Social Psychiatry and Psychiatric Epidemiology (2018) 53:773–783
Who is seeking whom? A person-centred approach to help-seeking
in adults with currently untreated mental health problems via latent
· G. Schomerus
· S. Stolzenburg
· H. Muehlan
· S. Schmidt
Received: 4 January 2018 / Accepted: 28 May 2018 / Published online: 6 June 2018
© Springer-Verlag GmbH Germany, part of Springer Nature 2018
Purpose Global surveys point to a gap in mental health service utilisation. However, contacting more than one source of
professional help may inﬂuence the estimates of utilisation. Currently, few studies statistically diﬀerentiate between diﬀerent
sources of help based on patient characteristics.
Methods We assessed sociodemographic and psychosocial data in a convenience sample of 188 adults with mental health
= 50.34 years; SD = 16.19; 71% female), who reported their help-seeking behaviour during the next 6 months.
We analysed their behaviour via latent class analysis and compared baseline characteristics between classes.
Results We found four latent classes: “mental health professionals” (MHP; 9.0%), “multiple sources” (4.3%), “primary
care” (35.6%), and “non-seekers” (51.1%). All classes had moderate to high probabilities of seeking help from friends or
family. Primary care utilisers were more often in a cohabiting partnership; MHP utilisers were more experienced in mental
health treatment and reported lower well-being and more depressive symptoms than non-seekers. By trend, non-seekers were
younger, and both non-seekers and primary care utilisers reported fewer depressive and somatic symptoms than utilisers of
multiple sources and MHP.
Conclusions In our analysis, MHP utilisation was even lower (9.0%) than in previous studies. However, MHP utilisers
appeared to suﬀer from more serious conditions than other latent classes. As informal sources such as family and friends
were present in all latent classes, help-seeking behaviour seems to transcend traditional MHP-focused approaches. Further
research is necessary to investigate tenability and trajectories of diﬀerent latent classes of help-seeking in larger and repre-
sentative samples with longer follow-ups.
Keywords Community mental health · Depression · Health service research · Mental health · Psychiatric services
Mental health impairment leads to many negative conse-
quences, such as social isolation, impaired well-being,
reduced productivity, and lack of participation. Worldwide
estimates approximate that among non-communicable
diseases, mental disorders such as depression are leading
factors for life years lost [1, 2]. Similar to most physical
illnesses, untreated mental illness can worsen over time,
leading to a vicious that is associated with negative conse-
quences for social and economic aspects of life [3, 4].
Although knowledge of treatment options for mental
health problems has increased in recent years [5, 6], a sub-
stantial proportion of people with symptoms of mental ill-
ness does not seek external help . Representative studies
report that between 6 and 52% of people with depression
seek help within the ﬁrst year of onset . However, the pre-
deﬁned source of help diﬀers between studies. To date, men-
tal health professionals (MHP), e.g. clinical psychologists
or psychiatrists, are mostly recommended as an appropriate
source of help for mental health problems [6, 9, 10]. Conse-
quently, most studies on help-seeking focus on MHP when
evaluating help for symptoms of psychological distress.
* S. Tomczyk
Department Health and Prevention, Institute of Psychology,
University of Greifswald, Robert-Blum-Straße 13,
17487 Greifswald, Germany
Department of Psychiatry, University Medicine Greifswald,
Ellernholzstraße 1-2, 17475 Greifswald, Germany