Advertisement

Social Psychiatry and Psychiatric Epidemiology

, Volume 42, Issue 12, pp 945–952 | Cite as

Adult and peer involvement in help-seeking for depression in adolescent population

A two-year follow-up in Finland
  • Sari FröjdEmail author
  • Mauri Marttunen
  • Mirjami Pelkonen
  • Bettina von der Pahlen
  • Riittakerttu Kaltiala-Heino
ORIGINAL PAPER

Abstract

Help-seeking among adolescents and adults is often perceived as a process involving only the health care system and the individual suffering from psychiatric symptoms. The present study attempted to create a model of help-seeking also including members of adolescents social networks. A prospective follow-up design included a school-based survey on all ninth grade students (mean age 15.5) during the academic year 2002–2003 in two Finnish towns (N = 3,278; response rate 94%); and a follow-up conducted two years later (N = 2,080; response rate 63%). The respondents were assessed for current depression and help-seeking for depression and other mental health problems each time. In the follow-up they were asked if they felt that they need help for depression and if their mother, father, sibling, peers, boy- or girl-friend or teacher had been worried about changes in their mood or behaviour. The associations of perceived need for help, help-seeking behaviour and concerns of different people, with depression at baseline were studied. Stepwise logistic regression models were computed to find the best predictors for help-seeking for depression. One third of the adolescents meeting R-BDI-13 criteria for depression at baseline still perceived a need for help for depression two years later but only a fifth of them had sought professional help. Depression at baseline was significantly associated with concerns about changes in mental health or behaviour among parents and significant others; and the concerns of mother, peers and teacher were among the best predictors of recent help-seeking for depression. To ensure adequate intervention for depressed adolescents without a social network capable of prompting referral, routine screening for depression should be applied in primary health care services and specialized services for adolescents.

Key words

adolescent health services/utilization family mental health services/utilization health services needs and demand 

References

  1. 1.
    Kessler RC, Avenevoli S, Ries Merikangas K (2001) Mood disorders in children and adolescents: an epidemiologic perspective. Biol Psychiatry 49:1002–1014PubMedCrossRefGoogle Scholar
  2. 2.
    Rushton JL, Forcier M, Schectman RM (2002) Epidemiology of depressive symptoms in the national longitudinal study of adolescent health. J Am Acad Child Adolesc Psychiatry 41:199–205PubMedCrossRefGoogle Scholar
  3. 3.
    Costello EJ, Foley DL, Angold A (2006) 10-year research update review: the epidemiology of child and adolescent psychiatric disorders: II. Developmental epidemiology. J Am Acad Child Adolesc Psychiatry 45:8–25PubMedCrossRefGoogle Scholar
  4. 4.
    Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication. Arch Gen Psychiatry 62:593–602PubMedCrossRefGoogle Scholar
  5. 5.
    Lewinsohn PM, Rohde P, Seeley JR, Klein DN, Gotlib IH (2000) Natural course of adolescent major depressive disorder in a community sample: predictors of recurrence in young adults. Am J Psychiatry 157:1584–1591PubMedCrossRefGoogle Scholar
  6. 6.
    Fergusson DM, Woodward LJ (2002) Mental health, educational, and social role outcomes of adolescents with depression. Arch Gen Psychiatry 59:225–231PubMedCrossRefGoogle Scholar
  7. 7.
    Dunn V, Goodyer IM (2006) Longitudinal investigation into childhood- and adolescence-onset depression: psychiatric outcome in early adulthood. Br J Psychiatry 188:216–222PubMedCrossRefGoogle Scholar
  8. 8.
    Leaf PJ, Alegria M, Cohen P, Goodman SH, Horwitz SM, Hoven CW, Narrow WE, Vaden-Kiernan M, Regier DA (1996) Mental health service use in the community and schools: results from the four-community MECA study. Methods for the epidemiology of child and adolescent mental disorders study. J Am Acad Child Adolesc Psychiatry 35:889–897PubMedCrossRefGoogle Scholar
  9. 9.
    Sourander A, Helstelä L, Ristkari T, Ikäheimo K, Helenius H, Piha J (2001) Child and adolescent mental health service use in Finland. Soc Psychiatry Psychiatr Epidemiol 36:294–298PubMedCrossRefGoogle Scholar
  10. 10.
    Zwaanswijk M, Van der Ende J, Verhaak PF, Bensing JM, Verhulst FC (2003) Factors associated with adolescent mental health service need and utilization. J Am Acad Child Adolesc Psychiatry 42:692–700PubMedCrossRefGoogle Scholar
  11. 11.
    Bergeron E, Poirier LR, Fournier L, Roberge P, Barrette G (2005) Determinants of service use among young Canadians with mental disorders. Can J Psychiatry 50:629–636PubMedGoogle Scholar
  12. 12.
    Flament MF, Cohen D, Choquet M, Jeammet P, Ledoux S (2001) Phenomenology, psychosocial correlates, and treatment seeking in major depression and dysthymia of adolescence. J Am Acad Child Adolesc Psychiatry 40:1070–1078PubMedCrossRefGoogle Scholar
  13. 13.
    Essau CA (2005) Frequency and patterns of mental health services utilization among adolescents with anxiety and depressive disorders. Depress Anxiety 22:130–137PubMedCrossRefGoogle Scholar
  14. 14.
    Lin E, Parikh SV (1999) Sociodemographic, clinical, and attitudinal characteristics of the untreated depressed in Ontario. J Affect Disord 53:153–162PubMedCrossRefGoogle Scholar
  15. 15.
    Meadows G, Burgess P, Fossey E, Harvey C (2000) Perceived need for mental health care, findings from the Australian national survey of mental health and well-being. Psychol Med 30:645–656PubMedCrossRefGoogle Scholar
  16. 16.
    Menna R, Ruck MD (2004) Adolescent help-seeking behaviour: how can we encourage it? Guid Couns 19:176–183Google Scholar
  17. 17.
    Flisher AJ, Kramer RA, Grosser RC, Alegria M, Bird HR, Bourdon KH, Goodman SH, Greenwald S, Horwitz SM, Moore RE, Narrow WE, Hoven CW (1997) Correlates of unmet need for mental health services by children and adolescents. Psychol Med 27:1145–1154PubMedCrossRefGoogle Scholar
  18. 18.
    Wisdom JP, Clarke GN, Green CA (2006) What teens want: barriers to seeking care for depression. Admin Policy Ment Health Ment Health Serv Res 33:133–145CrossRefGoogle Scholar
  19. 19.
    Sourander A, Multimaki P, Santalahti P, Parkkola K, Haavisto A, Helenius H, Nikolakaros G, Piha J, Tamminen T, Moilanen I, Kumpulainen K, Aronen ET, Linna SL, Puura K, Almqvist F (2004) Mental health service use among 18-year-old adolescent boys: a prospective 10-year follow-up study. J Am Acad Child Adolesc Psychiatry 43:1250–1258PubMedCrossRefGoogle Scholar
  20. 20.
    Teagle SE (2002) Parental problem recognition and child mental health service use. Ment Health Serv Res 4:257–266PubMedCrossRefGoogle Scholar
  21. 21.
    Verhulst FC, van der Ende J (1997) Factors associated with child mental health service use in the community. J Am Acad Child Adolesc Psychiatry 36:901PubMedCrossRefGoogle Scholar
  22. 22.
    Laitinen-Krispijn S, Van der Ende J, Wierdsma AI, Verhulst FC (1999) Predicting adolescent mental health service use in a prospective record-linkage study. J Am Acad Child Adolesc Psychiatry 38:1073–1080PubMedCrossRefGoogle Scholar
  23. 23.
    Pihlakoski L, Aromaa M, Sourander A, Rautava P, Helenius H, SillanpAA M (2004) Use of and need for professional help for emotional and behavioral problems among preadolescents: a prospective cohort study of 3- to 12-year-old children. J Am Acad Child Adolesc Psychiatry 43:974–983PubMedCrossRefGoogle Scholar
  24. 24.
    Cuffe SP, Waller JL, Addy CL, McKeown RE, Jackson KL, Moloo J, Garrison CZ (2001) A longitudinal study of adolescent mental health service use. J Behav Health Serv Res 28:1PubMedCrossRefGoogle Scholar
  25. 25.
    Ciarrochi J, Wilson CJ, Deane FP, Rickwood D (2003) Do difficulties with emotions inhibit help-seeking in adolescence? The role of age and emotional competence in predicting help-seeking intentions. Counsell Psychol Quart 16:103CrossRefGoogle Scholar
  26. 26.
    Schonert-Reichl KA, Muller JR (1996) Correlates of help-seeking in adolescence. J Youth Adolesc 25:705–731CrossRefGoogle Scholar
  27. 27.
    Helsen M, Vollebergh W, Meeus W (2000) Social support from parents and friends and emotional problems in adolescence. J Youth Adolesc 29:319–335CrossRefGoogle Scholar
  28. 28.
    Frojd S, Marttunen M, Pelkonen M, von der Pahlen B, Kaltiala-Heino R (2006) Perceived financial difficulties and maladjustment outcomes in adolescence. Eur J Pub Health 16:542–548CrossRefGoogle Scholar
  29. 29.
    Raitasalo R (1995) Elämänhallinta sosiaalipolitiikan tavoitteena [Coping as the Target of Social Policy] The Social Insurance Institution, Finland, Helsinki: Studies in social security and health 1Google Scholar
  30. 30.
    Beck AT, Beck RW (1972) Screening depressed patients in family practice. A rapid technique. Postgrad Med 52:81–85PubMedGoogle Scholar
  31. 31.
    Beck AT, Steer RA, Garbin MG (1988) Psychometric properties of the beck depression inventory: twenty-five years of evaluation. Clin Psychol Rev 8:77–100CrossRefGoogle Scholar
  32. 32.
    Kaltiala-Heino R, Rimpelä M, Rantanen P, Laippala P (1999) Finnish modification of the 13-item beck depression inventory in screening an adolescent population for depressiveness and positive mood. Nord J Psychiatry 53:451–457CrossRefGoogle Scholar
  33. 33.
    Aalto-Setälä T, Marttunen M, Tuulio-Henriksson A, Poikolainen K, Lönnqvist J (2002) Psychiatric treatment seeking and psychosocial impairment among young adults with depression. J Affect Disord 70:35PubMedCrossRefGoogle Scholar
  34. 34.
    Haarasilta L, Marttunen M, Kaprio J, Aro H (2003) Major depressive episode and health care use among adolescents and young adults. Soc Psychiatry Psychiatr Epidemiol 38:366–372PubMedGoogle Scholar
  35. 35.
    Bergeron E, Poirier L, Fournier L, Roberge P, Barrette G (2005) Determinants of service use among young canadians with mental disorders. Can J Psychiatry 50:629–636PubMedGoogle Scholar
  36. 36.
    Zimmer-Gembeck M, Alexander T, Nystrom R (1997) Adolescents report their need for and use of health care services. J Adolesc Health 21:388–399PubMedCrossRefGoogle Scholar
  37. 37.
    Rabinowitz J, Gross R, Feldman D (1999) Correlates of a perceived need for mental health assistance and differences between those who do and do not seek help. Soc Psych Psych Epidem 34:141CrossRefGoogle Scholar
  38. 38.
    Burns JR, Rapee RM (2006) Adolescent mental health literacy: young people’s knowledge of depression and help seeking. J Adolesc 29:225–239PubMedCrossRefGoogle Scholar
  39. 39.
    Sourander A, Haavisto A, Ronning JA, Multimäki P, Parkkola K, Santalahti P, Nikolakaros G, Helenius H, Moilanen I, Tamminen T, Piha J, Kumpulainen K, Almqvist F (2005) Recognition of psychiatric disorders, and self-perceived problems. A follow-up study from age 8 to age 18. J Child Psychol Psychiatr 46:1124–1134CrossRefGoogle Scholar
  40. 40.
    Hofstra MB, Van Der Ende J, Verhulst FC (2001) Adolescents’ self-reported problems as predictors of psychopathology in adulthood: 10-year follow-up study. Br J Psychiatry 179:203–209PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Sari Fröjd
    • 1
    Email author
  • Mauri Marttunen
    • 2
    • 3
    • 4
  • Mirjami Pelkonen
    • 3
    • 4
  • Bettina von der Pahlen
    • 3
    • 5
  • Riittakerttu Kaltiala-Heino
    • 1
    • 6
  1. 1.Tampere School of Public HealthUniversity of TampereTampereFinland
  2. 2.Dept. of PsychiatryKuopio University Hospital and University of KuopioKuopioFinland
  3. 3.Dept. of Mental Health and Alcohol ResearchNational Public Health InstituteHelsinkiFinland
  4. 4.Dept. of Adolescent Psychiatry, Hospital for Children and AdolescentsHelsinki University HospitalVantaaFinland
  5. 5.Åbo Akademi UniversityTurkuFinland
  6. 6.Psychiatric Treatment and Research Unit for Adolescent Intensive Care (EVA)Tampere University HospitalTampereFinland

Personalised recommendations