School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada.
Department of Health Sciences, Brock University, St. Catharines, ON L2S 3A1, Canada.
Int J Environ Res Public Health. 2020 Sep 29;17(19):7128. doi: 10.3390/ijerph17197128.
Youth populations represent a key population for addressing mental health, yet many youths express reluctance towards help seeking. Considering the volume of time that almost all youth spend at school during the school year, it is important to assess the role of the school environment in relation to students' attitudes toward help-seeking. Data from 47,290 grade 9 to 12 students and 116 Canadian secondary schools that participated in the 2018-19 wave of the COMPASS (Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, Sedentary behaviour) study were analyzed using GEE models to assess the student and school characteristics associated with attitudes regarding seeking help for mental health concerns from an adult at school. Overall, 58% of students reported being reluctant to seek help for mental health concerns at school. Students who reported lower self-rated mental health (aOR = 1.76, 95% CI = 1.65, 1.87), emotion regulation (aOR = 1.08, 95% CI = 1.07, 1.09), family support (aOR = 2.31, 95% CI = 2.16, 2.47), peer support (aOR = 1.20, 95% CI = 1.13, 1.31), and school connectedness (aOR = 0.93, 95% CI = 0.92, 0.93) scores were more likely to be reluctant towards help-seeking at school than students with more favourable scores on these variables. Students with higher flourishing scores were less likely than students who were languishing to report reluctance to help-seeking at school (aOR = 0.96, 95% CI = 0.96, 0.97). Students attending schools in areas with lower population densities and median household incomes between $50,000-75,000 were less likely to be reluctant to help-seeking relative to students attending schools in areas with higher density (aOR = 0.85, 95% CI = 0.79, 0.93) and median household incomes (aOR = 1.20, 95% CI = 1.13, 1.31), respectively. The availability of school mental health services and specialists were not associated with student help-seeking reluctance. High levels of resistance towards help-seeking among youth remain a significant barrier, particularly among youth at highest risk (i.e., with lower support and poorer mental health). The student and school characteristics identified in the current study can help inform strategies to promote greater acceptance of help seeking among students in schools.
青年人群是解决心理健康问题的关键人群，但许多年轻人表示不愿意寻求帮助。考虑到几乎所有年轻人在学年期间都要在学校度过大量时间，因此评估学校环境与学生寻求帮助的态度之间的关系非常重要。本研究使用广义估计方程模型分析了来自 47290 名 9 至 12 年级学生和 116 所加拿大中学的数据，这些学生参加了 2018-19 年的 COMPASS（大麻、肥胖、心理健康、身体活动、酒精、吸烟、久坐行为）研究，以评估与从学校成人那里寻求心理健康问题帮助的态度相关的学生和学校特征。总体而言，58%的学生表示不愿意在学校寻求心理健康问题的帮助。报告自我评估心理健康水平较低（OR = 1.76，95%CI = 1.65，1.87）、情绪调节能力（OR = 1.08，95%CI = 1.07，1.09）、家庭支持（OR = 2.31，95%CI = 2.16，2.47）、同伴支持（OR = 1.20，95%CI = 1.13，1.31）和学校联系（OR = 0.93，95%CI = 0.92，0.93）得分较低的学生比这些变量得分较高的学生更不愿意在学校寻求帮助。表现出更高的繁荣得分的学生比表现出萎靡不振的学生更不可能报告不愿意在学校寻求帮助（OR = 0.96，95%CI = 0.96，0.97）。与在人口密度较高地区（OR = 0.85，95%CI = 0.79，0.93）和中等家庭收入（OR = 1.20，95%CI = 1.13，1.31）的学校就读的学生相比，在人口密度较低且家庭中位数收入在 50000-75000 加元之间的地区上学的学生不太可能不愿意寻求帮助。学校心理健康服务和专家的可用性与学生寻求帮助的意愿无关。年轻人中存在高水平的寻求帮助的阻力仍然是一个重大障碍，特别是对那些处于高风险（即支持度较低和心理健康较差）的年轻人而言。当前研究中确定的学生和学校特征可以帮助确定策略，以促进学生在学校中更愿意接受帮助。
