The Role of Health-Related Cognitions in Help-Seeking for Depression

Abstract

Depression accounts for the largest proportion of the burden associated with all mental health disorders and is predicted to be the second leading cause of the global burden of disease by 2020. Despite the apparent efficacy of prevention programmes, international rates of help-seeking for depression remain poor. Cognitive theories of help-seeking and empirical studies suggest that help-seeking for health conditions is largely determined by beliefs about the condition (e.g., likelihood and severity of the condition) as well as beliefs about help-seeking itself (e.g., how easy and beneficial it would be to get help). An understanding of the role of health beliefs in help-seeking for depression will hopefully close the gap between the number of people eligible for depression treatment and the number of people actually receiving it. A systematic review of literature was conducted to identify studies that examined the relationship between health beliefs and help-seeking for depression using the highest quality study design, i.e., experimental trial or prospective cohort. Six electronic databases were searched and a manual search of the reference lists of the included studies was conducted. Ten studies with a total of 7,878 participants were included in the review. In line with theories of health behaviour, what participants believed about depression and about preventive health action was related to whether they sought help; however, the association between beliefs and help-seeking varied across studies. Methodological issues and overall low study quality point to the need for high quality studies with clearly defined constructs and reliable and valid variable measurements. The findings of this review suggest that beliefs about depression are important targets for interventions aimed at improving rates of help-seeking for the illness.