title: Help-seeking preferences for psychological distress in primary care: effect of current mental state.
abstract: BACKGROUND
  There is much debate over when it is appropriate to intervene medically for psychological distress, and limited evidence on patients' perspectives about a broad range of possible treatment options. It is currently unclear whether preferences may differ for those patients with milder symptoms compared to those experiencing more severe distress.
  
  
  OBJECTIVE
  To determine patient preferences for professional, informal, and alternative help for psychological distress in primary care, and the impact of their current mental state on these.
  
  
  METHODS
  Cross-sectional survey in seven general practices across suburban/urban London.
  
  
  METHODS
  Participants were 1357 consecutive general practice attenders aged 18 years and over. The main outcome measure was the General Health Questionnaire 12-item version and a questionnaire on help-seeking preferences.
  
  
  RESULTS
  Overall, only 47% of participants reported wanting 'some help' if feeling stressed, worried, or low and it was affecting their daily life. Those currently experiencing mild-to-moderate distress preferred informal sources of help such as friends/family support, relaxation/yoga, exercise/sport, or massage along with general advice from their GP and talking therapies. Self-help (books/leaflets or computer/internet) was not popular at any level of distress, and less favoured by those with mild-to-moderate distress (odds ratio [OR] = 0.50; 95% confidence interval [CI] = 0.35 to 0.70). Those experiencing severe distress were much more likely to want talking therapies (OR = 3.43, 95% CI = 2.85 to 4.14), tablets (OR = 3.07, 95% CI = 2.00 to 4.71), and support groups (OR = 3.07, 95% CI = 1.72 to 5.47).
  
  
  CONCLUSIONS
  People with mild-to-moderate distress appear to prefer informal sources of help and those involving human contact, compared to medication or self-help. This has implications for the implementation of potential interventions for psychological distress in primary care.
authors.affiliation: Research Department of Primary Care and Population Health, University College London. k.walters@pcps.ucl.ac.uk
authors.forename: Kate
authors.initials: K
authors.lastname: Walters
authors.forename: Marta
authors.initials: M
authors.lastname: Buszewicz
authors.forename: Scott
authors.initials: S
authors.lastname: Weich
authors.forename: Michael
authors.initials: M
authors.lastname: King
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005194:Family Practice; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy; D008875:Middle Aged; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires