(PS6-68) Examining the Association Between Barriers to Mental Healthcare and Help-Seeking Intentions and Recommendations for Posttraumatic Stress Symptoms

Exposure to potentially traumatic events (PTEs) is common—89.7% of adults in the U.S. report experiencing at least one PTE (Kilpatrick et al., 2013). This is concerning, as PTEs increase the risk for posttraumatic stress symptoms (PTSS) and other negative outcomes (Roberts et al., 2019; Watson, 2019). Unfortunately, not everyone who might benefit from mental health care seeks it. Several factors can act as barriers to mental health service utilization, such as stigma and logistical challenges (e.g., financial constraints, limited access; Michel et al., 2018; Mojtabai et al., 2016). However, less is known about how these barriers relate to help-seeking for specific mental health concerns, such as PTSS.
Help-seeking involves recognizing the need for support and forming an intention to seek help (Rickwood et al., 2005). While help-seeking behaviors and attitudes have been widely studied, less is known about individuals' help-seeking intentions (HSI) or how they recommend help for others (HSR). Even less is known about HSI and HSR in the context of PTSS. This study explored how mental healthcare barriers influence HSI and HSR for PTSS.
Data were analyzed from 412 participants (ages 18–61; 70.9% women; 60.4% White, 12.6% Black, 14.3% Hispanic/Latinx, 13% other races) as part of a broader study. Inclusion criteria for participants: age 18 or older, have internet access, and English-reading proficiency. Participants were asked to read a novel vignette depicting a fictional character (“Nina”) endorsing PTSS and rate their HSR for Nina as well as their HSI if they were experiencing Nina’s symptoms. To assess attitudes towards barriers to mental healthcare, participants were asked to rate their agreement with eight statements relating to barriers that might prevent them from engaging with mental health services (Structural Barriers Questionnaire; Villalobos, 2017).
Due to the nature of the data, non-parametric analyses were conducted. Spearman’s rank correlations indicated that HSI and HSR were related but distinct constructs (ρ(412) = .374, p < .001). Financial barriers showed weak positive correlations with both HSI (ρ(412) = .262, p < .001) and HSR (ρ(412) = .299, p < .001). Stigma and low perceived mental health concern were negatively correlated with HSI (ρ(412) = -.156, p = .002; ρ(412) = -.245, p < .001) and HSR (ρ(412) = -.135, p = .006; ρ(412) = -.310, p < .001). Weak negative correlations were also found between HSI and preference for non-professional help (ρ(412) = -.272, p < .001), as well as between HSR and both lack of transportation (ρ(412) = -.258, p < .001) and lack of childcare access (ρ(412) = -.276, p < .001).
Barriers like financial constraints, lack of recognition of mental health concerns, and preference for non-professional support appear to relate to both help-seeking intentions and recommendations for PTSS, while lack of transportation and childcare mainly impact HSR. This study adds to the literature by developing a novel approach to assessing help-seeking intentions and exploring factors linked to HSI and HSR for PTSS. Understanding factors that contribute to HSI and HSR can improve community mental health service utilization, especially following trauma exposure. Further interpretation and implications will be discussed.