Investigating the use of support in secondary school: the role of self-reliance and stigma towards help-seeking

Abstract

Purpose: Adolescents are the least likely to seek help for their mental health problems. School may be an important route to improve early recognition of adolescents with mental health problems in need for support, but little is known about the barriers to school support.

Materials and methods: Data were collected in a longitudinal cohort study of Dutch adolescents (age 12–16) in secondary school (n = 956). We assessed the relation between level of psychosocial problems at the beginning of the school year (T1) and the support used in school at the end of that school year (T2), whether the willingness to talk to others (measured at T1) mediates this relation, and whether stigma towards help-seeking (T1) moderates this mediation.

Results: Adolescents with more psychosocial problems were more likely to use support in school and were less willing to talk to others about their problems, but the willingness to talk to others was not a mediator. Stigma moderated the relationship between psychosocial problems and willingness to talk to others.

Conclusions: Most adolescents with psychosocial problems get support in Dutch secondary school regardless of their willingness to talk to others about their problems. However, perceiving stigma towards help-seeking makes it less likely for someone to talk about their problems.

Keywords:

• Adolescents
• mental health
• stigma
• self-reliance
• school support
• psychosocial problems

Acknowledgements

We would like to thank the adolescents and their parents who kindly accepted to participate in the study. We thank the principals and teachers of the schools for their contribution to the organization of the data-collection. We are also grateful to Roy Stewart for his valuable contribution to the data-analysis. And we thank the research assistants for their help with data collection.

Ethical approval

On behalf of all authors, the corresponding author states that this study complied with the ethical standards in accordance with the Helsinki Declaration. The Medical Ethical Committee of the UMCG granted this study exemption from requiring ethics approval due to the observational nature of the study (reference number: M17.213729).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Author contributions

LB participated in the design of the study and performed the data-collection, analyzed and interpreted the data, and wrote the paper. AFW participated in the design of the study, helped in the interpretation, and contributed to the writing of the manuscript. ELK participated in the design of the study, and helped in the interpretation and writing the manuscript. JH participated in the design of the study, and helped in the interpretation and writing the manuscript. SAR obtained the funding, participated in the design of the study, and helped in the interpretation and writing the manuscript.

Disclosure statement

On behalf of all authors, the corresponding author states that there are no competing interests to declare, neither financial or non-financial.

Data availability statement

The data that support the findings of this study are available on request.

Additional information

Funding

This study received a grant from the from The Netherlands Organization for Health Research and Development [ZonMw grant number 737200017].