Broadening Understanding of Mental Health Decision-Making: Examining a Set of Options Young Adults Consider for Management of Mental Health

Purpose:Behavioral health conditions cause the greatest burden of disability among young adults. Yet, we know young adults often do not seek professional help. Research has long examined utilization as a single behavioral option focused on evaluation of seeking professional help without taking into account the full ‘set of behavioral options’ (i.e., alternative courses of action to dealing with negative affect) (Jaccard, 2012). The purpose of this study was to explore a fuller set of behavioral options perceived as viable for dealing with mental health challenges.

Method: Participants were recruited from public housing developments in an urban city in the Northeast using area sampling (N=28, 65% female, 90% youth of color, mean age=23.19, 50% met criteria for depression-PHQ-9). Face-to-face interviews were conducted with open-ended questions eliciting the behavioral beliefs (i.e., advantages and disadvantages) regarding fouroptions for managing mental health. The main question was “If you were experiencing mood and emotional difficulties (i.e., anger, sadness, irritability), what do you see as the advantages (disadvantages) of seeking help from a mental health professional now or in the next 6 month?" These items were also asked regarding alternative options for managing mental health (i.e., using substances, using religious practices, and seeking help from a non-professional). Participants were also asked if they would use each option if difficulties were to arise. Content analysis was completed by four analysts.

Results:Forty-three percent of participants reported they would use mental health services, 25% would use substances, 79% would talk to a non-professional, and 46% would use religious practices. Commonly reported advantages of using mental health care were, “I would get perspective on my situation,” and “I would get help for dealing with stress.” A common disadvantage was “I would have to pay too much money”. With regard to using substances, participants perceived advantages, “it helps me relax,” and “reduces anger and violence”. A common disadvantage was “It only helps in the moment.” A common advantage discussed for using religious practices was “provides and increases hope” and a common disadvantage was “It isn’t enough”. Finally, many participants discussed the advantages of talking to a non-professional, “They are easy to relate to,”  “It is more mutual (the help goes both ways)”. Fewer disadvantages were mentioned, yet, a common disadvantage was concern around confidentiality, “It can get complicated if they know people you know”. Complete belief taxonomies for each option will be reported.

Implications: For many using professional mental health providers is only one strategy for managing mental health. Research needs to move toward examining the multiple options young adults consider for self-management of mental health in order to understand how they construe their decisions and ultimately decide to use mental health services rather than pursue a different course of action. The present study is unique in that it explored these alternatives, not just constructs of using mental health services per se. These data can inform intervention programs designed to influence the behavioral beliefs around the entire full set of potential behavioral options that young adults consider.