Explaining non-help-seeking amongst young adults with mental distress: a dynamic interpretive model of illness behaviour
Explaining non-help-seeking amongst young adults with mental distress: a dynamic interpretive model of illness behaviour
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DOI：
10.1111/j.1467-9566.2007.01030.x
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发表时间：
2007-11-01
影响因子：
2.9
通讯作者：
Gunnell, David
中科院分区：
文献类型：
--
作者：
Biddle, Lucy;Donovan, Jenny;Gunnell, David
精神障碍在年轻人中很常见，并与许多不良后果有关。然而，数据表明，年轻人特别不可能因这种痛苦而寻求帮助。本文描述了一个定性研究的23个年轻人（16至24岁）的精神困扰。访谈被用来获得详细的叙述疾病的行为，并探讨原因，不寻求帮助。对求助者和非求助者进行了访谈。研究结果允许开发一个解释性模型-回避周期（COA）-这有助于试图提供一个动态的理解寻求帮助的行为。占主导地位的方法往往是确定性的和静态的，并考虑到不寻求帮助的照顾的'障碍'，这虽然很容易转化为政策干预的目标，是复杂问题的表面表现。COA将寻求帮助概念化为一个循环过程，并提供了一个“非寻求帮助”的模式，其中精神痛苦的非专业概念，“寻求帮助”和治疗的社会意义，以及个人的有目的的行动，具有核心重要性。虽然这一模式是在青年和精神痛苦的背景下得出的，但作为解释其他年龄组和条件下不寻求帮助的理论模板，以及其他疾病行为，这一模式可能具有更广泛的适用性。
Mental disorder is common amongst young adults and is associated with many adverse outcomes. Data, however, indicate that young adults are particularly unlikely to seek help for such distress. This paper describes a qualitative study of 23 young adults (aged 16 to 24 years) with mental distress. Interviewing was used to obtain detailed narratives of illness behaviour and to explore reasons for non-help-seeking. Help-seekers and non-help-seekers were interviewed. The findings allowed development of an explanatory model - the cycle of avoidance (COA) - which contributes towards attempts to provide a dynamic understanding of help-seeking behaviour. Dominant approaches tend to be deterministic and static and to account for non-help-seeking in terms of 'barriers' to care, which although easily translated into targets for policy intervention, are superficial representations of complex issues. The COA conceptualises help-seeking as a circular process and offers a model of 'non-help-seeking' in which lay conceptions of mental distress, the social meanings attached to 'help-seeking' and treatment, and the purposeful action of individuals, assume central importance. Although derived in the context of young adulthood and mental distress, this model may have wider applicability as a theoretical template for explaining non-help-seeking in other age groups and conditions, and other illness behaviours.