title: Preferences and intention of rural adolescents toward seeking help for mental health problems.
abstract: INTRODUCTION In Australia, rural adolescents still face barriers to obtaining professional psychological help due to poor availability and accessibility of services in rural areas when delay in seeking help for mental health problems can lead to poorer treatment outcomes. The aims of this study were to: investigate the preferences and intentions of rural Australian youth towards seeking help for mental health problems; determine predictors of help-seeking intention among rural adolescents; and verify results from previous qualitative research on the barriers to help-seeking in a rural context.
  
  
  METHODS
  Participants were 201 adolescents recruited from 8 rural schools in the state of Victoria, Australia. Participants ranged in age from 11 to 18 years. Using the Accessibility and Remoteness Index of Australia (ARIA+), approximately 149 participants were classified as currently living in an inner regional area of Victoria, whereas 52 participants lived in an outer regional area. Participants completed an open-ended survey of help-seeking intention.
  
  
  RESULTS
  Overall, 55.7% of the sample indicated that they would seek help for a mental health problem. The majority of participants, regardless of subgroup, indicated that they would seek help for a mental health problem from a school counsellor as their first choice. Gender differences were observed such that males had a higher preference for seeking help from a psychologist than females. Furthermore, older adolescents were more likely to prefer seeking help from a GP than younger participants. A multivariate analysis of help-seeking intentions revealed that ARIA was the only predictor of help-seeking intention; however, when extreme scores of depression and anxiety were also taken into account, these also predicted help-seeking intention. A content analysis of the barriers to help-seeking nominated by participants revealed that perceived limited availability of professional services in towns, perceived social proximity and fear of rural gossip, and difficulties associated with travelling to obtain help were the most significant concerns for these youth.
  
  
  CONCLUSIONS
  These findings verify previous research on help-seeking among rural youth and reinforce that these young people face additional barriers to help-seeking by virtue of living in a rural environment. The availability of services for rural youth needs to be improved, as do young people's knowledge of service availability and access (especially travel options). It must be taken into account that rural adolescents of different ages and sex may differ in their help-seeking preferences. Finally, mental health promotion work with rural youth should consider the influence of rural culture on help-seeking intentions.
authors.affiliation: Orygen Youth Health Research Centre, Centre for Youth Mental Health, Melbourne, Victoria, Australia. cboyd@unimelb.edu.au
authors.forename: Candice P
authors.initials: CP
authors.lastname: Boyd
authors.forename: Louise
authors.initials: L
authors.lastname: Hayes
authors.forename: Sarah
authors.initials: S
authors.lastname: Nurse
authors.forename: Damon L
authors.initials: DL
authors.lastname: Aisbett
authors.forename: Kristy
authors.initials: K
authors.lastname: Francis
authors.forename: Krystal
authors.initials: K
authors.lastname: Newnham
authors.forename: Jessica
authors.initials: J
authors.lastname: Sewell
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D033182:Intention; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D057240:Patient Preference; D000297:Psychology, Adolescent; D012737:Sex Factors; D014739:Victoria