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Adolescents’ Suicidal Thinking and Reluctance to Consult General Medical Practitioners

  • Empirical Research
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Abstract

Appropriate help-seeking is widely recognized as a protective factor, and vital for early treatment and prevention of mental health problems during adolescence. General medical practitioners (GPs), that is, family doctors, provide a vital role in the identification of adolescents with mental health problems and the provision of treatment as well as access to other specialists in mental health care services. The current study examined the association between suicidal ideation and intentions to seek help from a GP for suicidal thoughts, emotional problems and physical health problems, using a sample of 590 Australian high school students that was 56.7% female and aged 13–18 years (M = 15.56 years, SD = .66 years). Higher levels of suicidal ideation and general psychological distress were related to lower intentions to seek help from a GP for suicidal and physical problems. The results suggest that even at subclinical levels, increases in suicidal ideation or psychological distress may lead to help avoidance. School personnel and other gatekeepers need to be aware of this trend in order to be more assertive in encouraging and supporting appropriate help-seeking for mental health problems. School health promotion programs should consider including information to explicitly address the help-negation process.

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References

  • Australian Bureau of Statistics. (2006). Census data. Retrieved 15 April 2009 from http://www.abs.gov.au/websitedbs/d3310114.nsf/home/Census+data.

  • Australian Bureau of Statistics. (2008). Australian social trends. Canberra; ABS (ABS Catalogue No. 4102.0).

  • Barney, L. J., Griffiths, K. M., Jorm, A. F., & Christensen, H. (2006). Stigma about depression and its impact on help seeking intentions. Australian and New Zealand Journal of Psychiatry, 40, 51–54.

    PubMed  Google Scholar 

  • Beautrais, A. L. (1998). Risk factors for suicide and attempted suicide amongst young people. A report prepared for the National Health and Medical Research Council, Canberra, Australia.

  • Belfer, M. L. (2008). Child and adolescent mental disorders: The magnitude of the problem across the globe. Journal of Child Psychology and Psychiatry, 49, 226–236.

    Article  PubMed  Google Scholar 

  • Black, D. R., & Frauenknecht, M. (1990). A primary prevention problem-solving program for adolescent stress management. In J. H. Humphrey (Ed.), Human stress: Current selected research, Vol. 4 (pp. 89–109). New York: AMS Press.

    Google Scholar 

  • Bratman, M. E. (1987). Intentions, plans, and practical reason. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Britt, H., Miller, G. C., Charles, J., Henderson, J., Bayram, C., et al. (2008). General practice activity in Australia 1998–99 to 2007–08: 10 year data tables. General practice series no. 23. Canberra: Australian Institute of Health and Welfare (AIHW Catalogue No. GEP 23). Retrieved 15 April 2009 from http://www.aihw.gov.au/publications/index.cfm/title/10661.

  • Brown, G. K., Beck, A. T., Steer, R. A., & Grisham, J. R. (2000). Risk factors for suicide in psychiatric outpatients: A 20-year prospective study. Journal of Consulting and Clinical Psychology, 68, 371–377.

    Article  PubMed  Google Scholar 

  • Carlton, P. A., & Deane, F. P. (2000). Impact of attitudes and suicidal ideation on adolescents’ intentions to seek professional psychological help. Journal of Adolescence, 23, 35–45.

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention (CDC). (1991). Attempted suicide among high school students—United States, 1990. Journal of the American Medical Association, 266, 1911–1912.

    Article  Google Scholar 

  • Chown, P., Kang, M., Sanci, L., Newnham, V., & Bennett, D. L. (2008). Adolescent health: Enhancing the skills of general practitioners in caring for young people from culturally diverse backgrounds, GP Resource Kit (2nd ed.). Sydney: NSW Centre for the Advancement of Adolescent Health and Transcultural Mental Health Centre.

    Google Scholar 

  • Cole, D. E., Protinsky, H. O., & Cross, L. H. (1992). An empirical investigation of adolescent suicidal ideation. Adolescence, 27, 813–818.

    PubMed  Google Scholar 

  • Deane, F. P., Leathem, J., & Spicer, J. (1992). Clinical norms, reliability and validity for the Hopkins Symptom Checklist-21. Australian Journal of Psychology, 44, 21–25.

    Article  Google Scholar 

  • Deane, F. P., Wilson, C. J., & Ciarrochi, J. (2001). Suicidal ideation and help negation: Not just hopelessness or prior help. Journal of Clinical Psychology, 57, 1–14.

    Article  Google Scholar 

  • Deane, F. P., Wilson, C. J., & Russell, N. (2007). Brief report: Impact of classroom presentations about health and help-seeking on rural Australian adolescents’ intentions to consult health care professionals. Journal of Adolescence, 30, 695–699.

    Article  PubMed  Google Scholar 

  • Elliot, A. J. (1999). Approach and avoidance motivation and achievement goals. Educational Psychologist, 34, 169–189.

    Article  Google Scholar 

  • Felner, R. D., Adan, A. M., & Silverman, M. M. (1992). Risk assessment and prevention of youth suicide in schools and educational contexts. In R. W. Maris, A. L. Berman, J. T. Maltsberger, & R. I. Yufit (Eds.), Assessment and prediction of suicide (pp. 420–447). Guilford: New York.

    Google Scholar 

  • Frauenknecht, M., & Black, D. R. (2003). The social problem solving inventory for adolescents (SPSI-A): A manual for application, interpretation, and psychometric evaluation. Morgantown, WV: PNG Publications.

    Google Scholar 

  • Goldney, R. D., Smith, S., Winefield, A. H., Tiggemann, M., & Winefield, H. R. (1989). Suicidal ideation: Its enduring nature and associated morbidity. Acta Psychiatrica Scandinavica, 83, 115–120.

    Article  Google Scholar 

  • Gould, M. S., Velting, D., Kleinman, M., Lucas, C., Thomas, J. G., & Chung, M. (2004). Teenagers’ attitudes about coping strategies and help-seeking behavior for suicidality. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 1123–1130.

    Article  Google Scholar 

  • Grantham, R. J., & Gordon, M. E. (1986). The nature of preference. Journal of Counseling and Development, 64, 396–400.

    Google Scholar 

  • Green, D. E., Walkey, F. H., McCormick, I. A., & Taylor, A. J. W. (1988). Development and evaluation of a 21-item version of the Hopkins Symptom Checklist with New Zealand and United States respondents. Australian Journal of Psychology, 40, 61–70.

    Article  Google Scholar 

  • Haddad, Y. (2000). Parental support and children’s immunity against learned helplessness in achievement situations. Dirasat: Educational Sciences, 27, 287–311.

    Google Scholar 

  • Harari, M. J., Waehler, C. A., & Rogers, J. R. (2005). An empirical investigation of a theoretically based measure of perceived wellness. Journal of Counseling Psychology, 52, 93–103.

    Article  Google Scholar 

  • Hokoda, A., & Fincham, F. D. (1995). Origins of children’s helpless and mastery achievement patterns in the family. Journal of Educational Psychology, 87, 375–385.

    Article  Google Scholar 

  • Kang, M., Bernard, D., Booth, M., Quine, S., Alsperstein, G., Usherwood, T., et al. (2003). Access to primary health care for Australian young people: Service provider perspectives. British Journal of General Practice, 53, 947–952.

    PubMed  Google Scholar 

  • Kessler, R. C., Berglund, P., Demler, O., Jin, R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions for DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593–602.

    Article  PubMed  Google Scholar 

  • Launer, J. (2004). Inattention to primary care: A form of institutional discrimination? Clinical Child Psychology and Psychiatry, 9, 613–616.

    Article  Google Scholar 

  • Madge, N., & Harvey, J. G. (1999). Suicide among the young: The size of the problem. Journal of Adolescence, 22, 145–155.

    Article  PubMed  Google Scholar 

  • MaGPIe Research Group. (2004). Frequency of consultations and general practitioner recognition of psychological symptoms. British Journal of General Practice, 54, 838–842.

    Google Scholar 

  • MaGPIe Research Group. (2006). The treatment of common mental health problems in general practice. Family Practice, 23, 53–59.

    Article  Google Scholar 

  • Martin, G. (2002). The prevention of suicide through lifetime mental health promotion: Healthy, happy young people don’t suicide, do they? In L. Rowling, G. Martin, & L. Walker (Eds.), Mental health promotion and young people: Concepts and practice (pp. 245–257). Sydney: McGraw-Hill.

    Google Scholar 

  • Martin, G., Roeger, L., Dadds, V., & Allison, S. (1997). Early detection of emotional disorders in South Australia: The first two years. Adelaide, South Australia: Southern Child and Adolescent Mental Health Service.

    Google Scholar 

  • Marttunen, M. J., Hillevi, M. A., Hendriksson, M. M., & Lonnqvist, J. K. (1991). Mental disorders in adolescent suicide DSM III-R-Axes I and II diagnoses in suicide among 13 to 19 year olds in Finland. Archives of General Psychiatry, 48, 834–839.

    PubMed  Google Scholar 

  • McGorry, P. D., Purcell, R., Hickie, I. B., & Jorm, A. F. (2007). Investing in youth mental health is a best buy. The Medical Journal of Australia, 187, S5–S7.

    Google Scholar 

  • Meehan, P. J., Lamb, J. A., Saltzman, L. E., & O’Carroll, P. W. (1992). Attempted suicide among young adults: Progress toward a meaningful estimate of prevalence. American Journal of Psychiatry, 149, 41–44.

    PubMed  Google Scholar 

  • News Release (October 2008). Youth mental health forum declares “state of emergency” (17 Friday 2009). Prepared by ORYGEN Research Centre, University of Melbourne, Australia, Brain & Mind Research Centre, University of Sydney, Australia, Mental Illness Fellowship of Australia inc., & SANE Australia. Retrieved 15 April 2009 from www.carersnsw.asn.au/storage/pdfs/ebulletin/YouthMentalHealth.PDF.

  • Pfeffer, C. R., Klerman, G. L., Hurt, S. W., Kakuma, T., Peskin, J. R., et al. (1993). Suicidal children grow up: Rates and psychosocial risk factors for suicide attempts during follow-up. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 409–616.

    Google Scholar 

  • Pinto, A., Whisman, M. A., & McCoy, K. J. M. (1997). Suicidal ideation in adolescents: Psychometric properties of the suicidal ideation questionnaire in a clinical sample. Psychological Assessment, 9, 63–66.

    Article  Google Scholar 

  • Reinherz, H. Z., Giaconia, R. M., Silverman, A. B., Friedman, A., Pakiz, B., Frost, A. K., et al. (1995). Early psychosocial risks for adolescent suicidal ideation and attempts. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 559–561.

    Article  Google Scholar 

  • Reynolds, W. M. (1987). Reynolds Adolescent Depression Scale: Professional manual. Odessa, FL: Psychological Assessment Resources.

    Google Scholar 

  • Reynolds, W. M. (1988). Suicidal Ideation Questionnaire: Professional manual. Odessa, FL: Psychological Assessment Resources.

    Google Scholar 

  • Rickwood, D. J., Deane, F. P., & Wilson, C. J. (2007). When and how do young people seek professional help for mental health problems. The Medical Journal of Australia, 187, S35–S39.

    PubMed  Google Scholar 

  • Rickwood, D. J, Wilson, C. J., & Deane, F. P. (2006). Supporting young people to seek professional help for mental health problems: Cover feature. InPsyc: Bulletin of the Australian Psychological Society, 28 August. Retrieved 30 July 2007 from www.psychology.org.au/publications/inpsych/12.2_160.asp.

  • Rudd, M. (1989). The prevalence of suicidal ideation among college students. Suicide and Life-threatening Behavior, 19, 173–183.

    PubMed  Google Scholar 

  • Rudd, M. D., Joiner, T. E., Jr., & Rajab, M. H. (1995). Help negation after acute suicidal crisis. Journal of Consulting and Clinical Psychology, 63, 499–503.

    Article  PubMed  Google Scholar 

  • Ryan, K. D., Kilmer, R. P., Cauce, A. M., Watanabe, H., & Hoyt, D. R. (2000). Psychological consequences of child maltreatment in homeless adolescents: Untangling the unique effects of maltreatment and family environment. Child Abuse and Neglect, 24, 333–352.

    Article  PubMed  Google Scholar 

  • Samargia, L. A., Saewyc, E. M., & Elliott, B. A. (2006). Foregone mental health care and self-reported access barriers among adolescents. The Journal of School Nursing, 22, 17–24.

    Article  PubMed  Google Scholar 

  • Saunders, S. M., Resnick, M. D., Hoberman, H. M., & Blum, R. W. (1994). Formal help seeking behavior of adolescents identifying themselves as having mental health problems. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 718–728.

    Article  PubMed  Google Scholar 

  • Saunders, S. M., Zygowicz, K. M., & D’Angelo, B. R. (2006). Person-related and treatment-related barriers to alcohol treatment. Journal of Substance Abuse Treatment, 30, 261–270.

    Article  PubMed  Google Scholar 

  • Sawyer, M. G., Arney, F. M., Baghurst, P. A., Clark, J. J., Graetz, B. W., et al. (2000). The mental health of young people in Australia. Canberra: Mental Health and Special Programs Branch, Commonwealth Department of Health and Aged Care.

    Google Scholar 

  • Schweitzer, R., Klayich, M., & McLean, J. (1995). Suicidal ideation and behaviours among university students in Australia. Australian and New Zealand Journal of Psychiatry, 29, 473–479.

    Article  PubMed  Google Scholar 

  • Sen, B. (2004). Adolescent propensity for depressed mood and help seeking: Race and gender differences. Journal of Mental Health Policy and Economics, 7, 133–145.

    PubMed  Google Scholar 

  • Smith, K., & Crawford, S. (1986). Suicidal behavior among “normal” high school students. Suicide and Life-threatening Behavior, 16, 313–325.

    PubMed  Google Scholar 

  • Stanistreet, D., Gabbay, M. B., Jeffrey, V., & Taylor, S. (2004). The role of primary care in the prevention of suicide and accidental deaths among young men: An epidemiological study. British Journal of General Practice, 54, 254–258.

    PubMed  Google Scholar 

  • Swanson, J. W., Linskey, A. O., Quintero-Salinas, R., Pumariega, A. J., & Holzer, C. E. (1992). A binational school survey of depressive symptoms, drug use and suicidal ideation. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 599–678.

    Article  Google Scholar 

  • Tinsley, H. E. A. (1992). Am I the fifth horseman of the apocalypse? Comment on Galassi, Crace, Martic, James, and Wallace (1992) and comments on research concerning expectations about counseling. Journal of Counseling Psychology, 39, 59–65.

    Article  Google Scholar 

  • Tinsley, H. E. A., & Westcott, A. M. (1990). Analysis of the cognitions stimulated by the items on the expectations about counseling-brief form: An analysis of construct validity. Journal of Counseling Psychology, 37, 223–226.

    Article  Google Scholar 

  • Vandana, J., & Ambelas, A. (2004). General practitioner perceptions and practice related to adolescent depressive presentations. Clinical Child Psychology and Psychiatry, 9, 341–346.

    Article  Google Scholar 

  • Veit, F. C. M., Sanci, L. A., Coffey, C. M. M., Young, D. Y. L., & Bowes, G. (1996). Barriers to effective primary health care for adolescents. The Medical Journal of Australia, 165, 131–133.

    PubMed  Google Scholar 

  • Vogel, D. L., Wade, N. G., & Hackler, A. J. (2007a). Perceived public stigma and the willingness to seek counseling: The mediating roles of self-stigma and attitudes toward counseling. Journal of Counseling Psychology, 54, 40–50.

    Article  Google Scholar 

  • Vogel, D. L., Wester, S. R., & Larson, L. M. (2007b). Avoidance of counseling: Psychological factors that inhibit seeking help. Journal of Counseling & Development, 85, 410–422.

    Google Scholar 

  • Wagner, B. M. (1997). Family risk factors for child and adolescent suicidal behavior. Psychological Bulletin, 121, 246–298.

    Article  PubMed  Google Scholar 

  • Webb, T. L., & Sheeran, P. (2006). Does changing behavioural intentions engender behaviour change? A meta-analysis of the experimental evidence. Psychological Bulletin, 132, 249–268.

    Article  PubMed  Google Scholar 

  • Wilson, C. J., Bignell, B., & Clancy, H. (2003). Building bridges to general practice: A controlled trial of the IDGP “GPs in Schools” program, first edition. PARC Special Issue: Youth Mental Health, 8, 19.

    Google Scholar 

  • Wilson, C. J., & Deane, F. P. (2001). Adolescent opinions about reducing help seeking perceived barriers and increasing engagement. Journal of Educational and Psychological Consultation, 12, 345–364.

    Article  Google Scholar 

  • Wilson, C. J., Deane, F. P., & Ciarrochi, J. (2005a). Can hopelessness and adolescents’ beliefs about seeking help account for help negation? Journal of Clinical Psychology, 61, 1525–1539.

    Article  PubMed  Google Scholar 

  • Wilson, C. J., Deane, F. P., Ciarrochi, J., & Rickwood, D. (2005b). Measuring help seeking intentions: Properties of the general help seeking questionnaire. Canadian Journal of Counselling, 39, 15–28.

    Google Scholar 

  • Wilson, C. J., Deane, F. P., Marshall, K. L., & Dalley, A. (2008). Reducing adolescents’ perceived barriers to treatment and increasing help-seeking intentions: Effects of classroom presentations by general practitioners. Journal Youth and Adolescence, 37, 1257–1269.

    Article  Google Scholar 

  • Wilson, C. J., Rickwood, D., & Deane, F. P. (2007). Depressive symptoms and help-seeking intentions in young people. Clinical Psychologist, 11, 98–107.

    Article  Google Scholar 

  • Yung, A. R., & McGorry, P. D. (1996). The initial prodrome in psychosis: Descriptive and qualitative aspects. Australian and New Zealand Journal of Psychiatry, 30, 587–599.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors wish to thank the following people for their contribution to project coordination and data collection. From the Illawarra Division of General Practice: Beth Bignell and Janette Ellis. From the New South Wales Department of Education and Training: Helen Clancy, Dianne Young, Kathy Russell, Fiona Kyle, and Greg Hand together with the School Counsellors and welfare staff who provided follow-up student support. From the University of Wollongong: the intern clinical psychologists and clinical supervisors who also provided follow-up student support. Our thanks also go to Professor John Bushnell who reviewed an earlier draft of this manuscript, and the Australian Commonwealth Department of Health and Ageing and University of Wollongong who provided infrastructure funding for this research.

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Authors and Affiliations

  1. Illawarra Institute for Mental Health, Wollongong, NSW, Australia

    Coralie J. Wilson & Frank P. Deane

  2. Graduate School of Medicine, University of Wollongong, Building 28, Wollongong, NSW, 2522, Australia

    Coralie J. Wilson

  3. School of Psychology, University of Wollongong, Wollongong, NSW, Australia

    Frank P. Deane

  4. Illawarra Division of General Practice, Wollongong, NSW, Australia

    Kellie L. Marshall & Andrew Dalley

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  1. Coralie J. Wilson
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  2. Frank P. Deane
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Correspondence to Coralie J. Wilson.

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Wilson, C.J., Deane, F.P., Marshall, K.L. et al. Adolescents’ Suicidal Thinking and Reluctance to Consult General Medical Practitioners. J Youth Adolescence 39, 343–356 (2010). https://doi.org/10.1007/s10964-009-9436-6

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  • DOI: https://doi.org/10.1007/s10964-009-9436-6

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