Boyd Candice P, Hayes Louise, Nurse Sarah, Aisbett Damon L, Francis Kristy, Newnham Krystal, Sewell Jessica
Orygen Youth Health Research Centre, Centre for Youth Mental Health, Melbourne, Victoria, Australia.
Rural Remote Health. 2011;11(1):1582. Epub 2011 Feb 14.
INTRODUCTION In Australia, rural adolescents still face barriers to obtaining professional psychological help due to poor availability and accessibility of services in rural areas when delay in seeking help for mental health problems can lead to poorer treatment outcomes. The aims of this study were to: investigate the preferences and intentions of rural Australian youth towards seeking help for mental health problems; determine predictors of help-seeking intention among rural adolescents; and verify results from previous qualitative research on the barriers to help-seeking in a rural context.
Participants were 201 adolescents recruited from 8 rural schools in the state of Victoria, Australia. Participants ranged in age from 11 to 18 years. Using the Accessibility and Remoteness Index of Australia (ARIA+), approximately 149 participants were classified as currently living in an inner regional area of Victoria, whereas 52 participants lived in an outer regional area. Participants completed an open-ended survey of help-seeking intention.
Overall, 55.7% of the sample indicated that they would seek help for a mental health problem. The majority of participants, regardless of subgroup, indicated that they would seek help for a mental health problem from a school counsellor as their first choice. Gender differences were observed such that males had a higher preference for seeking help from a psychologist than females. Furthermore, older adolescents were more likely to prefer seeking help from a GP than younger participants. A multivariate analysis of help-seeking intentions revealed that ARIA was the only predictor of help-seeking intention; however, when extreme scores of depression and anxiety were also taken into account, these also predicted help-seeking intention. A content analysis of the barriers to help-seeking nominated by participants revealed that perceived limited availability of professional services in towns, perceived social proximity and fear of rural gossip, and difficulties associated with travelling to obtain help were the most significant concerns for these youth.
These findings verify previous research on help-seeking among rural youth and reinforce that these young people face additional barriers to help-seeking by virtue of living in a rural environment. The availability of services for rural youth needs to be improved, as do young people's knowledge of service availability and access (especially travel options). It must be taken into account that rural adolescents of different ages and sex may differ in their help-seeking preferences. Finally, mental health promotion work with rural youth should consider the influence of rural culture on help-seeking intentions.
引言 在澳大利亚,农村青少年在获取专业心理帮助方面仍面临障碍,因为农村地区服务的可获得性和可及性较差,而心理健康问题寻求帮助的延迟可能导致更差的治疗结果。本研究的目的是:调查澳大利亚农村青少年对心理健康问题寻求帮助的偏好和意愿;确定农村青少年寻求帮助意愿的预测因素;并验证先前关于农村地区寻求帮助障碍的定性研究结果。
参与者是从澳大利亚维多利亚州8所农村学校招募的201名青少年。参与者年龄在11至18岁之间。使用澳大利亚可达性和偏远指数(ARIA+),大约149名参与者被归类为目前居住在维多利亚州的内地区域,而52名参与者居住在外地区域。参与者完成了一项关于寻求帮助意愿的开放式调查。
总体而言,55.7%的样本表示他们会为心理健康问题寻求帮助。大多数参与者,无论所属亚组如何,都表示他们会首选向学校辅导员寻求心理健康问题的帮助。观察到性别差异,即男性比女性更倾向于向心理学家寻求帮助。此外,年龄较大的青少年比年轻参与者更倾向于向全科医生寻求帮助。对寻求帮助意愿的多变量分析表明,ARIA是寻求帮助意愿的唯一预测因素;然而,当也考虑到抑郁和焦虑的极端分数时,这些也预测了寻求帮助的意愿。对参与者提名的寻求帮助障碍的内容分析表明,城镇专业服务可获得性有限、感知到的社会亲近度和对农村流言蜚语的恐惧,以及与前往寻求帮助相关的困难是这些年轻人最主要的担忧。
这些发现验证了先前关于农村青少年寻求帮助的研究,并强化了这些年轻人由于生活在农村环境中而在寻求帮助方面面临额外障碍的观点。农村青少年服务的可获得性需要提高,年轻人对服务可获得性和获取途径(特别是出行选择)的了解也需要提高。必须考虑到不同年龄和性别的农村青少年在寻求帮助的偏好上可能存在差异。最后,针对农村青少年的心理健康促进工作应考虑农村文化对寻求帮助意愿的影响。