (0.04) Attitudes to seeking help. A total of 10 302 (95.0%) respondents completed at least part of the question regarding their attitudes to seeking help for mental health problems. Of these, 8368 (81.2%) said that they would seek some form of help if they thought their health was suffering as a result of stress or strain.

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